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Compulsory treatment in the community: considerations for legislation in Europe

  • James G. Strachan
Extract

In late 2008, the Regional Office for Europe of the World Health Organization (WHO, 2008) issued a report based on a survey of the policies and practices for mental health within its area of operation. Forty-two European states were examined and a great diversity in practice was recorded. Almost everywhere, the report suggested, policy making and legislative initiatives were seen; since 2005, some 57% of the countries studied had adopted new mental health policies and 48% had introduced new legislation. Many countries were reported to be closing mental hospital beds and replacing them with community-based services. In some countries, however, the report suggested, desks in ministries were collapsing under the weight of policies that had never been implemented, and compliance with legislation by planners and psychiatrists was distinctly variable. The WHO felt that even the role that general practitioners played in treating people with mental illness was limited in many European states and that the availability of home treatment options, assertive outreach for people with complex mental health needs and community-based early intervention was not only variable but often severely limited. Given the wide discrepancies of procedure and practice, it was difficult for the WHO to gain any clear perspective on such legislative matters as arrangements for compulsory care in the community.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits noncommercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.
References
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Applebaum, P. S. (2001) Thinking carefully about outpatient commitment. Psychiatric Services, 52, 347350.
Kisely, S. & Campbell, L. A. (2007) Does compulsory or supervised community treatment reduce ‘revolving door’ care? British Journal of Psychiatry, 191, 373374.
Kisely, S., Campbell, L. A. & Preston, N. (2005) Compulsory community and involuntary outpatient treatment for people with severe mental disorders (review). Cochrane Database of Systematic Reviews, issue 3, CD004408.
Millan, B. (2001) New Directions. Review of the Mental Health (Scotland) Act 1984 (SE/2001/56), pp. 1622. Scottish Executive.
Pinfold, V. & Bindman, J. (2001) Is compulsory community treatment ever justified? Psychiatric Bulletin, 25, 268270.
UEMS (2008) Compulsory Treatment in the Community. UEMS (http://admin.uems.net/uploadedfiles/1098.pdf).
WHO (2008) Policies and Practices for Mental Health in Europe. WHO.
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BJPsych International
  • ISSN: 1749-3676
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Compulsory treatment in the community: considerations for legislation in Europe

  • James G. Strachan
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