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Involuntary psychiatric hospitalization: Current status and future prospects

Kallert Thomas W. (Park Hospital Leipzig, Department of Psychiatry, Psychosomatic Medicine, and Psychotherapy, Leipzig, Germany + Faculty of Medicine, Dresden University of Technology, Dresden, Germany)

The general aims of this article are: a) to cover the current status of research on the important clinical and human rights issue of involuntary psychiatric hospitalization, and b) to discuss some factors which might influence future developments in this area of mental health care provision. Firstly, the article will outline main results from two literature reviews on outcomes of involuntary hospital admission. Secondly, selected results from the clinical part of a recent European multi-site research project on coercion in psychiatry (Acronym: EUNOMIA) will be presented in detail on the following issues: the association of patients’ views of involuntary hospital admission and differences in legislation, patient characteristics associated with more or less positive outcomes of coerced hospital admission, coercive measures (e.g. mechanical restraint, seclusion and forced medication) used during these hospitalizations. Thirdly and finally, the article will shed some light on future prospects of this topic. Thus, some recommendations for best clinical practice in the use of involuntary hospital admission will be discussed, and arguments for two future scenarios, increase vs. decrease of involuntary psychiatric hospitalizations, will be contrasted and analyzed.

Keywords: involuntary psychiatric hospitalization, coerced admission, coercion, human rights, mental health legislation, best practice recommendation