Involuntary Treatment and Hospitalization: Review of Mental Health Acts

Disregard of the rights of the mentally ill is a prevalent condition in the world. Whereas until the mid twentieth century most legislations were enacted to protect the society against individuals with mental disorders, in recent years the attitudes of legislators has been focused on protecting the rights of the mentally ill. The aim of this study is to review the laws related to involuntary hospitalization in different countries, and world Health Organization (WHO)’s recommendations in this regard. In a review study, the mental health act of some countries especially concerning involuntary hospitalization is evaluated. Information was gathered in a two year period through review of more than 40 electronic sources and hand searching 15 available sources. Laws of involuntary hospitalization of countries as well as World Health Organiza- tion comments on separation of involuntary treatment and hospitalization, establishing environments with the least restrictions, criteria for involuntary hospitalization, authorities of diagnosis and certification of involuntary hospitalization and the duration of involuntary hospitalization were compared. This study reveals that the WHO and most studied countries have emphasized the imposing of the following rules: The establishment of the least restrictive environment, the presence of “dangerousness” and “need to treatment” as criteria for involuntary hospitalization, the requirement of two accredited persons for determination of indication of hospitalization, the approval of the mentioned indication by an impartial source, and the limitation of the duration of emergency hospitalization to a few days. Also, the process of involuntary hospitalization and treatment are separated in some countries and combined in some others. Considering the significance of the reciprocal rights of the society and the mentally ill, involuntary hospitalization encompasses a major part of mental health legislations. WHO considers involuntary hospitalization to be not only a deprivation of liberty but also a psychological trauma, and deems the establishing of principles for involuntary hospitalization law necessary. In addition, considering the insufficiency of legislations related to this issue in Iran, a need to deal with the insufficiencies and legalize the process of involuntary hospitalization is evident.