Spain's Law 4/2026, which strengthens patient rights in involuntary mental health interventions, has entered into force. It aims to protect patients' autonomy, encourage voluntary care and clarify the duties of health services and professionals.
Mental health interventions must be based on free and informed consent. Care should be centred on the individual and provided through a community-based approach that respects the patient's wishes and preferences.
If a patient cannot make a decision, their registered advance directives or information in their medical record must be consulted. In an urgent involuntary admission, the record must show that voluntary alternatives were exhausted and that the patient was informed of their rights.
The law prohibits protocol-based involuntary interventions without an individual assessment, unjustified continuation of such measures, and their use as punishment or discipline. Mechanical restraints may be considered only in exceptional circumstances, must be documented and must be reviewed afterwards.
An urgent admission is permitted when a person's life or physical integrity, or that of others, is threatened. The facility must notify the court as soon as possible and no later than 24 hours after admission; judicial approval must follow within 72 hours of the court learning of it.
Within one year of the law taking effect, the government must submit a bill to parliament to reform the judicial procedure for involuntary admissions. The future framework must take into account recommendations of the UN Committee on the Rights of Persons with Disabilities and the European Convention on Human Rights.
