Practicum Journal:Voluntary and Involuntary Commitment
By description, voluntary commitment refers to the act and practice of a patient admitting them to the psychiatric hospital or any other mental health facility, voluntarily. On the other hand, involuntary commitment is a condition where an individual or a patient is free to leave the hospital or healthcare facility against medical advice, but with a period of notice. In voluntary admission, the patient is willing to signs into a psychiatric unit/facility. A person can be involuntarily admitted to a healthcare facility when he or she has deemed a danger to herself/ himself or the other and is frankly psychotic or otherwise too impaired to have himself safe and attend to the usual and basic daily needs (Karlsson et al. 2015).
Voluntary And Involuntary Commitment
Recommendation for the client to or not be voluntarily committed
`A voluntary commitment can be appropriate for any person who is 14 years of age or older who is having a mental health problem and feels that an in-patient stay is essential for his/her safety. Adolescents who are under the age of 14 years can also be admitted on the voluntary admission by their parents or legal guardian. In addition, parents or legal guardians of the patient can sign for an adolescent who is under the age of 18 years, but this only happens if the adolescent is already in an emergency room and physician recommended so. There is no duration or time limit on a voluntary in-patient stay. The patient can stay as long as he/she and the medical staff have confirmed and believed that there is a need for continued in-patient treatment.
According to this case, the patient is a 14-year-old male and has attempted to commit suicide. At present, the patient has not spoken about his act, and therefore, he was still deemed a danger to himself. Therefore, it would be prudent to recommend the patient to remain in the mental health facility for observation. A voluntary commitment would not be recommended for this patient as this will make him have more freedom to leave the ward when he wants, within reason and go harm himself and therefore, the involuntary commitment would be recommended.
Maryland state law on involuntary commitment
According to Maryland State law, an inpatient is eligible for involuntary commitment under MD. CODE ANN., HEALTH-GEN. §10-632(e)(2) if;
a. The individual has a mental disorder (Treatment Advocacy Center, 2019).
b. The patient presents a danger to the life or safety of himself and or individuals
c. The patient requires inpatient care and proper treatment
d. The patient is not able or unwilling to be admitted voluntarily (Craw& Compton, 2016
Mary state law does confirm the initial recommendation regarding involuntarily committing the client. This is because the client is having depression and the possible reason for attempting suicide. He has a mental disorder and presents a danger to the life or safety of himself because when set free to go home, he may still attempt suicide being that he has refused to speak to the doctors or nurses. No one knows what he is thinking and therefore, need to stay in the hospital for further observation and care
Recommendation for parents
If the client were not eligible for involuntary commitment, the actions that may be taken to support the parents against voluntary commitment is to request for referral to a voluntary residential crisis bed (Miller, Earley& Hanson, 2018). Having not spoken to the healthcare providers, the parents would be requested to allow for at least twenty days of observation while the patient still under supervision before being set free. The other action is based on the fact that the patient has already threatened suicide right, and he is still in immediate danger, he should be taken psychiatric crisis center.
Initial action if the client is not eligible for involuntary commitment
The presence of mental illness in a patient is a prerequisite for civil commitment. However, this patient has not been confirmed for any mental illness. The initial action is examined and diagnoses the patient’s condition. The patient has already dangerous behavior toward self by attempting to commit suicide.
1. Craw, J., and Compton, M. T. (2016). Characteristics associated with involuntary versus voluntary legal status at admission and discharge among psychiatric inpatients. Social Psychiatry and Psychiatric Epidemiology, 41, 12, 981-988.
2. Karlsson, P., Judith, N., Sjo?strand, M., Helgesson, G., Eriksson, S., and Sandman, L. (2015). Ethical deliberations about involuntary treatment:
interviews with Swedish psychiatrists. Bmc Medical Ethics, 16, 1, 1-12
3. Miller, D., Earley, P., and Hanson, A. (2018). Committed: The battle over involuntary psychiatric care.Baltimore: John Hopkins University Press.
4. Treatment Advocacy Center. (2019). Mandatory Treatment Laws in Maryland. Retrieved from https://www.treatmentadvocacycenter.org/browse-by-state/maryland.