Involuntary Hospitalization: Psychiatric Emergency

Involuntary hospitalization is a procedure in which a person is hospitalized without consent in a psychiatric medical center or psychiatric ward.

In Israel, approximately 6,000 involuntary hospitalizations of individuals with a mental disorder or illness are carried out every year on the orders of a district psychiatrist or through a court order. A situation in which the system makes decisions about the individual while looking out for the best interest of the individual and his mediate environment.

In the following article, we will try to provide all of the formal information on the involuntary hospitalization process, the mental health crises that would allow this procedure to be used and the parties authorized to issue said order.

Circumstances that require involuntary hospitalization

Although involuntary hospitalization is an extreme measure, there are cases and circumstances attributed to mental state (psychotic state) for which this tool is a “last resort”:

• Immediate danger to the individual’s own life or the lives of others.
• Inability of the individual to take care of his basic needs, such as eating, drinking and sleeping.
• Violent and dangerous behavior towards the individual himself or towards others.

In other words, this legal tool is designed for severe mental health crises that require intense observation to protect the safety of the patient.

District psychiatrists

Authorized to order an involuntary psychiatric evaluation, hospitalization or treatment in both cases emergency and non-emergency. The difference between the two cases is the level of dangerousness of the individual attributed to their mental state.

Directors of psychiatric hospitals

Authorized to order an involuntary hospitalization of up to 48 hours only if all of the following conditions are satisfied:

• The individual is in a psychotic state.
• As a result of the psychotic state, the individual is a danger to himself or the environment.
• The individual refuses voluntary hospitalization.
• The individual is on hospital premises.

If, within 48 hours of the issuing of the order, the hospital staff is convinced of the need for further hospitalization and only if the individual is refusing hospitalization, the staff may contact the district psychiatrist with a request to authorize an involuntary hospitalization.

Court

A court order for involuntary hospitalization can be issued under the following circumstances:

• When an individual who is suspected of having committed a crime, is arrested by the police, or is indicted, he is claiming that his mental state caused him to commit his acts or is preventing him from standing trial. In this case, the suspect can petition the court to issue an order for his evaluation or observation in an involuntary hospitalization to test his competency to stand trial and to determine if he was sane at the time of the act.
• When the police are interested in having a suspect or prisoner undergo a psychiatric evaluation,.
• When there is an indictment against any person, the court can proactively order a psychiatric evaluation or observation to determine whether the person is capable of standing trial and whether the person was sane at the time of the act.