This report provides a compendium of good practices to promote voluntary measures in mental health care and support. It draws from practices submitted to the DH-BIO Secretariat by delegations representing the 47 Member States of the Council of Europe (COE) as well as civil society stakeholders. The compendium fulfils the aim set out in the DH-BIO Strategic Action Plan on Human Rights and Technologies in Biomedicine 2020-2025 to:

assist member States [by developing] a compendium of good practices to promote voluntary measures in mental healthcare, both at a preventive level and in situations of crisis, by focusing on examples in member States.

 

The practices may directly aim to reduce, prevent, or even eliminate coercive practices in mental health settings, and others will indirectly result in similar outcomes by advancing the general aim to promote voluntary mental health care and support.

The compendium is not meant as an exhaustive list of leading practices in COE Member States. Instead, it is meant as an initial step toward compiling practices aimed at promoting voluntary mental healthcare and support, and reducing and preventing coercion in mental health settings. More generally, the materials promote compliance with the Convention on the Rights of Persons with Disabilities (CRPD), notwithstanding debates about coercion in mental healthcare which will be noted in Part 1(B) of the report.

Zurück Community mental health initiative – Novara, Italy

In the Northern Italian city of Novara, a mobile support program was developed by the South Unit Area to assist people in mental health crisis in their own home, including those who have been just discharged from a psychiatric ward. The program has reportedly produced relatively low rates of involuntary admissions compared to other Italian services despite the program having less resources for mental health services than other parts of Italy (Submission 12).

The Unit covers an area with approximately 168000+ inhabitants. It comprises of the following (Submission 12):

  • One psychiatrist and two nurses available for urgent interventions during opening hours (8am-8pm weekdays)
  • Daily oral assumption of therapy at South Community Mental Health Centers, to improve compliance and therapy adherence’.
  • 100% of outpatient visits occur within 30 days after hospital discharge (within 72 hours).

In 2017, data was compared with that collected for departments of mental health at the Regional, National, and city level using the Italian National Mental Health Information System (year 2017). The South Unit Area has the same avarage of treated prevalence of any mental health disorder despite having less resources (contributing to staff, residential facilities and rehabilitation centres) than Italy, but the number of involuntary admissions is fewer.

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