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.

Research suggests that urbanicity and lower socio-economic status are risk factors for psychosis.

To calculate the incidence and period prevalence of patients admitted with psychosis in Malta, and to examine differences between districts. To date, this is the first study of its kind carried out in the Maltese Islands.

One year prospective cross-sectional study, including all ICD-10 psychosis patients admitted to any one of the three psychiatric hospitals (n = 180).

Incidence of hospital admissions due to psychosis was 26.0 at risk per year per 100, 000 population. Period prevalence for 6 years was 41.9 per 100,000 person-years. Highest incidence: Southern-Harbour area (32.1, CI = 31.9–32.3), and lowest incidence: Western District (20.1, CI = 19.9–20.2). the period prevalence was highest in Gozo District (63.9, CI = 63.2–64.7). 5.2% of participants were irregular migrants, having an approximate estimate for incidence of psychosis of 400 per 100,000 person years at risk.

The high incidence of psychosis may be explained by the fact that Malta is the eighth most densely populated country worldwide. the district with the lowest socio-economic groups were found to have the highest incidence of psychosis, followed by the most densely populated district. Cultural factors, small genetic pool or readily available services could account for the high period prevalence in the Gozo district -a more rural area. Higher education in the Western district area could partially explain the lower incidence. Multiple Stressors and trauma may partially be the reasons for the much higher incidence rate in the irregular immigrant group.