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People who pose serious imminent risks to themselves or others may be involuntarily hospitalized.

Involuntary hospitalization does not necessarily mean treatments can be imposed without consent.

Hospitalized patients have a right to make their own treatment decisions, provided they have mental capacity.

Psychologists should balance safety, client autonomy, doing good, avoiding harm, and due process.

When people experiencing a mental health crisis pose a serious, imminent risk to themselves or others, they may be hospitalized for a defined period of time without their consent. Although the precise standards vary by jurisdiction, involuntary hospitalization is generally intended to provide an opportunity to ensure immediate safety, allow time to evaluate the patient’s needs and risk, and stabilize the patient during a period of crisis.

Taking away someone’s freedom is an extraordinary exercise of state power. Accordingly, the goals of preventing harm and providing care must be balanced against autonomy: the right to make decisions about one’s own life, body, and medical or mental health treatment (Barsky, 2023).

A crucial distinction that sometimes gets lost in this discussion is that legal authorization to hospitalize a person involuntarily does not necessarily constitute authorization to treat that person without their consent. The legal standards for involuntary hospitalization, decision-making capacity, emergency intervention, and treatment over objection may be different.

Even when hospitalization is justified, patients should retain as much control as possible over such matters as medication, therapy, communication with family, cultural or spiritual support, daily routines, and discharge planning.

Mental Illness Does Not Automatically Mean Incapacity

People sometimes assume that involuntary hospitalization necessarily means that the patient lacks decision-making capacity. This assumption is incorrect. From a legal perspective, capacity depends on the particular decision to be made, at a particular time. A person may have difficulty making one type of decision while remaining capable of making others. Capacity can also fluctuate as symptoms, medications, sleep, stress, drug use, or medical conditions change.

Depending on particular state laws, assessing mental capacity for treatment decisions typically involves determining whether patients have the ability to:

understand information about their situation and treatment options;

appreciate how that information applies to their situation;

reason about their treatment options (given the benefits and risks of each); and

communicate a choice........

© Psychology Today