Skip to main content

Comparison of involuntary hospitalization rates


Civil commitment rates show substantial variation between different countries and over time. Legislation, professionals' ethics and attitudes, socio-demographic variation, and psychiatric services have been suggested as reasons for this. International variations in procedures and registration of coercion might affect reliability and validity of the data used, complicating international comparison. Objective: To discuss reasons for international variation of commitment rates, to expose periods of deprivation of liberty introduced during psychiatric admissions, classified formally as voluntary or involuntary, and to evaluate the impact of these results on the public statistics of commitment rates in the Nordic countries.


6,048 admissions, 1,841 involuntary, 4,207 voluntary, to psychiatric wards in the Nordic countries were, based on information in the medical files, evaluated by a uniform registration form of introduced deprivation of liberty during referral, admission and stay.


Almost all involuntary admissions in Denmark, Finland and Norway were preceded by an involuntary referral; in Iceland and Sweden it was 94.6% and 88.9%. In Denmark, Iceland and Sweden 0.1% – 0.7% of the voluntary admissions were preceded by an involuntarily referral, while it was 3.3% and 11.4% in Finland and Norway. Denmark and Norway had the highest proportion of patients who were subjected to deprivation of liberty in spite of being voluntarily admitted, 20.8% and 11.6%, compared to 3.6% – 9.8% in the other countries.


Commitment rates based on the formal classification of commitment in the Nordic countries are not directly comparable due to differing registration of deprivation of liberty introduced during referral, admission and stay. Deprivation of liberty introduced during psychiatric admissions formally classified as voluntary exists to a varying degree in the Nordic countries, resulting in a varying underestimation of coercion used.

Author information

Authors and Affiliations


Rights and permissions

Open Access This article is published under license to BioMed Central Ltd. This is an Open Access article is distributed under the terms of the Creative Commons Attribution 2.0 International License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reprints and Permissions

About this article

Cite this article

Engberg, M., Kaltiala-Heino, R., Høyer, G. et al. Comparison of involuntary hospitalization rates. BMC Psychiatry 7 (Suppl 1), S141 (2007).

Download citation

  • Published:

  • DOI:


  • Substantial Variation
  • International Comparison
  • International Variation
  • Nordic Country
  • Hospitalization Rate