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Approaches to Civil Commitment in Psychiatry in Europe

Hans Joachim Salize, MD, and Harald Dressing, MD

The civil commitment, involuntary placement, and coercive treatment of mentally ill individuals are central issues in mental healthcare. The application of coercive measures in certain circumstances singularly distinguishes psychiatry from most other medical disciplines. The profound impact upon the liberty and freedom of the individuals concerned is a topic of ongoing and highly controversial ethical and professional debate. The potential infringement of human rights that is inevitably connected to detention or commitment procedures in mental healthcare require appropriate, comprehensive, and accurate legal regulation. Coercive measures are part of the spectrum of medical interventions available for the treatment of severe mental health problems and should have defined quality standards and strict guidelines, in the same way as most other interventions do. However, the application of coercive measures differs widely throughout the world and even within countries [1,2].

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