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Involuntary Hospitalization: What to Expect

Dr. Sergey Raskin, Senior Psychiatrist, the Ministry of Health;  Razeq Khaled, esq., Nurse educator, Ministry of Health
15 June 2025

In extreme psychiatric states, when an individual poses a risk to himself or to the environment due to his mental state and is unwilling or incapable of voluntary hospitalization, an emergency proceeding known as involuntary hospitalization may be initiated.

If an order is received from the district psychiatrist for your involuntary hospitalization, a date will be scheduled for your arrival and hospitalization at a psychiatric medical center. You will arrive from your home or your place of residence accompanied by a team from a private ambulance company. You may also request to arrive on your own, but this is contingent upon approval by the district psychiatrist. If the hospitalization is immediate, you will arrive at the center within 90 minutes. If the involuntary hospitalization is not immediate, you must arrive within 24 hours.

Duration of hospitalization

The initial period of involuntary hospitalization is up to 7 days. After which, if the medical team decides that continuation of your hospitalization is necessary, they can contact the district psychiatrist and request a 7-day extension of the hospitalization. The district psychiatric committee has the authority to decide whether to extend hospitalization past 14 days.

Conditions of hospitalization

Involuntary hospitalization is performed in closed wards in mental health centers, such as psychiatric hospitals or psychiatric departments in general hospitals.

To prepare you for the process that you may expect during hospitalization, it is important to address several issues:

  • Restricting movement during hospitalization: in most cases, involuntary hospitalization does not require use of physical restraints or isolation. If you or your environment are in immediate danger, however, the staff may decide to use physical restraints, place you in isolation, or adopt other measures for a very short and limited period of time until you calm down and consent to treatment without risk.
  • Administration of medication during hospitalization: during hospitalization, a decision may be made to provide you with medication, including administration of injections, if it is determined that the treatment is necessary to save your life and prevent serious injury.
  • Electroconvulsive Therapy (ECT): ECT is an accepted medical procedure for some mental illnesses and can be used (even without your consent) when there is no other effective treatment. The treatment is contingent upon special approval by three physicians in the hospital.
  • Leaves: the hospital staff or the staff of the psychiatric department can allow you, under certain conditions, to take a leave from hospitalization for several hours or days.
  • Filing a complaint: for any complaint related to hospitalization and treatment, you can contact the person in charge of patients' rights at the medical institution where you are hospitalized, or you can contact the Medical Professions Ombudsman of the Ministry of Health.

In extreme psychiatric states, when an individual poses a risk to himself or to the environment due to his mental state and is unwilling or incapable of voluntary hospitalization, an emergency proceeding known as involuntary hospitalization may be initiated.

The article below will focus on the main aspects of involuntary hospitalization: the actual admission and hospitalization process, the duration of hospitalization according to law, and the physical and therapeutic conditions in the inpatient departments. Our goal is to provide you with comprehensive information on this sensitive subject, so that if an order has been issued to hospitalize you (or someone close to you), you will know what to expect.

Restricting freedom to save a life

Before we start explaining the procedure, it is important for us to note that we know it may be stressful and not simple for the patient, who is required to give up the basic right to autonomy and freedom of choice. If an order was given to involuntarily hospitalize you, it is very natural to feel overwhelming difficulty and anxiety, and even fear the reaction of the environment as well as social repercussions and stigmas that may occur following the hospitalization.

At the same time, it is important to understand that if a decision has been made that you need this type of hospitalization, this is probably the best solution for you. You should become familiar its purpose and understand that there are mental health emergencies that leave no choice, and this is the best way to protect your safety as well as the safety of others. For example, if a person is in a psychotic state with a risk of suicide, it is important to prevent self-harm and provide the person with psychological, medication and rehabilitation therapy until his quality of life improves. In other words, sometimes the only way to save a life is to significantly intervene in the person's freedom, while maintaining dignified treatment from the therapeutic system.

The goal is to improve your condition and that of those close to you, improve how you are feeling and to get your life back on track. We hope that the information in the article will help allay some of your concerns about the expected procedure, help you understand the importance of hospitalization and answer at least some of the questions that are bothering you.

Actual hospitalization

If an order is received from the district psychiatrist for your involuntary hospitalization, a date will be scheduled for your arrival and hospitalization at the selected psychiatric medical center. You will arrive from your home or place of residence accompanied by a team from a private ambulance company. You may also request to arrive on your own, but this is contingent upon approval by the district psychiatrist. If the hospitalization is immediate, you will arrive at the center within 90 minutes. If the involuntary hospitalization is not immediate, you must arrive within 24 hours.

At the medical institution, you will be received by the psychiatric staff, which will evaluate your condition and decide on the right therapeutic plan for you. During the admission process, you will be given an explanation of the need for your hospitalization and a proposal will be made to you to be hospitalized with consent - if you refuse, the hospitalization will be involuntary.

Length of the involuntary hospitalization

The initial period of involuntary hospitalization is up to 7 days. After which, if the medical team decides that continuation of your hospitalization is necessary, they can contact the district psychiatrist and request a 7-day extension of the hospitalization. The decision to extend hospitalization beyond 14 days is to be made by the district psychiatric committee. This decision may be appealed before a district court.

When a decision on involuntary hospitalization is issued by court order, the length of hospitalization is determined by the court. During this hospitalization, your case will be heard before the district psychiatric committee every six months, at which time a decision will be made whether to discharge you or extend your hospitalization until the next hearing.

Family members can object to your discharge at the end of the hospitalization period, and for this, they must contact the district psychiatrist. If their request is denied, they can appeal the denial before the district psychiatric committee.

Conditions for involuntary hospitalization

Involuntary hospitalization is performed in closed wards in mental health centers, such as psychiatric hospitals or psychiatric departments in general hospitals.

To help and prepare you for the process that you may expect during hospitalization, it is important to address several issues:

In most cases, involuntary hospitalization does not require use of physical restraints or isolation. The medical staff will first try to use various methods of sedation, to avoid physical restraint. If you or your environment are in immediate danger, however, the staff may decide to use physical restraints or place you in isolation or adopt other measures, for a very short and limited period of time, until you calm down and consent to treatment without risk - in accordance with Ministry of Health guidelines that regulate the use of physical restraints. In any case, it is important to remember that the decision on physical restraints will be based on a professional medical evaluation and will be used solely for the purposes of protection and safety, and not for purposes of punishment or shame. The staff will work to lift the restriction as soon as possible.

During hospitalization, a decision may be made to provide you with medication, including administration of injections, within the confines of several clear rules:

  • The medication treatment will be administered in accordance with the decision of a psychiatrist, if they decide that the treatment is necessary to save your life and to prevent serious damage to you or your environment.
  • The medical staff will select the most suitable medications for the medical condition, and will adjust the dosage and the continuation of the treatment according to your condition.
  • You are entitled to receive detailed information about the medication, including possible side effects, and you are also allowed to express your opinion on the matter. Refusing to accept medication, however, may lead to involuntary administration of medication.
  • The decision on involuntary medication (by injection) will be based on a medical decision and will be weighed against other alternatives as far as they exist.
  • Treatment will be administered to you only for medical purposes and not for punishment or shame. All of this in accordance with the Ministry of Health guidelines that regulate the medication treatment with regards to involuntary hospitalization.

ECT is an accepted medical procedure for some mental illnesses. In the therapeutic standards for mentally ill patients, reference is made to the therapeutic method with electricity during involuntary hospitalization, that allows treatment to be administered even without your consent. This therapeutic method is likely to be adopted when there is no other effective treatment, and it is contingent on obtaining special approval from three physicians at the hospital. This treatment is permitted for a limited series of treatments only.

The hospital staff or the staff of the psychiatric department can allow you, under certain conditions, to take a leave from hospitalization for several hours or days. The purpose of the leave is to give you time to recover and maintain contact with your family and loved ones. You will usually be appointed a companion (family member) during the leave. If unexpected events occur during the leave or your condition worsens, you may be forced to cut short the leave. It is also important to note that when the hospitalization is imposed by court order, permission to go on leave must be obtained from the district psychiatric committee authorized to approve leaves in this case.

If you or your family member wishes to make a complaint about any matter related to hospitalization and treatment, contact the person in charge of patients' rights at the medical institution where you are hospitalized, or you can contact the Medical Professions Ombudsman of the Ministry of Health.

Clarification regarding the concept of mental illness

The "Treatment of Mental Patients Law" of 1991 regulates the rights of individuals with a mental health disability, defines the conditions under which it is permissible to limit the freedom of choice and the measures that may be adopted to ensure proper and dignified treatment, while also establishing supervision and control procedures to prevent abuse of the law's powers. It is important to emphasize that although it is now less common to refer to individuals with a mental health disability as "mentally ill", as it is an old term that appears in the country’s laws, it is introduced here in its original form.

In conclusion, it is worth emphasizing that despite all the difficulty, it is important to remember that this is hospitalization for a limited time only and is apparently necessary for your sake and for the sake of your environment. It is also important to remember that the purpose of the procedure is ultimately to help you restore a normal and healthy life.

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