Changing patterns and influencing factors of involuntary admissions following the implementation of China’s mental health law: A 4-year longitudinal investigation

Abstract Involuntary admission (IA) is limited to particular situations in mental health laws to protect patients from unnecessary coercion. China’s first national mental health law has been in effect since 2013; however, the status of IA has not been sufficiently explored. To explore the changing patterns of IA since the clinical application of the IA criteria specified in the new law, an investigation of IA status was undertaken in 14 periods (each period lasting for one month from 05/2013 to 05/2017) in the tertiary specialized psychiatric hospital in Shanghai. The socio-demographic and clinical characteristics of 3733 patients were collected. The differences among IA rates in different periods were compared, and the characteristics of patients who were and were not involuntarily admitted were analysed. Multiple logistic regression analysis was used to clarify the independent variables of IA. The IA rate dramatically decreased after the implementation of the new law, while the overall trend gradually increased. The implementation of the IA risk criteria is effective, but IA is still common in China. The medical factors influencing IA following the implementation of the new law are similar to those in previous studies at home and abroad. Non-medical factors might be the main causes of the high IA rates in Chinese psychiatric institutions.

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Changing of Chinese psychiatrists’ attitudes toward consent process to treatment and its association with the China’s National Mental Health Law

The International Journal of Psychiatry in Medicine ◽

10.1177/0091217418791436 ◽

2018 ◽

Vol 54 (1) ◽

pp. 11-21

Author(s):

Jingjing Huang ◽

Yang Shao ◽

Huajian Ma ◽

Weimin Yang ◽

Huafang Li

Keyword(s):

Mental Health ◽

Informed Consent ◽

Treatment Plan ◽

Physical Restraint ◽

Informed Consent Process ◽

Self Report ◽

Consent Process ◽

Health Law ◽

Mental Health Law ◽

National Mental Health

Objective Few studies have addressed informed consent in Chinese psychiatric practice. We wished to explore psychiatrists’ attitudes toward informed consent in Shanghai after promulgation of the first national law for mental health care in China: the National Mental Health Law. Method A total of 398 psychiatrists were recruited from seven psychiatric hospitals in Shanghai. Their anthropometric data were collected. A confidential, self-report questionnaire addressing attitudes toward the informed consent process was completed by all participants. Results Most respondents would like to inform patients/guardians of the diagnosis (95.2%), treatment plan (93.5%), treatment goals and potential adverse effects of prescribed medications (94.7%), and alternative treatment plans (71.9%). In addition, 58.4% of psychiatrists thought that the informed consent process for physical restraint was difficult to follow. According to logistic regression, psychiatrists not trained to use the National Mental Health Law were more likely to have a negative attitude toward the informed consent process compared with those trained (adjusted odds ratio = 0.21; 95% confidence interval: 0.07–0.59; p = 0.003). Conclusions Psychiatrists trained to use the National Mental Health Law had more positive attitudes toward the informed consent process. Lack of such training could affect the attitudes of psychiatrists toward the informed consent process in China.

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Human Rights and Mental Health Law: International Human Rights Standards for National Mental Health Legislation

Dignity, Mental Health and Human Rights ◽

10.4324/9781315577258-9 ◽

2016 ◽

pp. 83-108

Keyword(s):

Mental Health ◽

Human Rights ◽

Health Law ◽

International Human Rights ◽

Mental Health Law ◽

Mental Health Legislation ◽

International Human ◽

National Mental Health ◽

Human Rights Standards ◽

Health Legislation

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Mental health law in Colombia

BJPsych International ◽

10.1192/s2056474000000659 ◽

2015 ◽

Vol 12 (4) ◽

pp. 92-94 ◽

Cited By ~ 3

Author(s):

Roberto Chaskel ◽

James M. Shultz ◽

Silvia L. Gaviria ◽

Eliana Taborda ◽

Roland Vanegas ◽

...

Keyword(s):

Mental Health ◽

Policy Development ◽

Mental Healthcare ◽

Epidemiological Data ◽

Health Law ◽

Mental Health Law ◽

The Past ◽

Law And Policy ◽

Laws And Policies ◽

Health Laws

Mental health law in Colombia has evolved over the past 50 years, in concert with worldwide recognition and prioritisation of mental healthcare. Laws and policies have become increasingly sophisticated to accommodate the ongoing transformations throughout Colombia's healthcare system and improvements in mental health screening, treatment and supportive care. Mental health law and policy development have been informed by epidemiological data on patterns of mental disorders in Colombia. Colombia is distinguished by the fact that its mental health laws and policies have been formulated during a 60-year period of continuous armed conflict. The mental health of Colombian citizens has been affected by population-wide exposure to violence and, accordingly, the mental health laws that have been enacted reflect this feature of the Colombian experience.

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Mental health law in Algeria: new amendments, old concerns

BJPsych International ◽

10.1192/bji.2021.14 ◽

2021 ◽

pp. 1-3

Author(s):

Zoubir Benmebarek

Keyword(s):

Mental Health ◽

International Standards ◽

Health Law ◽

Mental Health Law ◽

Coercive Measures ◽

The Core ◽

Patients Rights ◽

Health Laws

Since 2018 Algeria has had a new mental health law intended to be more practical and in line with international standards for patients’ rights and supervision of coercive measures. Despite its simpler formulation compared with the previous law it remains far from what psychiatrists need and what patients hope for. Some chapters are confusing and difficult to grasp. Like previous mental health laws, it is unlikely that the current law will actually be applied, owing to the huge gap between the core text and the available services.

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Physical restraint for psychiatric patients and its associations with clinical characteristics and the National Mental Health Law in China

Psychiatry Research ◽

10.1016/j.psychres.2016.04.101 ◽

2016 ◽

Vol 241 ◽

pp. 154-158 ◽

Cited By ~ 6

Author(s):

Feng-Rong An ◽

Sha Sha ◽

Qing-E. Zhang ◽

Gabor S. Ungvari ◽

Chee H. Ng ◽

...

Keyword(s):

Mental Health ◽

Clinical Characteristics ◽

Psychiatric Patients ◽

Physical Restraint ◽

Health Law ◽

Mental Health Law ◽

National Mental Health

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Opinions of professionals and family members about the National mental health law regulating involuntary commitment of psychiatric patients: An international comparative study in 10 countries

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.291 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S337-S337

Author(s):

I. Georgieva ◽

C. Lauvrud ◽

R. Almvik ◽

R. Whittington

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Psychiatric Patients ◽

Family Members ◽

Health Problems ◽

Best Interests ◽

Involuntary Commitment ◽

Health Law ◽

Mental Health Law ◽

National Mental Health

IntroductionPrevious research illustrated that the laws regulating involuntary placement and treatment of persons with mental health problems are very diverse across countries: procedures for involuntary commitment and stakeholders involved in the initiation and decision making vary across countries; most laws include criteria of danger/risk, which take various forms in EU Member States’ legal frameworks, while the need for treatment in the best interests of the patient is sufficient to detain individuals in other countries, etc.ObjectivesThis study will compare the opinions of professionals and family members about the operation of the National mental health law regulating forcibly admission and treatment of psychiatric patients in ten countries: Ireland, Iceland, UK, Romania, Slovenia, Denmark, Sweden, Germany, Norway and India.AimsTo gain insights into stakeholders’ satisfaction with the operation of their national legislation and to compare the effectiveness and acceptability of different legislative processes across countries. Such scientific findings are needed in order to improve and harmonize legal practices, and to enhance fundamental rights protection of persons with mental health problems, which eventually could result in a lower rate of compulsory admissions.MethodsA short anonymous questionnaire consisting of 9 items was developed, using the online software Survey Monkey. It was distributed to representative samples via e-mail to psychiatrists, general practitioners, acute and community mental health nurses, tribunal members, guards and family members in each collaborating country. The levels of agreement/disagreement were measured on a Likert- scale.Results/ConclusionsThe study's results and conclusions will be presented at the conference.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Mental health law in Germany

BJPsych International ◽

10.1192/s2056474000000088 ◽

2015 ◽

Vol 12 (01) ◽

pp. 14-16 ◽

Cited By ~ 2

Author(s):

Jürgen Zielasek ◽

Wolfgang Gaebel

Keyword(s):

Mental Health ◽

Acute Care ◽

Forensic Psychiatry ◽

Civil Code ◽

Health Law ◽

Mental Health Law ◽

State Laws ◽

German States ◽

National Mental Health

There is no national mental health law in Germany: the 16 German states are responsible for legislation concerning forced admissions, while the German Civil Code covers non-acute care, in particular for those not able to care for themselves. In forensic psychiatry, both federal and state laws apply. This article describes this situation and provides figures about detentions and other aspects of mental health law in Germany.

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Mental Health Law: Institutionalised Discrimination

Australian & New Zealand Journal of Psychiatry ◽

10.1080/00048679409080778 ◽

1994 ◽

Vol 28 (4) ◽

pp. 554-559 ◽

Cited By ~ 16

Author(s):

Tom D. Campbell

Keyword(s):

Mental Health ◽

Mental Illnesses ◽

Compulsory Treatment ◽

Health Law ◽

Legal Intervention ◽

Mental Health Law ◽

Compulsory Care ◽

Harm To Others ◽

Special Mental Health ◽

Health Laws

The aim of the paper is to propose that special mental health laws be replaced by generic protection and prevention legislation. The arguments used for the detention and compulsory treatment of persons with mental illnesses are analysed, and found not to justify protection and prevention rules which apply only to persons with mental illnesses. Two separate systems of legal intervention should be established to deal with (1) all persons in need of compulsory care and (2) all persons who require to be detained for the prevention of harm to others.

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Where does this take us?

10.1093/med/9780198801047.003.0013 ◽

2017 ◽

Author(s):

George Szmukler

Keyword(s):

Mental Health ◽

Mental Health Policy ◽

Law Reform ◽

Health Law ◽

Persons With Disabilities ◽

Mental Health Law ◽

Reduce Risk ◽

The One ◽

Health Laws

The final chapter summarizes the arguments leading to the conclusion that conventional mental health law is discriminatory and that action is now required to remedy this unacceptable situation. The reasons for a ‘Fusion Law’ are reviewed. What prospects the future might hold for reform are considered. Two major currents in mental health policy that are in conflict are noted—the empowerment of, and giving a ‘voice’ to, persons with mental illness, on the one hand; and, the attempts to reduce ‘risk’, especially to others, on the other. The prospects for mental health law reform will depend on which will be the stronger. The UN Convention on the Rights of Persons with Disabilities as well as the introduction of capacity-based criteria in recent mental health laws in some countries offer promise. The passing of a generic, fusion-based law in Northern Ireland in 2016 is especially noteworthy.

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