Psychiatric hospitalisation; transitioning from consenting to involuntarily admitting-re-conceptualisation and a...

Involuntary psychiatric hospitalisation (IPH) is a form of acute psychiatric service delivery that is practiced in some forms worldwide. When feasible, clinicians attempt to obtain consent from a patient for psychiatric hospitalisation before transitioning to consider IPH. Influenced by their clinical experience and local laws, clinicians develop variable practices to make this transition. Subtle forms of coercion are found to take place during the consenting process, many of which remain under-recognised. In this article, we propose a reconceptualisation for IPH that distances it from being a consequence of declining to consent for hospitalisation. Building on this, we then outline a step-by-step procedural framework to exemplify how to transition from conducting informed consent for psychiatric hospitalisation to pursuing it on an involuntary basis while maintaining clear ethical boundaries. Finally, we suggest how to respond to patients' inquiries about their admission status and negotiation requests and explain the usefulness of this framework for the patient and the mental health professional.