Involuntary psychiatric treatment, whether as an inpatient, or in the community, is under increasing scrutiny. This is highlighted by calls from the UN Committee on the Rights of Persons with Disabilities and the World Health Organization for the ending all forms of coercive treatment on the grounds of discrimination on the basis of disability (World Health Organization and Office of the United Nations High Commissioner for Human Rights, 2023). Of concern is evidence of significant variations internationally in the use of involuntary inpatient or community treatment that cannot entirely be explained by legal or clinical factors. Sociodemographic variables, such as non-white ethnicity, male gender, single marital status, unemployment and receiving welfare benefits, appear to increase the risk of coercive approaches to psychiatric care (Barnett et al., 2019; Walker et al., 2019). The effects on First Nations are highlighted by two papers from New Zealand in this issue (Beaglehole et al., 2024; Kirikiri et al., 2024). Despite these concerns, there are moves to extend the use and reach of compulsory treatment in both Canada and Australia.