Objectives The aim of this study was to explore trends associated with the amendment of The Mental Health Welfare Act by comparing involuntary admission processes in Asian countries. Methods We obtained copies of the Mental Health Acts for four East Asian countries – Korea, Japan, Singapore, and Taiwan (China). We then analyzed the contents of the acts including their definitions of mentally ill patients, the types of hospitalization, and the procedures for involuntary admission. Results The Japanese provision for involuntary admission was the prototype used for the Korean system prior to the total revision of the Korean system in 2016. Regardless, Korea and Japan still regard family members as pivotal in deciding on involuntary admission. Taiwan and Singapore acts are characterized by the involvement of government or government-designated medical practitioners, not caregivers, in the hospitalization process. In Taiwan, involuntary admission is decided by a judgment of a review committee and is a task of the government. In Singapore, the opinions of experts are considered when making the initial decision on involuntary hospitalization, whereas a judicial decision is essential for extension of that hospitalization. Conclusion Despite cultural and historical similarities, the systems of involuntary admission were considerably different across the countries. We observed a reduction in the role of family guardians and an increase in the use of more objective screening processes. All four countries were in the process of applying those recommendations from international organizations that were in accordance with their society/culture. There may be a need to partially amend The Mental Health Welfare Act in Korea in order to protect the human rights of psychiatric patients while maintaining a stable therapeutic environment.
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