Involuntary admission and the use of compulsion in the care sector

In the care sector, compulsion means admitting or treating someone against their will, or restricting their freedom. The government is working on simplifying legislation on involuntary admission and the use of compulsion in the care sector, and providing involuntary mental health care in community settings.

Current legislation on involuntary admission

A person who is a danger to himself or those around him can be admitted involuntarily (committed) to a mental health institution. The procedure for admitting a person involuntarily is laid down in the Psychiatric Hospitals (Committals) Act (BOPZ). The Act applies to people suffering from:

  • a psychiatric disorder or an intellectual disability;
  • memory problems/dementia.

Every patient who is committed to an institution is entitled to a clear description of the treatment he will receive. This is called a treatment plan. In the case of people with intellectual disabilities and patients with memory disorders (dementia), the plan is referred to as a care plan.

Institutions which may admit people on an involuntary basis

According to the Psychiatric Hospitals (Committals) Act, only institutions designated by the Ministry of Health, Welfare and Sport may admit patients on an involuntary basis. These institutions include psychiatric hospitals or facilities for people with an intellectual disability.

New legislation on compulsory care

If parliament agrees, two new Acts will replace the Psychiatric Hospitals (Committals) Act:

  • the Compulsory Mental Health Care Act, and
  • the Care and Compulsion (Psychogeriatric and Intellectually Disabled Patients) Act.

The two groups of patients (psychiatric patients and those suffering from an intellectual disability or dementia) have different problems and interests. The creation of two separate pieces of legislation means the needs of each group will be better catered for and their legal status better protected.

Main elements of Compulsory Mental Health Care Bill

The main elements of the Compulsory Mental Health Care Bill are:

  • compulsory care in community settings;
  • patients and their families will have more rights and more say about decisions concerning care;
  • compulsory care as a last resort;
  • aftercare as a standard part of treatment.

Main elements of Care and Compulsion (Psychogeriatric and Intellectually Disabled Patients) Bill

The main aims of the Care and Compulsion (Psychogeriatric and Intellectually Disabled Patients) Bill are:

  • to make compulsory care possible if the behaviour of the person in question is leading to serious disadvantage to himself or others; and
  • to establish clear treatment guidelines for people receiving care at home who are subject to restrictive measures, for instance, locking doors at night to prevent them wandering.