The Negotiation of Voluntary Admission in Chicago's State Mental Hospitals

Abstract

This study examines the admission of emergency certified patients to Chicago's state mental hospitals and the process by which patients decide to sign a voluntary admission form. Involuntary commitment is rarely used to admit Chicago's state mental patients. Patients, staff and court personnel negotiate with a common interest in avoiding commitment court.

Hospital staff use three different strategies to convince emergency certified patients to admit themselves voluntarily and avoid involuntary commitment: persuasion/coercion, bartering and stalling. Similar strategies are employed to discourage voluntary patients’ requests for release. Hospital staff in Chicago are disinclined to commit patients because they feel pressured to discharge the majority of patients as quickly as possible to make room for a steady flow of new admissions. Workers manage their caseload by choosing the most expedient form of admission, which is to obtain their patients’ signatures on a voluntary admission form. In order to accomplish this task, however, hospital staff sometimes circumvent legal standards of voluntariness in the admission process.