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Can we really treat mentally ill patients involuntarily?

Published online by Cambridge University Press:  01 September 2022

J. Gonçalves Cerejeira*
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
G. Medina Ojeda
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
I. Santos Carrasco
Affiliation:
Clinical Hospital of Valladolid, Psychiatry, Valladolid, Spain
C. De Andrés Lobo
Affiliation:
Hospital Clínico Universitario de Valladolid, Psiquiatría, VALLADOLID, Spain
T. Jiménez Aparicio
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
C. Vallecillo Adame
Affiliation:
Hospital Clínico Universitario, Psiquiatría, Valladolid, Spain
G. Guerra Valera
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
M. Queipo De Llano De La Viuda
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
A. Gonzaga Ramírez
Affiliation:
Hospital Clínico Universitario de Valladolid, Psychiatry, Valladolid, Spain
*
*Corresponding author.

Abstract

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Introduction

The therapeutic alliance is critical to the efficacy of psychiatric treatment and can be weakened by involuntary treatment measures. In Western culture, mental illness is still associated with violence and if significant risk of violence is detected, in Spain a civil court can order the application of involuntary treatments such as Involuntary Outpatient Commitment.

Objectives

To discuss the effectiveness of some psychiatric involuntary treatments used in Spain.

Methods

- Literature review about involuntary psychiatric treatments used in Spain - Case report about a patient undergoing Involuntary Outpatient Commitment

Results

We present the case of a 54-year-old man, diagnosed with schizophrenia, admitted to our acute psychiatric yard more than five times due to violent behavior and psychotic symptoms. Five years ago, he was summitted to a period of three years of Involuntary Outpatient Commitment. In Spain this measure can include the administration of involuntary medication, an injectable antipsychotic treatment in this case. At the end of the order, he immediately stops attending consultations and abandoned psychopharmacological treatment.

Conclusions

Involuntary Outpatient Commitment is a controversial measure and it stirs up the concepts of stigma, coercion, care, patient autonomy and, globally, the values of humanization in psychiatry.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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