ObjectivesFamily involvement in mental health care has been shown to reduce relapse and facilitate recovery of psychiatric patients. This paper describes systemic concepts and practices relevant in the specific context of compulsory admission. Materials and methodsBased on a focused review of systemic concepts, this work presents the critical elements of a systemic intervention during psychiatric hospitalization without consent and discusses them within three clinical case studies. ResultsIn undertaking the care of any psychiatric patient, systemic factors need to be considered. Psychiatric symptoms and reasons for compulsory admission can be influenced by the relational context of the patient. Conversely, the functioning of a relational unit is affected by a member's psychiatric illness and hospitalization. By focusing as a matter of priority on human interactions and relationship, systemic theories offer a framework and therapeutic approach which prove useful to psychiatric work. The framework allows the psychiatrist to invite the family members and enlist them in the care of the patient by organizing a family meeting during the hospitalization without consent. Occurring as early as possible and only with the patient's agreement, the family meeting has several important aspects and objectives. First, the clinician can focus on interactions among the individuals involved and understand how these interactions are related to the psychiatric symptoms and the reasons for compulsory admission. In light of this, he can assess psychosocial resources, cultural background, and dispositions of the relatives, by evaluating how they function together in terms of cohesion, adaptability and problem solving skills. Element such as the expression and regulation of emotional tension in the family may be a focus of clinical attention. The family meeting also gives the opportunity to provide psychoeducation, by addressing the needs of family members for information, clinical guidance and support. Psychoeducation includes the provision of information in a way that is personalized, i.e. tailored to help to understand their own specific needs, according to the patient's stage of illness and context. In addition to providing relevant information, it is often useful to support and enhance the caregiving capacity of family members, reducing in this way the stress associated with their caregiving roles. Relatives may be recognized as important agents affecting the patients’ mental functioning and the path to recovery. Another goal in working with the family is to provide information concerning hospitalization without consent and its legal context. Many patients experience compulsory admission as coercive. The psychiatrist may enlighten the decision-making processes and consider ways of reducing this sense of coercion. The systemic approach proposes a way of reducing patients’ perception of coercion by emphasizing the key role of the legal system's representative. Finally, the article highlights the limitations of a family intervention occurring during the hospitalization. Family members and patients may have apprehension and be hesitant to engage in family intervention. « Family » must also be considered in the widest sense – parents, partners, siblings, and all significant others. Different interventions are likely to be more relevant during a first episode than for families who have been managing mental illness for many years. The family meeting settings must therefore be flexible about the content, structure and participants so that they can address different types of families and situations. ConclusionsThe article shows the contributions of systemic approaches to improving patient care in involuntary psychiatric hospitalization.