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  • in reply to: Involuntary Client & Mental Health Practice #416

    Since Brian is locked in his bathroom and does not want to be admitted to the hospital, or talk to any medical professional I would explain to Brian what my concerns are and the options for him. I would tell Brian that his family has called me because they are concerned with his well being. I would ask him if he feels safe, if he is thinking of hurting himself or others. If he says no to both of these questions and since this is my first visit with Brian, I would not admit him involuntarily without seeing him for myself. However if he answered yes to those previous questions I would be obligated to involuntarily admit him. However I would do my best to convince him of the benefits of going to the hospital voluntarily.
    Although his family made me aware of his symptoms, I can not go by their perceptions alone and would need to do a full assessment. His family did not indicate that he was at harm to himself or others and has not broken the law or made threats so neither myself or the police have reason to bring him in in-voluntarily beyond knowing that he has a mental illness. There is also no mention of a substitute decision maker for Brian, although it is clear that he is able to make his own decisions.
    I would ask Brian if he feels comfortable meeting with me another time, perhaps the following day, or if he has any other medical professionals that are helping him and if he would feel more comfortable talking to them. I would ask his family to watch Brian’s behaviour over the next couple of days and to call me back if Brian’s behaviour become worse.
    In regards to drawing the line between respecting a client’s rights to self-determination and autonomy, and ensuring that they are able to stay safe and that their mental health does not worsen, it depends on the support network the client already has. For the moment, Brian is being taken care of by his family and he is not a threat to anyone so there is no immediate pressure to have him admitted. Brian’s case would be different if he did not have a place to sleep or his family’s support. However I do see the positives for involuntary care, because being a support for a family member who has a mental illness is a big responsibility and there can be a relief for the family knowing that their loved one is receiving help. But being involuntarily admitted to a psychiatric facility does not mean a patient will be cured of all ailments. Many times psych wards are stressful, especially when you can not leave, and do not necessarily think anything is wrong with you. Simply put, involuntary mental healthcare does not fit with anti-oppressive social work practice, but sometimes being anti-oppressive is not an option.
    The IPTA is the law that guides our practice. Do I think think that a person should be involuntarily admitted simply because they have are acting as if they have a mental illness, as stated in s.14? No. But I do believe that the act can be used to protect people who are vulnerable to harmful situations. There are times when mentally disabled people do not have supports and need police and medical intervention. However the act is carried out, it should be done with the client’s best interest in mind, which is not always possible.

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