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Involuntary Mental Treatment


The Mental Health Act defines mental disorder as severe dementia, mental illness, or substantial intellectual disability. This condition impairs one’s judgment hence risking deterioration of the condition in the absence of medical treatment offered in hospitals. A person with this condition has the likelihood of causing harm to themselves of others hence the need to seek medical intervention voluntarily or involuntarily. The Mental Health Act allows admission and treatment of people with a mental disorder without their consent (Moreira & Loyola, 2011 p.5). This is because these people are incapable of making sound judgment about their health and treatment measures. They can also pose danger to the community since their impaired judgment affects their actions. It therefore becomes necessary for the person to seek medical treatment voluntarily or the community may take the initiative of admitting the individual in a health facility involuntarily. This report seeks to assess the nature of the nursing intervention when a person is an involuntary mental patient.

Involuntary Mental Health Care

Various researchers have assessed the quality of health care offered to involuntary patients to determine its justification. (Johansson & Lundman, 2002) analyses the personal experience of patients who lack control over their lives. According to findings, health providers fail to consult patients on their experience as well as in making simple decisions. They also indicated presence of a high level of violation to involuntary mental patients physically and emotionally. However, some patients received strong support from the health practitioners. The experience of health care appears as one of good opportunities and great losses due to the positive and negative perspectives of service provision. The research uses primary data by collecting first hand narration of the patients’ experiences and observation of the service provision. The strength of this research is that it actively involves patients and health care providers. This enables collection of the perspective of patients and health providers. The weakness of the research is that the mental patients may not offer reliable information due to the compromise on their judgment. What they may consider harsh treatment may actually be the use of reasonable force to calm the patient down. The experiences labelled as bad may not necessarily be bad but misunderstood from the patient’s point of view.

The subject of involuntary mental health care provision has attracted extensive research as researchers seek to identify ways to improve service provision. (Moreira & Loyola, 2011) assesses the effect of involuntary psychiatric commitment to nursing/patient relationship. The study suggests that nursing care varies depending on the type of commitment of mental patients. The research involved the observation of nurses’ reactions and attitudes towards psychiatric patients admitted through various programs. The purpose was to determine whether nurses have a preconceived attitude towards involuntary patients. Findings however suggest that clinical practices administered on voluntary and involuntary patients remain the same. Despite the high level of aggression from involuntary patients, nurses use a similar approach when dealing with the mental patients. Unlike other situations of administering health care, involuntary treatment involves minimal patient involvement and absence of patient’s consent. This has the potential of deteriorating the quality and effectiveness of treatment administered to patients.

Despite their condition, people with a mental disorder have the right to proper medical care. It is therefore important to assess the quality of health care services offered to involuntary patients to determine areas that require improvement. For this reason, (Fiorillo et al 2010) conducted a research on areas of the involuntary patient treatment that interfere with quality of service. The report offers recommendations to improving the quality of health care provision offered to involuntary mental patients. The study acquires recommendations from the direct involvement of professionals and national leaders. The list of recommendations include informing patients on the need for their hospitalisation and the duration of their stay; protection of their rights; involvement of family; involvement of stakeholders; and training of professionals.

Clinical Practices at the Forensic Mental Health Hospital in Malabar

The Forensic Mental Health Hospital in Malabar holds some of the most mentally unwell people in NSW. Some of the patients having committed serious crimes such as murder but not found guilty due to their state of mind. The hospital is heavily guarded sighting a five-meter high perimeter wall and strong metal doors to ensure patients do not escape from the hospital. The management in this hospital has put a lot of effort in maintaining a hospital environment despite the heavy security that attracts the feeling of being in a prison. Patients with a high threat of harm to themselves and others are in seclusion to control them. The management has lined the seclusion walls with vinyl to protect patients in case they bang their heads. The patients also lack release dates due to the uncertainty of the period when their conditions might improve. Information about the patients is highly confidential to protect the privacy of patients and that of their families.

In extreme cases where doctors fail to comprehend the condition of a patient, they use strong antiseptic medicines that control the condition as they study patient’s behaviour. Sometimes the medicines can have negative effects on patients but are necessary to control aggressive patients who may harm others. The hospital has professional psychologists who observe the patients’ behaviour to determine their condition hence prescribe treatment. Psychotic illnesses prove harder to understand and control hence takes a lot of the psychologists’ time. The personalised care offered to patients ensures every patient receives proper care according to their unique condition. Some conditions such as schizophrenia are difficult for doctors to understand hence harder to treat and manage. This requires the hospital to place patients under observation as well as medication. Before administering treatment, the doctors have to inform the patient of the procedure then forcefully medicate them in case they fail to cooperate. Time is an important asset that allows doctors enough time to study, analyse, and understand patients’ conditions and histories hence offer effective treatment. Less ill patients in the hospital can play sports and take part in activities such as gardening, that aid in their healing.

The law focuses on treatment rather than punishment of mentally ill people who commit crimes that require them to serve a jail sentence. This hospital facilitates the protection of the patients’ rights by treating them with a high level of dignity despite their history. Due to the danger they pose to society, the law requires their admission in this facility where they receive proper treatment despite the unlikelihood of their release back into society. The doctors at the hospital keenly ensure the protection of patients’ rights as well as their active involvement in the treatment process to facilitate their healing. It is therefore in line with the requirements of the mental health act that authorises involuntary admission of mental patients while upholding their rights.


Fiorillo A., Roda C. D., Vecchio V. D., Kallert T. (2010). How to improve clinical practice on involuntary hospital admissions of psychiatric patients: Suggestions from the EUNOMIA study. European Psychiatry, 26(4), 201-7.

Johansson I. M., Lundman B. (2002). Patients’ experience of involuntary psychiatric care: good opportunities and great losses. Journal of Psychiatric and Mental Health Nursing. 9(6), 639-47.

Moreira L. H. O., Loyola C. M. D. (2011). Involuntary commitment implication for psychiatric nursing practice. SciELO Journal Vol 45(3), 1-13.