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Voluntary "involuntary" commitment--the briar-patch syndrome

R D Miller

    The Bulletin of the American Academy of Psychiatry and the Law
    |January 1, 1980
    PubMed
    Summary
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    Many mental health admissions involve coercion, not true voluntariness. Conversely, some involuntary commitments are self-initiated by patients seeking treatment, challenging traditional views on mental health care.

    Area of Science:

    • Psychiatry
    • Mental Health Law
    • Sociology of Mental Illness

    Background:

    • The concept of 'voluntary admission' in mental health settings is often debated due to subtle coercion.
    • Previous research by Szasz and others highlighted coercive elements in ostensibly voluntary psychiatric hospitalizations.

    Purpose of the Study:

    • To explore the phenomenon of patients arranging their own involuntary commitments.
    • To analyze the motivations behind self-initiated involuntary psychiatric admissions.
    • To challenge the dichotomy between voluntary and involuntary mental health treatment.

    Main Methods:

    • Literature review on mental health admission policies and patient autonomy.
    • Analysis of case histories of individuals who initiated their own involuntary commitment.

    Related Experiment Videos

  • Qualitative examination of the reasons and contexts for such decisions.
  • Main Results:

    • Evidence suggests a significant number of 'involuntary' commitments are initiated by patients themselves.
    • Patients may choose involuntary commitment to access treatment, avoid stigma, or gain legal/social support.
    • The distinction between voluntary and involuntary mental health treatment is more complex than commonly perceived.

    Conclusions:

    • The traditional understanding of mental health admissions requires re-evaluation.
    • Patient agency can manifest in unexpected ways, including seeking involuntary commitment.
    • Further research is needed to understand the full spectrum of patient motivations in psychiatric care.