{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T19:04:28Z","timestamp":1777748668071,"version":"3.51.4"},"reference-count":45,"publisher":"IMR Press","issue":"2","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Alpha Psychiatry"],"abstract":"<jats:p>The global crisis of recent years, including pandemics, armed conflicts, climate emergencies, and economic instability, has disproportionately jeopardized the health and rights of persons with psychosocial disabilities, who remain among the most marginalized groups. In this context, promoting a rights-based approach to mental health care is both urgent and ethically imperative. Building on the United Nations (UN) Convention on the Rights of Persons with Disabilities and the World Health Organization (WHO) QualityRights initiative, this study aimed to identify expert-informed priorities for implementing recovery-oriented, coercion-free practices in consultation-liaison psychiatry within a general hospital in Italy, while also incorporating perspectives from international stakeholders. A two-round Policy Delphi study was conducted between December 2024 and May 2025 with 17 invited experts from diverse professional and cultural backgrounds. Nine completed both rounds. The Delphi approach was used to identify areas of convergence while also capturing the diversity of expert perspectives. No fixed consensus threshold was set, reflecting the view that in ethically and contextually complex domains such as human rights in mental health, divergent opinions can yield valuable insights. In Round 1, participants provided qualitative responses to four open-ended questions, which were analyzed thematically to generate items for Round 2. In Round 2, participants prioritized structured response options (n = 8 items) derived from the thematic analysis. Descriptive statistics summarized the response distributions. Round 1 revealed strong convergence on the importance of community inclusion, user participation, and professional training. Round 2 confirmed these priorities: 78% identified \u2018mutual exchange and learning' as the main benefit of international collaboration, while 44% and 33% prioritized social inclusion and staff training, respectively, as essential for rights-based recovery. Reported barriers included control-oriented care cultures (33%) and insufficient training or tools (22% each). Experts envisioned future mental health care as fully integrated into community life (56%), with reduced reliance on institutional structures or technocratic solutions. This Delphi study underscores that rights-based, recovery-oriented mental health services must prioritize community inclusion, shared governance, and contextual adaptability. Experts cautioned against top-down or standardized reforms, favoring relational and participatory models. These findings provide actionable insights for developing coercion-free consultation-liaison psychiatry within general hospitals and can inform broader international efforts toward sustainable, rights-based mental health reform.<\/jats:p>","DOI":"10.31083\/ap46500","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:41:17Z","timestamp":1777459277000},"source":"Crossref","is-referenced-by-count":0,"title":["International Expert Priorities for Promoting Recovery and Coercion-Free Practices in Psychosocial Disability: A Delphi Study"],"prefix":"10.31083","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0645-3006","authenticated-orcid":true,"given":"Michela","family":"Atzeni","sequence":"first","affiliation":[{"name":"University Hospital of Cagliari, 09042 Cagliari, Italy"},{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-016X","authenticated-orcid":true,"given":"Giulia","family":"Cossu","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9155-4740","authenticated-orcid":true,"given":"Massimo","family":"Tusconi","sequence":"additional","affiliation":[{"name":"University Hospital of Cagliari, 09042 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3750-6147","authenticated-orcid":true,"given":"Peter Konstantin","family":"Kurotschka","sequence":"additional","affiliation":[{"name":"Department of General Practice, University Hospital W\u00fcrzburg, 97070 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5243-989X","authenticated-orcid":true,"given":"Thurayya","family":"Zreik","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"},{"name":"Mental Health Service User Association, Beirut, Lebanon"},{"name":"Capacities Building for Global Health, University of Cagliari, 09042 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2152-4669","authenticated-orcid":true,"given":"Antonio Egidio","family":"Nardi","sequence":"additional","affiliation":[{"name":"Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ 22290-140, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marietta","family":"Khurshudyan","sequence":"additional","affiliation":[{"name":"Armenian Psychiatric Association, 0025 Yerevan, Armenia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0351-6577","authenticated-orcid":true,"given":"Goce","family":"Kalcev","sequence":"additional","affiliation":[{"name":"The National Alliance for Neuromuscular Diseases and Neuroscience GANGLION Skopje, 1000 Skopje, North Macedonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Ciccu","sequence":"additional","affiliation":[{"name":"Associazione Sarda per l'Attuazione della Riforma Psichiatrica (ASARP), 09127 Cagliari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-5947","authenticated-orcid":true,"given":"Oye","family":"Gureje","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Ibadan, University College Hospital, Ibadan, Nigeria"},{"name":"Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-131X","authenticated-orcid":true,"given":"Rym","family":"Ghachem","sequence":"additional","affiliation":[{"name":"Razi Hospital, 2010 Tunis, Tunisia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1566-1974","authenticated-orcid":true,"given":"Cesar Ivan Aviles","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Kore, Piazza dell'Universit\u00e0, 94100 Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0706-9687","authenticated-orcid":true,"given":"Mauro Giovanni","family":"Carta","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health, University of Cagliari, Monserrato Blocco I (CA), 09042 Cagliari, Italy"},{"name":"Tropical Medicine, Universidad Popular del Cesar, 200001 Valledupar, Colombia"},{"name":"Department of Nursing, Universidad Popular del Cesar, 200001 Valledupar, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Form\u00e1nek T, Poto\u010d\u00e1r L, Wolfova K, Melicharov\u00e1 H, Mlad\u00e1 K, Wiedemann A, et al. 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