Schizophrenia, human rights and access to health care: A systematic search and review of judgements by the European Court of Human Rights

Int J Soc Psychiatry. 2021 Mar;67(2):168-174. doi: 10.1177/0020764020942797. Epub 2020 Jul 16.


Background: Persons with schizophrenia are vulnerable regarding human rights violations.

Aims: The aim of this research is to systematically analyse judgements by the European Court of Human Rights (ECtHR) involving persons with schizophrenia.

Methods: A systematic search of judgements by the ECtHR, using the search term 'schizophrenia'. Descriptive statistics and a qualitative thematic analysis were performed.

Results: A total of n = 105 judgements were included, originating in n = 29 countries. Article 5 (Right to liberty and security) of the European Convention on Human Rights was ruled by the ECtHR to have been violated in 45.7% of judgements, Article 3 (Prohibition of torture) in 20.0% and Article 8 (Right to respect for private and family life) in 19.0%. Relevant themes were inadequate access to mental health care, especially in prisons and during police operations, involuntary confinement, detention and ill-treatment as a risk factor for psychosis, the right to family life versus the rights of others, extradition/expulsion and protection of other persons' human rights against violent behaviour by persons with schizophrenia.

Discussion: Persons with schizophrenia often do not receive adequate treatment and are especially vulnerable in prisons, where ill-treatment can be an additional risk factor. They can have both offender and victim status. The judgements suggest that the ECtHR has a balanced view on involuntary confinement. National legislation and internal hospital guidelines should be written in a manner to help minimise human rights violations against persons with schizophrenia.

Keywords: Psychiatric ethics; involuntary confinement; law; structural stigma; torture.

MeSH terms

  • Criminals*
  • Health Services Accessibility
  • Human Rights
  • Humans
  • Schizophrenia* / therapy
  • Torture*