Psychiatric Hospitalization

Involuntary Treatment - Commitment to a Psychiatric Hospital

The National Association of Psychiatric Health Systems reports that about 88 percent of adults treated in its members' hospitals are admitted voluntarily. In many states, people so disabled by their illnesses that they don't fully recognize the need for 24-hour inpatient care and who refuse hospital treatment may be involuntarily admitted to the hospital, but only with the knowledge of the court system and following an examination by a physician.

Commitment procedures vary from state to state. There has been some attempt made to shield mentally ill people from the stigma of public court appearances, and sometimes patients can be too ill to attend a hearing. For these reasons, a mentally ill person may, in some states, be admitted on the advice of one or two physicians who act within a very strict set of procedures to insure full protection of the patient's legal rights. Most states allow a physician to prescribe that a person be admitted involuntarily to a hospital for a brief evaluation period, usually three-days.

During the evaluation period, a team of psychiatrists and mental health professionals can learn whether the person's illness requires longer hospital care or can be managed effectively with less intensive treatment, such as partial hospitalization.

If the evaluation team thinks a patient requires inpatient care past the three-day period, it can request longer admission--a request that, it should be emphasized, is subject to a hearing. At this hearing, the patient or his or her representative must be present. No decisions regarding a patient's hospitalization and subsequent treatment can be made without the presence of the patient or this representative. If involuntary admission is recommended, the court can issue an order for only a specific period of time. At the end of that period, the question of hospitalization must again go to a court hearing.

Involuntary treatment is sometimes necessary, but is used only in unusual circumstances and is always subject to a review which protects the civil liberties of patients.

There if You Need it

If your physician prescribes hospitalization, you, a member of your family, a friend or other advocate should tour the recommended facility and learn about its admissions procedure, daily schedules and the mental health care team with whom you or your family member will be working. Learn how treatment progress will be communicated and what your role will be. This may help you to feel more comfortable about complying with your physician's recommendation. And that comfort can only contribute to the progress you or your loved one will make during hospital care.

Regardless of the illness, it's good to know that a range of health care services are available for patients and their families. Certainly outpatient care is the most common treatment setting. But when an illness becomes severe, effective hospital services are there to meet the need.

For comprehensive information on psychiatric hospitalization and mental illness, visit the HealthyPlace.com Mental Illness Information Center here.

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(c) Copyright 1994 American Psychiatric Association

Produced by the APA Joint Commission on Public Affairs and the Division of Public Affairs. This document contains text of a pamphlet developed for educational purposes and does not necessarily reflect opinion or policy of the American Psychiatric Association.

Additional Resources

Dalton, R. and Forman, M. Psychiatric Hospitalization of School-Age Children. Washington, DC: American Psychiatric Press, Inc., 1992.

Consent to Voluntary Hospitalization: Report of the American Psychiatric Association Task Force on Consent to Voluntary Hospitalization. Washington,DC: American Psychiatric Press, Inc., 1992.

Facts for Families Information Sheet Series, "Children's Major PsychiatricDisorders," and "The Continuum of Care." Washington, DC: American Academyof Child and Adolescent Psychiatry, 1994.

Kiesler, C. and Sibulkin, A. Mental Hospitalization: Myths and Facts About A National Crisis. Newbury Park, CA: Sage Publications, 1987.

Korpell, H. How You Can Help: A Guide for Families of Psychiatric Hospital Patients. Washington, DC: American Psychiatric Press, Inc., 1984.

Krizay, J. Partial Hospitalization: Facilities, Cost & Utilization.Washington, DC: The American Psychiatric Association, Inc., 1989.

Policy Statements on Inpatient Hospital Treatment of Children and Adolescents. Washington, DC: American Academy of Child and AdolescentPsychiatry, 1989.

back to: Psychiatric Disorders Definitions Index