The American Psychiatric Association and Mental Health America have similar positions on
involuntary outpatient commitment in that they both recognize the need for involuntary treatment
when a patient is deemed to have a serious mental illness and is a danger to themselves or others.
The APA position statement is more specific in that it outlines the criteria, procedures, and
responsibilities of both the patient and the health care provider in regards to involuntary outpatient
commitment. The criteria outlined in the APA statement include the presence of a serious mental
illness, the likelihood of danger to self or others, the presence of substantial deterioration, and the
lack of voluntary acceptance of treatment. In regards to procedures, the APA statement outlines the
process of obtaining an involuntary treatment order, which includes an evaluation by a qualified
mental health professional, a court hearing, and a determination of the least restrictive alternative
treatment. The responsibilities of the health care provider in regards to involuntary outpatient
commitment are also outlined in the statement, which include providing the patient with
information about their rights, the need for treatment, and the risks associated with the treatment.
The legal requirements in North Carolina state of practice are similar to the APA position statement,
but also require an evaluation by a mental health professional prior to committing a patient
involuntarily. The North Carolina Mental Health Commitment Laws also require that a court hearing
be held before an individual can be involuntarily committed. This hearing is intended to ensure that
the decision to commit a patient is fair and based on sound evidence. The court must also determine
the least restrictive alternative treatment for the patient, which is in line with the APA position
statement. In addition, the court must also consider the patient's right to self-determination and
autonomy.
2. After reading the position statements, I find myself more philosophically aligned with the
statement from Mental Health America. I believe that involuntary treatment should only be used as
a last resort and that it should be carried out in a way that respects the autonomy and dignity of the
patient. The Mental Health America statement also outlines the importance of utilizing the least
restrictive alternative treatment, which is something that I strongly agree with. I also agree with
Mental Health America's position that involuntary treatment should be used to help protect the
patient, as well as the public, while also aiming to restore the patient's autonomy and self-
determination. As a provider, I believe that it is my responsibility to ensure that the patient's rights
are respected and that their autonomy and self-determination are not compromised.
3. Clients who disagree with involuntary treatment decisions in North Carolina state of practice have
the right to appeal the decision by filing a petition in court. The court then has the discretion to
either affirm the decision or to order different treatment. The court also has the authority to modify
the terms of the commitment and to require the patient to continue to receive treatment in an
alternative setting if necessary. The court also considers the patient's right to self- determination
and autonomy, and the patient has the right to be represented by legal counsel at the hearing.
4. Situations that might create moral distress for me as a provider include when a patient is deemed
to be in need of involuntary treatment, but the patient is refusing treatment. In this situation, it can
be difficult to make a decision that is in the best interest of the patient, while also respecting their
autonomy and self-determination. It can be difficult to balance the need to protect the patient and
the public from harm, while also respecting the patient's right to make their own decisions about
their treatment. Resources that exist for providers experiencing moral distress include the American
Psychiatric Association's Ethics Hotline, the National Council for Behavioral Health's Professional
involuntary outpatient commitment in that they both recognize the need for involuntary treatment
when a patient is deemed to have a serious mental illness and is a danger to themselves or others.
The APA position statement is more specific in that it outlines the criteria, procedures, and
responsibilities of both the patient and the health care provider in regards to involuntary outpatient
commitment. The criteria outlined in the APA statement include the presence of a serious mental
illness, the likelihood of danger to self or others, the presence of substantial deterioration, and the
lack of voluntary acceptance of treatment. In regards to procedures, the APA statement outlines the
process of obtaining an involuntary treatment order, which includes an evaluation by a qualified
mental health professional, a court hearing, and a determination of the least restrictive alternative
treatment. The responsibilities of the health care provider in regards to involuntary outpatient
commitment are also outlined in the statement, which include providing the patient with
information about their rights, the need for treatment, and the risks associated with the treatment.
The legal requirements in North Carolina state of practice are similar to the APA position statement,
but also require an evaluation by a mental health professional prior to committing a patient
involuntarily. The North Carolina Mental Health Commitment Laws also require that a court hearing
be held before an individual can be involuntarily committed. This hearing is intended to ensure that
the decision to commit a patient is fair and based on sound evidence. The court must also determine
the least restrictive alternative treatment for the patient, which is in line with the APA position
statement. In addition, the court must also consider the patient's right to self-determination and
autonomy.
2. After reading the position statements, I find myself more philosophically aligned with the
statement from Mental Health America. I believe that involuntary treatment should only be used as
a last resort and that it should be carried out in a way that respects the autonomy and dignity of the
patient. The Mental Health America statement also outlines the importance of utilizing the least
restrictive alternative treatment, which is something that I strongly agree with. I also agree with
Mental Health America's position that involuntary treatment should be used to help protect the
patient, as well as the public, while also aiming to restore the patient's autonomy and self-
determination. As a provider, I believe that it is my responsibility to ensure that the patient's rights
are respected and that their autonomy and self-determination are not compromised.
3. Clients who disagree with involuntary treatment decisions in North Carolina state of practice have
the right to appeal the decision by filing a petition in court. The court then has the discretion to
either affirm the decision or to order different treatment. The court also has the authority to modify
the terms of the commitment and to require the patient to continue to receive treatment in an
alternative setting if necessary. The court also considers the patient's right to self- determination
and autonomy, and the patient has the right to be represented by legal counsel at the hearing.
4. Situations that might create moral distress for me as a provider include when a patient is deemed
to be in need of involuntary treatment, but the patient is refusing treatment. In this situation, it can
be difficult to make a decision that is in the best interest of the patient, while also respecting their
autonomy and self-determination. It can be difficult to balance the need to protect the patient and
the public from harm, while also respecting the patient's right to make their own decisions about
their treatment. Resources that exist for providers experiencing moral distress include the American
Psychiatric Association's Ethics Hotline, the National Council for Behavioral Health's Professional
