title: Involuntary treatment in Europe:  different countries, different practices.
abstract: OBJECTIVE
  Involuntary treatment is burdened by the lack of evidence. One of the challenges is the difference in practice across borders in Europe. While reviewing the current literature, a proposal of monitoring guidelines is discussed.
  
  
  RESULTS
  The field is characterized by a small number of dedicated researchers. A study of violence in first-episode psychosis shows that differences in criteria for involuntary admission lead to different prognosis for the patients. The most recent contributions from the cross-national EUNOMIA study point to great variation across countries, regarding frequencies of involuntary admission as well as outcome. The EUNOMIA study provides suggestions for good quality in involuntary admission. A Cochrane review has examined the evidence of involuntary community treatment compared with standard treatment. The effectiveness of involuntary community treatment is limited. The review concludes that the benefits for a small number of patients are outweighed by the high numbers needed to treat in terms of avoided re-admission.
  
  
  CONCLUSIONS
  Despite pioneering work, involuntary treatment is still caught up in tradition. There is a lack of standard and proof of effectiveness. A proposal of monitoring guidelines for involuntary measures is a first step to improve the situation.
authors.affiliation: UEMS Section and European Board of Psychiatry, London, UK. tbj@dadlnet.dk
authors.forename: Torsten B
authors.initials: TB
authors.lastname: Jacobsen
mesh_terms: D003134:Commitment of Persons with Psychiatric Disorders / Q000592:standards*; D005060:Europe; D006739:Hospital Administration / Q000592:standards; D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000592:standards*; D017410:Practice Guidelines as Topic