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Legal issues also come in to play when an individual needs treatment but is refusing it. There are laws in North Carolina that govern both inpatient and outpatient commitment. Sometimes, it is necessary for a person with severe mental illness to be hospitalized against his or her will. This process is called involuntary inpatient commitment.

For people to be committed as an involuntary patient, they must meet two conditions:

  • Have a mental illness
  • Be a danger to self or others

These facts must be presented to the magistrate in your community, in the form of a petition. The petition must state the facts of the case, and the information should come from someone who has direct information about the facts. Some examples of dangerousness are if a person has hurt himself or someone else; is threatening to hurt himself or someone else; is not providing for his basic needs, such as by not eating; or is engaging in dangerous behaviors, such as walking into traffic or going outside wearing little or no clothes when the weather is very cold. The magistrate will review the facts stated on the petition, and if the magistrate agrees that the two conditions are met, he or she will issue a custody order that requires the local police or sheriff to pick up the individual and take them to the nearest psychiatric facility for a psychiatric evaluation. If the evaluating psychiatrist agrees that the person meets the two conditions, the person will be admitted to an inpatient facility. The patient will then be evaluated by a second psychiatrist within 24 hours. The person who is admitted involuntarily has the right to a court hearing within 10 days of his admission. At this hearing, the person will go before a judge. If the person contests his admission and makes a convincing case before the judge, he may be released. An attorney will be available to represent the patient in the commitment hearing. At a commitment hearing, a person may get up to 90 days of commitment time. However, the length of stay in the hospital is determined by the treating physician, and it is likely that the admission will be brief, given the current preference for shorter inpatient stays. When a person is under an involuntary inpatient commitment, he still has the right to refuse treatment. Under certain conditions, the treating psychiatrist may use forced medications.