Parliamentary Assembly of the Council of Europe unanimously rejects protocol on involuntary measures in mental health
The Parliamentary Assembly of the Council of Europe (PACE) has unanimously adopted an opinion opposing the draft additional protocol on involuntary placement and treatment in mental healthcare services to the Convention on Human Rights and Biomedicine (Oviedo Convention) on 28 January 2026.
The EPA regards involuntary placement and treatment within mental healthcare as one of the most sensitive areas where clinical needs and human rights intersect and the protection of fundamental rights of individuals subjected to coercive measures remains a paramount concern.
The importance of this issue for the European psychiatry community is reflected in studies conducted by the Association’s members and in its guiding principles. The EPA Code of Ethics states that the “use of involuntary (compulsory) measures shall only be considered when all other options have been exhausted and no alternative is available to provide adequate care and ensure patient’s and/or other’s safety.”
The PACE Rapporteur, Carmen Leyte, emphasised this point in the session, stating “our objective is a common objective. We do not want to promote involuntary treatment; we want to promote autonomy. Coercive practices should be exceptional and should only be a last resort.”
The EPA shares the PACE’s support for the stated aims of the draft additional protocol to protect dignity, autonomy, and fundamental rights in cases of involuntary treatment in mental healthcare.
The EPA Viewpoint on the Protection of Human Rights during Involuntary Treatment in Mental Healthcare Services, published in September 2025, provides additional recommendations. We support the development of a Council of Europe instrument aiming to harmonise practice across Europe, emphasising involuntary treatment as a last resort, guaranteeing access to legal counsel, and ensuring continuous monitoring. We emphasise several aspects that should be included in such an instrument:
- Future reforms must integrate legal safeguards with innovations in community care and evidence-based practice, ensuring that involuntary measures remain exceptional and rigorously justified.
- It is important to emphasise the need for regular staff training, knowledge exchange, and consistent application of high standards, with a focus on minimising the use of involuntary treatment within facilities while developing alternatives.
- Coercive treatment is regularly used in general hospitals for patients lacking decision-making capacity. Addressing all involuntary treatment, in both psychiatric and other healthcare settings, to ensure that the same legal, ethical, and clinical values and standards are applied to all, is also critical in order to confine coercion to the absolute minimum.
EPA Treasurer, Prof. Martina Rojnić Kuzman, expressed these points at a hearing of the PACE Committee on Social Affairs, Health and Sustainable Development in Strasbourg on 24 June 2025.
The Assembly has now invited the Council of Europe’s Committee of Ministers to consider proceeding by means of a non-binding standard-setting instrument, such as a recommendation, rather than a protocol, in order to better protect human rights in the context of involuntary treatment.
Photo credit: Council of Europe (Carmen Leyte, 2026).
