International variations in mental-health law regulating involuntary commitment of psychiatric patients as measured by the Mental Health Legislation Attitudes Scale

Previous research illustrated that the laws regulating involuntary placement and treatment of people with mental-health problems are diverse across countries. International studies comparing satisfaction levels between countries are rare. We compared 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 11 countries: Ireland, Iceland, England and Wales, Romania, Slovenia, Denmark, Germany, Sweden, Norway and India. An online survey design was adopted using a Mental Health Legislation Attitudes Scale (MHLAS). This brief nine-item questionnaire was distributed via email to psychiatrists, general practitioners, acute and community mental-health nurses, tribunal members, police officers and family members in each collaborating country. The levels of agreement/disagreement were measured on a Likert scale. Data were analysed both per question and with regard to a total MHLAS ‘approval’ score computed as a sum of the nine questions. We found that respondents in England and Wales and Denmark expressed the highest approval for their national legislation (76% and 74%, respectively), with those in India and Ireland expressing the lowest approval (65% and 64%, respectively). Almost all countries had a more positive attitude in comparison to Ireland on the admission criteria for involuntary placement and the way people are transferred to psychiatric hospitals. There are significant variations across Europe and beyond in terms of approval for how the national mental-health law framework operates in each country.

Some Continental European Perspectives on Safeguards in the Case of Deprivation of Liberty in Health and Social Care Settings

<p>This article highlights perspectives and regulations on safeguards in the case of deprivation of liberty of some continental European countries – namely Germany, Switzerland, France, Austria, and Spain. It illustrates the continent’s disparate approaches to the subject, both those founded in history and in the different legal traditions.</p><p><br />Continental legislation struggles to cope with the UN Convention on the Rights of Persons with Disabilities. The most recent observations of the Committee on the Rights of Persons with Disabilities in Germany, in May 2015, recommend for example, that Germany “amend legislation to prohibit involuntary placement and promote alternative measures”. Nevertheless, legislation and practice in these countries might provide some different points of view on deprivation of liberty safeguards.</p>

Epidemiology of involuntary placement of mentally ill people across the European Union

BackgroundDespite the tendency for harmonisation of strategies for mental health care delivery, rules and regulations for involuntary placement or treatment of mentally ill persons still differ remarkably internationally. Rapid European integration and other political developments require valid and reliable international overviews, sound studies and profound analyses of this controversial issue.AimsTo give an overview of compulsory admission data from official sources across the European Union (EU).MethodData on the legal frameworks for involuntary placement or treatment of people with mental illness and their outcomes were provided and assessed by experts from all EU member states.ResultsTotal frequencies of admission and compulsory admission rates vary remarkably across the EU. Variation hints at the influence of differences in legal frameworks or procedures. Time series suggest an overall tendency towards more or less stable quotas in most member states.ConclusionsFurther research is greatly needed in this field. Common international health reporting standards are essential to the compilation of basic data.

Effects of Enforced Relocation on Life Adjustment in a Nursing Home

A group of 75 institutionalized elderly patients was studied to determine the relationship of involuntary relocation to life adjustment in a nursing home. Data were collected by means of medical records and structured questionnaire. Patients who had experienced enforced relocation from other institutions expressed greater life dissatisfaction than those who had relocated voluntarily from their own home environment. For the group in general, life dissatisfaction was correlated with financial dependence, poor health, and limited social participation. Length of stay in the institution was not related to life satisfaction. The evidence suggests that involuntary placement, multiple moves, disruption of social networks, and financial dependence may contribute to life dissatisfaction among institutionalized elderly.