Involuntary psychiatric admission – a comparison between legal frameworks

Persons suffering from psychiatric disorders are included in a category of patients consideredas vulnerable. Therefore, mental health practitioners walk a fine line around various ethicalaspects related to these patients’ care. Consent is a fundamental part of every medical act,which makes admission and treatment without consent a delicate issue surrounded by muchdebate. Despite efforts to unify the approach to involuntary admission of the psychiatricpatient, the mental health acts vary greatly between different countries. This review describeslegal frameworks applicable in countries across Europe and America, underlining the legalprocedures and the most often used criteria that qualify the patient for involuntaryadmission. These criteria include the presence of a psychiatric disorder, the dangerousnesscriterion and the need for treatment. The differences in concept regarding the necessaryclinical criteria for a mental disorder to be included on the list of diagnoses subjectable toinvoluntary admissions create an uneven ethical and moral picture regarding the status of thepsychiatric patient amongst the different legislation frameworks, thus predisposing him toother possible issues, such as discrimination. An important aspect in the procedure ofinvoluntary admission of the patient with psychiatric disorders consists of keeping a balancebetween the right to self-determination and the care duties of the medical personnel.Therefore, managing psychiatric patients involuntarily admitted proves a challenge formental health practitioners and society, as a whole, as it touches multiple ethical and socialissues.