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Compulsory or Involuntary Treatment

Compulsory treatment is undesirable and should be avoided whenever possible.  

However, situations arise in which compulsory treatment may be necessary, for instance:  

  • Where someone refuses life-saving medical or psychological treatment  
  • Where there is an immediate risk of suicide or self-harm   

When necessary, it is appropriate to treat eating disorders under the Mental Health Act. It has certainly been done before. In some circumstances, such action can be lifesaving. 

Over the age of consent, carers may also obtain a legal order under guardianship legislation permitting them to take temporary control over the person’s care and make decisions on their behalf to authorise medical or psychiatric treatments. Alternatively, the Guardianship Tribunal may appoint a public guardian.

Going to hospital can be an extremely distressing experience for people with an eating disorder, particularly when it is involuntary.  

The way in which you present the prospect of hospital treatment can influence whether a person feels coerced and powerless about what is happening, or whether they feel a sense of agency.

At the very outset of treatment planning, it is helpful to discuss the prospect of hospital as an intensive treatment option that might be required down the track. 

Avoid using hospital as a threat or punishment, for example, for not putting on weight. This can make them feel more resistant to inpatient treatment.    

InsideOut's National Programs manager and mental health nurse, Peta Marks, explains how to introduce the prospect of inpatient treatment to a patient with empathy and compassion.

The idea of going to hospital was incredibly scary for me - and also shameful - I felt like a failure because I couldn’t get better on my own. It was really hard in hospital. But looking back, I can see that is what I needed to help slingshot me towards recovery.Lived experience quote
Seek assistance and advice from specialist eating disorder clinicians where compulsory admission is being considered.  

Whilst it is imperative to be clear and transparent about the imminent risks and need for involuntary treatment, it is important to remember that this will be an incredibly disempowering and distressing time for the person, and empathy, respect and validation will assist in maintaining the therapeutic relationship.  

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