Proposal for the management of involuntary hospitalizations in the outpatient setting

Abstract

Involuntary commitment in mental health represent a challenge for professionals working in outpatient services, due to tensions between therapeutic necessity and criticisms from a human rights perspective. Effective management of involuntary commitment requires a dual-level approach: comprehensive risk assessment followed by appropriate risk management. This paper outlines practical guidelines for managing involuntary detention across diverse outpatient settings. We analyze six distinct healthcare scenarios: 1) outpatient services within specialized or general hospitals; 2) public outpatient care services; 3) private outpatient care services within healthcare centers; 4) private outpatient care services outside healthcare centers; 5) private practice offices; and 6) telepsychiatry. For each scenario, we provide detailed recommendations addressing referral protocols, patient safety measures, and inter-professional-institutional coordination. Our findings suggest that implementing clear protocols and standardized guidelines significantly reduces professional uncertainty, minimizes improvisation in critical situations, and ensures consistent, high-quality patient care.