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> Generally, if the patient is cognizant it’s extremely hard to force them into an involuntary hold. Sometimes patients will agree to a voluntary, involuntary hold to force themselves to commit to a treatment plan, but if they’re fighting it from the start, it’s hard to get it approved.

That is absolutely, entirely inaccurate. As a paramedic, I've cared for and transported probably hundreds of cognizant and lucid patients who nevertheless were a danger to themselves or others, or gravely disabled (i.e. not self harm, but unable to effectively care for themselves).

The judge is specifically a judge who has received extra training in mental health issues, and the patient is appointed an advocate and a MHP who must present the risks. Describing overcoming that obstacle as "extremely hard" is not a sentiment that I've seen.

> Further, “he checked himself out” isn’t necessarily a thing. He could leave against medical advice or he could have simply told the staff that he decided against treatment.

I think this is being overly pedantic. Yes, he may have AMA'd. Most non-professionals would consider that "checking yourself out" regardless of the formalities of discharge process.



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