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Voluntary Commitment and Mental Health Law

Voluntary commitment is the act or practice of a person voluntarily going into a mental hospital, psychiatric ward, or other facility or institution, without the process of involuntary commitment. Unlike in involuntary commitment, the person is free to leave the facility against medical advice (AMA), although a period of notice (usually the requirement that leaving the facility takes place during daylight hours) is sometimes required.

In some jurisdictions, a distinction is drawn between "formal" and "informal" voluntary commitment, and this may have an effect upon how much notice the person must give before they leave the facility. This period may be used for the hospital to use involuntary commitment procedures against the patient.

Against Medical Advice (AMA) is a term used to refer to a patient who checks him/herself out of a hospital against the advice of the patient’s doctor. While it may not be medically wise for the person to leave early, in most cases the wishes of the patient are considered first. The patient is usually asked to sign a form stating that he/she is aware of leaving the facility against medical advice, and the term AMA is used on all reports concerning the patient. This is for legal purposes – in case there are complications – to limit liability on the part of the facility.

In a mental hospital setting, a patient is typically allowed to check out of the hospital by giving at least a day's notice (although in some jurisdictions the time may vary, depending on whether the patient is under "formal" or “informal” voluntary commitment). This is so that if the doctor feels that the patient would be a danger to him/herself or others, the doctor has time to begin commitment proceedings against the patient to compel the patient to remain in the hospital for treatment.

Mental health law is that area of law which deals with mental conditions. This includes areas in both common law and statute law. Common law, which is based on case law rather than statutes, includes such concepts as insanity defenses, sane and insane automatism, and mens rea (Latin term for “guilty mind”), among others.

Statute law usually takes the form of a Mental Health Act or equivalent. An example is the Mental Health Act 1983 in England. This act sets codes for the aspects of the treatment of mental illness and provide rules and procedures to be followed, with penalties for breaches.

Mental Health Acts are largely used in the management of psychosis, where a person has lost the ability to test reality. They may also be used for other conditions as well, including psychiatric disorders such as Borderline Personality Disorder. The laws generally allow for compulsory (mandatory) treatment in a psychiatric hospital or in the community.

In some jurisdictions, court orders are required for compulsory treatment; while in other jurisdictions, treating psychiatrists can treat the patient compulsorily by following set procedures. In the latter case, there are usually methods of appeal or regular scrutiny to ensure compliance with the law. Not all countries have Mental Health Acts, however.

About the Author

David Oliver is the founder of a one stop source of information on how to cope and deal with borderline personality disorder.

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