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Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
The prevalence of mental disorders in emergency department (ED) is high and usually underestimated. Mental health system has to be developed in concordance to the needs.
of this study are evaluation the diagnosis rate of mental health clients in ED of general hospital, evaluation of rate of referrals to recommended.
The current study is aimed to analyze (a) the rate of mental health diagnosis in ED clients from general hospitals and (b) rates of referrals to recommended psychiatric services and other specific treatment.
Material and method:
This is an observational study performed within the EDs from five different East European countries: Romania, Serbia, Moldova, Bulgaria and Albania. The data collected from every ED include the number of recorded patients with psychiatric diagnosis, characteristics of these patients (age, gender, rural/urban origin, and professional status), number of recommended referrals to psychiatric settings and specific treatment and covers the 3 months’ period. The identification data were not collected from patients as for the ethical reasons.
estimate level of diagnosis of mental health disorders in ED patients in general hospitals in East European countries and find gaps in needs and services received in ED for mental health clients.
All countries involved in project are in the period of mental health services development and identification of the specific unmet needs for mental health clients in ED that can contribute for further strategy development based on study's findings.
The history of mental health in Moldova has been centered on psychiatric institutions. Current reform goals are centered on the reduction in psychiatric hospital beds, shifting the focus towards outpatient therapy, where community mental health centers have a central role in coordinating recovery and social reintegration.
to collect different data according guidance for establishing a situational analyses about Moldova.
we elaborated a guidance with outline: the historical perspective:
– a. back a 5–10 years events/developments; epidemiologic data;
– b. the service delivery system;
– c. mental health system: laws/regulations, role of the government as well as civil organizations, mechanisms for data collection, monitoring of performance, costs, quality of care and outcomes;
– d. opportunities, barriers, and needed changes/innovations needed to address these.
The current focus is on moving from a relatively centralized system towards a more community-based approach to psychiatric care and community supports, as well as deinstitutionalization and integration of mental health care with primary care. Besides over reliance on institutionalization, the Moldovan mental health care system faces other challenges, including access to care, workforce limitations, and stigma.
Looking forward, success in these efforts will require continued strong political will to bring domestic law, policies and practices into line with international standards in the field of human rights for persons with disabilities. By supporting deinstitutionalization and improving the accessibility of mainstream services, more people will have the opportunity for social inclusion and the ability to contribute to the communities’ social and economic growth.
Disclosure of interest
The author has not supplied his/her declaration of competing interest.
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