Voluntary and Involuntary Commitment Essay

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. Voluntary and Involuntary Commitment Essay

The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?


Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client. Voluntary and Involuntary Commitment Essay

Voluntary and Involuntary Commitment

Recommendation of Voluntarily Commitment

From the provide scenario, a PMHNP should allow voluntary commitment of the client. This is because, in the US, majority of the jurisdictions stipulate that any individual whose age is 14 years and above and has a mental health crisis can be suitable for voluntary commitment (Saya et al, 2019). Additionally, for an individual to be perceived as appropriate for voluntary commitment, the person should be ready to voluntarily consent for admission to a mental health institution. In this case, it would be appropriate to try to seek consent from the client because he is aged 14 years.


Eligibility for Involuntary Commitment

State laws in Tennessee allow involuntary commitment a person meets the following conditions: the individual has a psychiatric condition and requires treatment; and the individual poses a serious risk of harm to others or self and needs treatment (Hedman et al, 2016). According to Dilillo et al (2015) a threat of suicide is a common reason for being admitted involuntarily because the person poses risk to self. In this scenario, the client has a mental condition that is due to relationship issues with the girlfriend and also the client poses a risk to self as indicated by the suicide attempt that landed the client in ICU. The client also needs treatment in order to address the mental issues that led him to attempt suicide.  Therefore, the client is eligible for involuntary commitment.

State Laws and Recommendation for Involuntarily Commitment

The state laws challenged my earlier understanding of voluntary laws. This is because my initial argument was that the client is supposed to be voluntarily committed because he is aged 14 years and above and thus, he can give consent for voluntary commitment. However, after reading the state laws regarding involuntary commitment, it has come to my understanding that a person with a mental condition and poses a risk to others and self and needs treatment is eligible for involuntary commitment (Saya et al, 2019). The client in this scenario attempted suicide and therefore poses a risk of harm to self and thus he is eligible for involuntary commitment to have the mental crisis treated

Actions to Take to Support the Parents for/or Against Voluntary Commitment

If the client was not eligible for involuntary commitment, it would be important to educate the parents regarding the need to have their son committed and the risks associated with not committing the son. This is because the mother who is the client’s custodian is not aware that the son is suffering from a mental condition/mental crisis because she thinks the son is only pretending. Therefore, it will be necessary to educate the parents, especially the mother who is not against the son being committed (McGuinness et al, 2018). The education may convince the parents to give consent to have the son voluntarily committed.

Initial Actions to Take to Treat the Client

If the client was not eligible for involuntary commitment, as a PMHNP, one should seek informed consent from the parents and the client before starting any form of treatment to address the client’s mental condition. Informed consent is necessary before the provision of any medical care given to individuals who are competent to make treatment decisions (Saya et al, 2019). Since the parents of the client have not been declared incompetent, it would be necessary to seek informed consent before starting any form of treatment.


Dilillo D, Mauri S, Fabiano V, Chiara M & Gian V. (2015). Suicide in pediatrics: epidemiology, risk factors, warning signs and the role of the pediatrician in detecting them. Ital J Pediatr. 41(49).

Hedman L, Petrila J, Fisher W, Swanson J, Dingman D & Scott B. (2016). State Laws on Emergency Holds for Mental Health Stabilization. Psychiatric Services. 67(5), 529-535.

McGuinness D, Murphy K, Liz B, Keys M, Heike F, Brian H & Higgins A. (2018). Individuals’ experiences of involuntary admissions and preserving control: a qualitative study. BJPsych Open. 4(6), 501–509.

Saya A, Chiara B, Piazzi G, Ciaccia G, Niolu C & Alberto S. (2019). Criteria, Procedures, and Future Prospects of Involuntary Treatment in Psychiatry Around the World: A Narrative Review. Front Psychiatry. 10(271).  Voluntary and Involuntary Commitment Essay


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