Legislative differences in compulsory mental health care for children and adolescents across European countries

There is growing concern about the protection of children's rights in compulsory psychiatric care. To examine procedural and legal variations in compulsory mental health care for children and adolescents across European nations, the European Society for Child and Adolescent Psychiatry (ESCAP) commissioned this study. A structured questionnaire was developed using Google Forms and distributed via email to representatives of all 36 ESCAP member countries. The survey gathered information on legislation, commitment criteria, and procedural requirements for compulsory mental health care in minors. Data were analysed qualitatively to identify common themes and notable legislative differences. A total of 35 responses were received, covering 24 countries. 29% of participating countries reported child-specific legislation for involuntary hospitalisation of minors, with key differences from adult legislation concerning commitment criteria, involvement of legal guardians, and considerations regarding minors' capacity to consent to treatment. A mental disorder diagnosis is required for involuntary admission in 88% of countries, with 52% of those countries specifying severe mental disorder. Further, 71% of countries require that the person pose a danger to themselves or others. The legal age of consent for treatment varies widely (12-18 years), with 92% of countries allowing appeals against involuntary hospitalisation by the minor or their guardians. The observed legislative disparities underscore the varied approaches to compulsory mental health care for minors in Europe, suggesting a need for developing shared guidelines to promote equitable and effective care across countries.