Protection of human rights during involuntary treatment in mental healthcare services: A European perspective

Involuntary placement and treatment within mental healthcare represent one of the most sensitive areas where clinical needs and human rights intersect and the protection of fundamental rights of individuals subjected to coercive measures remains a paramount concern. This issue has been along-standing interest of the European Psychiatric Association (EPA), reflected in studies conducted by the EPA members and by the EPA Code of Ethics. Moreover, the EPA supports the work of the Parliamentary Assembly of the Council of Europe on a Draft Additional Protocol to the Convention on Human Rights and Biomedicine, as an European document aiming to harmonize practice across Europe, emphasizing involuntary treatment as a last resort, guaranteeing access to legal counsel, and ensuring continuous monitoring. However, weemphasize several aspects that should be included: 1) future reforms must integrate legalsafeguards with innovations in community care and evidence-based practice, ensuring that involuntary measures remain exceptional and rigorously justified; 2) while evidence-based strategies to reduce coercive treatment exist, it is important to emphasize the need for regular staff training, knowledge exchange, and consistent application of high standards, with a focus on minimizing the use of involuntary treatment within facilities while developing alternatives; 3)coercive treatment is regularly used in general hospitals for patients lacking decision-making capacity. Addressing all involuntary treatment, in both psychiatric and other healthcare settings, to ensure that the same legal, ethical and clinical values and standards are applied to all, is also critical in order to confine coercion to the absolute minimum.