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Psychiatric Risk Governance Across Jurisdictions: A Comparative Analysis of Involuntary Treatment, Community Treatment Orders, and Forensic Mental Health Services

Identification

Clé publique

doi:10.3390/healthcare13182363

Auteurs

Matteo Lippi · Laura Leondina Campanozzi · Giuseppe D’Andrea · Donato Morena · Francesca Orsini · Felice Marco Damato · Giuseppe Fanelli · Yasin Hasan Balcıoğlu · Howard Ryland · Thomas Fovet · Birgit Vӧllm · Javier Vicente-Alba · Charles L. Scott · Paola Frati · Vittoradolfo Tambone · Raffaella Rinaldi

Année déclarée

2025

Langue déclarée

en

Type source

review

Première détection

2026-11-09T19:04:47.759319+00:00

Dernière observation des métadonnées

2026-11-09T19:04:47.759319+00:00

Dernière vérification HTTP

Non effectuée

Institutions déclarées par la source

Bakırköy Psychiatric Hospital · Donders Institute for Brain, Cognition and Behaviour · Inserm · Lille Neurosciences & Cognition · McGill University · Oxford Health NHS Foundation Trust · Radboud University Medical Center · Radboud University Nijmegen · Sapienza University of Rome · Universidade de Santiago de Compostela · University of Bologna · University of California Davis Medical Center · University of Oxford · Università Campus Bio-Medico · Universitätsmedizin Rostock · Université de Lille

Pays d’affiliation déclarés

CA · DE · ES · FR · GB · IT · NL · TR · US

Résumé documentaire — langue originale

Background: This article presents an international comparative review of involuntary psychiatric care, Community Treatment Orders (CTOs), and forensic mental health services, with operational implications for Italy. Italy has a community-based model inspired by the “Basaglia Law” (Law No. 180/1978), emphasizing deinstitutionalization and continuity of care. Nevertheless, risk governance gaps persist for high-complexity patients, imposing a disproportionate legal and clinical burden on mental health professionals. This group includes individuals who refuse treatment despite meeting criteria for compulsory admission, patients at elevated risk with substantial management complexity, and offenders with a current or suspected psychiatric disorder. Methods: We conducted a comparative legal and policy review across seven jurisdictions (Italy, England and Wales (UK), France, Germany, Spain, the United States, and Canada) to map frameworks for involuntary treatment, forensic services, CTOs (or equivalents), and community-based risk management. We also extracted procedural safeguards, duration and renewal limits, and interfaces with forensic services. Results: CTOs are available in five of the seven jurisdictions (England and Wales, France, Spain, the United States, and Canada) but are absent in Italy and Germany. We propose a three-pillar framework: (1) enforceable outpatient measures, including CTOs; (2) Forensic Psychiatry Units within Local Health Authorities; and (3) oversight boards with judicial, clinical, and social representatives. These components aim to redistribute responsibility, ensure continuity of care, and provide proportional oversight within a least restrictive, graduated system. Conclusions: When narrowly targeted, time limited, and paired with robust safeguards and service-quality standards, CTOs can support adherence and continuity for patients who repeatedly disengage from care. For Italy, integrating this instrument within the three-pillar framework and under independent oversight could strengthen patient rights and public safety, reduce revolving-door admissions, and improve outcomes.

Identifiants

OPENALEX

W4414428175

DOI

10.3390/healthcare13182363

HAL

hal-05383316

HANDLE

11390/1331146 · 11573/1751007 · 2066/324074

Repères documentaires

Famille documentaire

Doctrine

Types déclarés par les sources

review

Juridictions étudiées — sources explicites

CA · DE · ES · FR · IT · US

Les mentions d’entités ne constituent pas une preuve de reconnaissance juridique. La juridiction étudiée est distincte du pays d’affiliation des auteurs.

Sources

OpenAlex · Document 1 · Document 2 · Document 3 · Document 4 · Document 5 · Document 6

• DOI · https://doi.org/10.3390/healthcare13182363
• Handle · https://hdl.handle.net/11390/1331146
• Handle · https://hdl.handle.net/11573/1751007
• Handle · https://hdl.handle.net/2066/324074
• HAL · https://hal.science/hal-05383316
• OpenAlex · https://openalex.org/W4414428175

Relations bibliographiques documentées

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Statut documentaire

Pertinence à examiner

Bibliothèque

Cette identité n’est pas encore intégrée à la Bibliothèque juridique.