Apart from a few dissenting perspectives, social workers have not coherently engaged with the moral dilemmas inherent in the profession’s participation in coercing or mandating patients to mental health treatment. With roots in the development of asylums in 1400s Western Europe, involuntary mental health services continue to rely on processes involving the state in order to detain individuals who are deemed severely mentally ill. Legal precedent and practices in the United States as they pertain to involuntary mental health treatment reflect tensions about promoting individual freedom while maintaining safety. Given the diversity of circumstances that social workers may navigate in this particular area of practice, the profession’s ethical commitments to self-determination are potentially in conflict with practices of involuntarily hospitalizing or providing mental health services to individuals. In fact, international health and human rights bodies have weighed in on the role of coercion in mental health treatment, advocating for decreased use of coercive means of confining and treating patients with severe mental illness. Critical perspectives on involuntary mental health services are often rooted in the critiques of psychiatric consumer/survivor/ex-patient organizers, who argue that detaining patients against their will and mandating them to participate in treatment or take medication is a form of violence that violates their rights. There are also some promising approaches to severe mental illness that promote self-determination and attempt to reduce the likelihood of involuntary or coerced treatment, reorienting toward the value of peer support and denouncing the use of nonconsensual active rescue in crisis hotline work. Abolitionists also advocate for the elimination of involuntary mental health services, advocating instead for the development of non-coercive forms of crisis response and care that rely on alternatives to the police.
