Involuntary treatment is treatment provided without a person's consent or against his or her explicit wishes, and almost always refers to psychiatric treatment for severe mental illness. Supporters view it as sometimes necessary and helpful, and opponents view it as forced drugging and abuse. It should always be a last resort, used only when other treatments fail.
There are special criteria that must be met before a person can be treated involuntarily. These vary between countries, but generally include that the mental illness must be very severe and disabling, or the person must be a danger to self or others. The person needs to have refused all other treatment or be unable to consent to any treatment. Other less restrictive treatments need to be considered first, and be found inadequate or impossible for a particular patient.
Involuntary treatment is a very controversial issue, particularly since in the past it was used to control and abuse vulnerable members of society. Patients could be involuntarily committed even if they did not have a diagnosable mental illness, and then had a very hard time getting out of treatment. This sometimes happened to wives who were seen as problematic and to unwanted children. Current practices address this historical precedent and ensure that this does not happen to patients today.
Medical professionals who make the decision to treat a person involuntarily, as well as people who pursue involuntary commitment for a mentally ill loved one, have a great deal of responsibility and a difficult choice. Treatment without consent can be used to save the life of a person who is temporarily incapable of making decisions or stop a destructive downward spiral. It can also be used to give treatment that a person finds dehumanizing and aversive, such as electroconvulsive therapy or heavy sedative psychiatric medication.
Some people with mental illnesses such as schizophrenia and bipolar disorder view involuntary treatment as a violation of human rights and believe that nobody should ever be involuntarily committed. Other people with mental illnesses believe that involuntary hospitalization started them on the road to recovery and was necessary. Involuntary treatment must be decided on a case by case basis, taking into consideration the person's rights and needs. The need must be very severe, and all other options must have been exhausted before involuntary treatment should be considered.
One of the main concerns is that involuntary treatment needs to have a defined ending point so that people with mental illnesses can choose treatment for themselves after the crisis period is over. The effectiveness of different types of involuntary care is also in question, and further research is needed to determine how to provide it in the most effective and least restrictive way possible. Preventing the need for involuntary treatment is always the best option, which may be achieved by developing better outpatient care programs and ways of reaching people in need before a crisis point is imminent.
