Voluntary and Involuntary Commitment
Decision between Voluntary and Involuntary Psychiatric Commitment in the Case of a Suicidal Fourteen Year-Old
Voluntarily committing a patient to psychiatric care means that they or their family freely give consent for the same. Involuntarily committing them on the other hand implies that they or their family have not freely given their consent for the same. Based on this particular scenario in the case study, therefore, what would be recommended would be that the minor be involuntarily committed? This is because first and foremost the divorced parents cannot agree whether this adolescent suicide attempt patient should be admitted or not. Secondly, suicidality is the most common reason for inpatient psychiatric admission, with up to 75% of child, adolescent, and adult patients getting hospitalized for the reason of wanting to harm self (National Academy of Sciences, 2019). Voluntary and Involuntary Commitment
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Based on Indiana laws, this client is eligible for involuntary commitment. According to Indiana code 12-26-1-1 sec. 1, a client who is deemed to be a danger to themselves by virtue of being mentally unstable can be committed to psychiatric care involuntarily (LawServer Online, 2019). This can either be emergency detention for a maximum of 72 hours (IC 12-26-5) or temporary commitment for a maximum of 90 days (IC 12-26-6). In Indiana, the temporary commitment requires that the PMHNP petitions the municipal court to grant this by giving a written statement outlining the results of examination and assessment as well as the professional expert opinion. However, another physician or clinician giving the same reasons must also be produced (Pace, 2017). Because this young client wants to kill himself, he is eligible for involuntarily commitment under this statute by virtue of intent to harm self. Voluntary and Involuntary Commitment
The understanding of the Indiana state laws therefore served to confirm the initial PMHNP opinion that this client required involuntary commitment to the psychiatric unit. Statistics show that close to half of completed suicides in the United States are related to an underlying mental disorder. Also, involuntary commitment is known to be tied to many common suicide risk factors (American Academy of Sciences, 2019). This child is dangerous to himself and may attempt to kill himself once again. According to Ng and Kelly (2012), perception of dangerousness is a factor associated with involuntary commitment or admission.
If this client were not eligible for involuntary commitment, to support the parents in voluntary commitment some of the actions that would be taken would include thorough assessment of the child for future suicide risk. This would be through either or both the Scale for Suicide Ideation (SSI) and/ or the Beck Hopelessness Scale. Also, if the client were not eligible for involuntary commitment, one of the actions that would be taken to start treatment would be to initiate the psychotherapeutic intervention of cognitive behavioral therapy or CBT (National Academy of Sciences, 2019). This is a non-pharmacologic intervention that intends to modify the client’s behavior and positively influence and direct his future actions. Other measures of psychotherapy that would be attempted would include group psychotherapy. In this, the therapeutic factors of universality and altruism would help the client realise that they are not only alone in what they are going through; but also that there are other persons who care about them and their wellbeing. Needless to say, the divorced parents would also benefit from some counselling individually in order to know how to cope with their son’s condition. Voluntary and Involuntary Commitment
References
LawServer Online, Inc. (2019). Indiana code 12-26-1-1. Statutes under which mentally ill and either dangerous or gravely disabled may be involuntarily detained or committed. Retrieved from https://www.lawserver.com/law/state/indiana/in-code/indiana_code_12-26-1-1
National Academy of Sciences, (2019). Chapter: 7 medical and psychotherapeutic interventions. Retrieved from https://www.nap.edu/read/10398/chapter/9#231
Ng, X.T. & Kelly, B.D. (2012). Voluntary and involuntary care: Three-year study of demographic and diagnostic admission statistics at an inner-city adult psychiatry unit. International Journal of Law and Psychiatry, 35, 317-326. Doi: 10.1016/j.ijlp.2012.04.008
Pace, T. (2017, July 21). How to have someone committed to a psychiatric facility in Indiana. Legal Beagle. Retrieved from https://legalbeagle.com/8573504-someone-committed-psychiatric-facility-indiana.html
Voluntary and Involuntary Commitment
