Avoiding Liability Bulletin – September 2026
Psychiatric/Mental Health Nursing is a specialty of nursing practice that requires not only knowledge of the general legal issues relating to nursing practice but also to their application to the specific legal rights of patients who undergo mental health treatment.
The additional legal protections are especially important to protect when a person is involuntarily admitted for such treatment. In most states, an involuntary admission requires an individual to be a danger to self or others and/or be mentally ill, or other criteria (such as an inability to care for his or her own basic needs).
Moreover, state and federal constitutional issues are raised with an involuntary admission. These issues include protection under the United States’ Constitution 14th Amendment (due process, privacy, the right to refuse treatment) and its 8th Amendment’s protection against cruel and unusual punishment, especially if medications and other treatments are ordered.
In the following case, People v. Scott A.,(In re Scott A.), 4-25-0435, Ill. App. 4th, December 19, 2025, whether the state statute for involuntary admissions was followed was at issue.
Facts Leading Up to Case
The male patient was admitted to the ICU of a hospital after attempting to take his life with an overdose of medication. A nurse at the hospital completed a petition for involuntary admission under the state’s mental health code. She asserted that the patient was in need of “immediate hospitalization” to prevent him from harming himself.
She also noted in the petition that the patient’s family was “unknown due to patient not able to provide further information.” An attachment to the petition, signed by the same nurse, stated she provided the patient with a copy of the petition and a statement of his rights under the state mental health code.
A psychiatrist signed an inpatient certificate attached to the petition and stated the patient should be involuntarily admitted immediately. The petition was filed with a state circuit court. A second psychiatrist filed a second inpatient certificate supporting the involuntary admission.
Once stabilized, he was admitted to the adult psychiatric unit of the hospital.
A hearing on the petition was held at the hospital 7 days after the petition in the circuit court was filed. The patient’s attorney was present at the hearing.
The patient’s attorney made a motion to strike the petition because the State had not submitted a written predispositional report. The State acknowledged that it did not submit the report but stated that all the necessary information was in the patient’s medical records which were admitted into evidence.
One of the psychiatrists who signed one of the inpatient certificates and had daily contact with the patient diagnosed him with major depressive disorder. This suicide attempt was the third is six weeks. As a result, the psychiatrist again recommended inpatient hospitalization, either at the hospital or at a state mental health facility. The psychiatrist believed that inpatient hospitalization was the least restrictive setting for the patient since the patient’s prior history did not support outpatient treatment or partial hospitalization.
Given the patient’s elevated risk for suicide in the future, the psychiatrist also recommended continued evaluation of his medications and participation in individual and group therapy. Although difficult to determine, the psychiatrist deemed it would take “a few weeks” for the patient to leave the hospital safely.
The trial court found that the petition’s assertions were proven by clear and convincing evidence that involuntary hospitalization was necessary and granted the petition. The court also concluded the State had “sufficiently complied” with the statutory requirement with the patient’s admitted medical records and the testimony of the psychiatrist.
The court ordered involuntary commitment for the patient either at the hospital or another psychiatric facility for up to 90 days.
The patient appealed that decision to the state appellate court, asking that the order for involuntary admission be reversed because the petition was deficient in failing to notify his family or take steps to locate his family and due to the failure of the State to provide the require written report prior to a determination of involuntary admission.
Appellate Court Analysis and Decision
The appellate court reviewed the state mental health code and prior court decisions interpreting the code. In reversing the decision of the trial court’s granting of the petition, the appellate court held that:
- Strict compliance with state statutory requirements governing involuntary admissions is essential due to important liberty interests (rights) of individuals
- The State did not comply with the requirement of a predispositional report, nor did the patient’s medical records provide the requisite information
- No family members were contacted or attempted to be contacted as required even when identities of an ex-wife, a brother, several adult children, friends, and a daughter were included in the patient’s medical records
Guidelines From This Case
The case does not indicate whether the nurse was an RN or an APRN. Although she may have been correct in assessing the patient as needing immediate hospitalization to prevent further harm to himself, she falsely documented that the family was unknown and could not be contacted. What prompted her to document this misinformation is not clear. To begin with, the information was available in his records, as the appellate court pointed out. The documentation was a falsehood that was easy to discover. Unfortunately, the patient was required to contest this misinformation and he was successful, but his efforts should never have had to be undertaken.
Know that any falsification in a patient’s record can clearly result in you being terminated from your job. It can also result in a professional disciplinary proceeding by your state board of nursing.
The case also illustrates the importance of you knowing and complying with your state mental health code and its rules. Keeping abreast of that law and its rules can be easily done through workshops, seminars, and continuing education programs.
The decision of the appellate court does not stand for the fact that the patient did not need treatment for his many suicide attempts due to major depression.
What it does stand for is that if a person does need treatment for depression and potential suicide, the person’s right to be assessed consistent with his rights constitutional rights and state laws in support of those rights must be adhered to.
It also supports a patient’s right to the least restrictive alternative treatment setting. Out-patient treatment or partial hospitalization is much less restrictive than involuntary confinement in a facility. It is not a treatment option for everyone, however.
Here, the patient’s hospital psychiatrist did not think the patient was suited for a lesser restrictive treatment option. If true, that decision was not well supported consistent with the state’s mental health code.
Although the case is not binding on state courts in future case, it is a persuasive case that highlights shortcuts in the assessment and documentation of those being considered for involuntarily mental health treatment cannot be upheld when health care providers and health care facilities fail their legal and ethical duties.
This information is for educational purposes only and is not to be taken as specific legal or other advice by the reader. Nor does it create an attorney-client relationship. If legal or other advice is needed, the reader is encouraged to seek such information from a nurse attorney, attorney or other professional.
