There is growing evidence for the success of measures to reduce and prevent coercion in mental health settings and crisis support services. This evidence suggests that many assumptions about the appropriateness and ‘necessity’ of coercion held by many governments, professionals and communities need to be re-visited.

Few if any governments have sought to systematically reduce and prevent coercive practices, and none in the COE have explicitly committed to aspiring to coercion-free support. What would happen if a single city, country or region implemented the broad range of measures outlined in this report, and others like it? At present, the answer to this question is not clear because implementation of alternatives has been largely ad hoc, contained to provincial or municipal levels, or focused only on specific types of coercion and not system-wide patterns. The practices set out in the compendium hint at what is possible.

The compendium suggests that many contemporary coercive measures are not ‘necessary’ if there is investment in alternative practices and an explicit commitment to reduction, prevention and elimination initiatives. There is a compelling legal and moral case for mandating the introduction of such practices and providing accountability measures to ensure a broader transition to rights-based and recovery-oriented systems.

It is hoped that this compendium might inform a policy framework for COE Member States and civil society to help chart the path ahead.