A Medical Incapacity Hold Policy Reduces Inappropriate Use of Involuntary Psychiatric Holds While Protecting Patients From Harm

Differentiating Domains of Involuntary Containment for Persons With Severe Psychiatric Impairment and COVID-19

“…For psychiatry, historically, Black Americans and members of other racial and ethnic minorities have less access to mental healthcare and even when treated receive lower quality healthcare. 4 The recent brutal deaths of Black Americans have been traumatic for many individuals, especially people of color, supporting prior evidence of the impact of police killings on Black American mental health. 5 Hence, for the sake of our patients, we must educate ourselves, stay abreast of current events and their historical and societal antecedents and take action.…”

“…Although admittedly not an uncommon practice, restricting patients for primarily medical reasons with a psychiatric hold is medically and legally misguided, as thoroughly described by 2 recently published articles by this journal. 3,4 Creating hospital policies specifically for medical involuntary holds is proposed. Although COVID-19 is undoubtedly potentially lethal, a positive COVID-19 status does not automatically meet criteria for medical involuntary hold.…”

Reconsidering the ethics of compulsive treatment under the light of clinical psychiatry

“…Disregarding such differences might increase the stigma of mental disorders and awareness of them improves the moral weight and reduces random interpretations of clinical practice (Fistein et al 2016). If CT is to be considered for both then perhaps segregating their legal features is valuable (1) Medical Incapacity Hold (MIH) to those who are considered unable to decide and have a psychiatric illness, and (2) Involuntary Psychiatry Hold (IPH) for patients with psychiatric disease without insight and in need of treatment (Heldt et al 2018). This would allow health professionals to Drug and addiction disorders have other ethical challenges and while they are clear disturbances of behavior they do not fit into key features of mental disorders and also don't apply to "medical" incapacities (Williams 2015).…”

Reconsidering the ethics of compulsive treatment in light of clinical psychiatry: A selective review of literature

“…Disregarding such differences might increase the stigma of mental disorders and awareness of them improves the moral weight and reduces random interpretations of clinical practice ( Fistein et al 2016 ). If CT is to be considered for both then perhaps segregating their legal features is valuable (1) Medical Incapacity Hold (MIH) to those who are considered unable to decide and have a psychiatric illness, and (2) Involuntary Psychiatry Hold (IPH) for patients with psychiatric disease without insight and in need of treatment ( Heldt et al 2018 ). This separation might allow health professionals to better understand the nature of CT in Psychiatry and distinguish it from the lack of competence in many medical illnesses that confusional states bring about.…”