Involuntary psychiatric admission: Comparative study of mental health legislation in Brazil and in England/Wales

Int J Law Psychiatry. May-Jun 2019;64:184-197. doi: 10.1016/j.ijlp.2019.04.005. Epub 2019 Apr 17.

Abstract

Involuntary admission is a controversial measure that can lead to violation of various human rights. On the opposite, involuntary admissions may contribute for the recovery of those with severe mental disorders who represent a danger to themselves or others. From this perspective, legislation must define and limit the circumstances in which this may occur preventing human rights violations. In this context, this descriptive-comparative study aimed at analyzing the similarities and differences between the mental health' laws related to involuntary psychiatric admission in Brazil and England/Wales. Data were collected through bibliographic and documentary research. The analysis was based on the World Health Organization's Checklist on Mental Heallth Legislation, using the comparative method. Results showed that the Brazilian legislation meets 52 (31.32%) of the 166 WHO standards, while legislation in England/Wales meets 90 (54.2%). In addition, the law from England/Wales establishes clearer and detailed procedures for "involuntary admissions" and has "oversight and review mechanisms" more effective than Brazil; the legislation presents a medium compliance of "competence, capacity and protection", and Brazil does not address these issues in its legislation; Brazilian legislation establishes a larger list of "fundamental rights", but does not provide "penalties" for the breach of those rights, while England/Wales meets WHO criteria in relation to this issue. The main similarities between Brazil and England/Wales refer to standards that require review: "voluntary patients", "emergency treatment", "economic and social rights", "civil issues" and "protection of vulnerable groups." Both jurisdictions also have the same level of compliance regarding "clinical and experimental research", and "special treatments, seclusion and restraint". This study may bring light for a reflection from competent authorities on the need to have audits for national mental health legislations, carried out by multidisciplinary committees, as recommended by WHO.

Keywords: Comparative study; Human rights; Involuntary admission; Mental health; Patients rights.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brazil
  • England
  • Human Rights / legislation & jurisprudence
  • Humans
  • Involuntary Commitment / legislation & jurisprudence*
  • Mental Disorders / therapy
  • Mental Health / legislation & jurisprudence*
  • Wales