The Emotional Impact of Involuntary Treatment

One of the most difficult aspects of my manic and psychotic episode was not the mania itself. It was the experience of involuntary treatment.

For those who have never experienced it, involuntary treatment means being admitted to a mental health hospital against your wishes. Once admitted, many decisions about your life are no longer yours to make. The treating team determines your treatment, your medication, and ultimately when you are considered well enough to leave. The intention is to keep people safe during periods when they may be unable to keep themselves safe. Yet regardless of the intention, the emotional impact can be profound.

For me, involuntary treatment was an extremely isolating experience. What I found most confronting was the loss of control. During the manic episode, I already felt as though my life was moving at a rapid pace and slipping beyond my grasp. Once admitted to the hospital, that feeling intensified. Decisions that I would normally make for myself were suddenly made by others. When I woke up. When I ate. What medication do I take? When I went to bed. How long will I stay in the hospital? Almost every aspect of daily life was determined by someone else.

On the ward, I regularly witnessed people becoming distressed, overwhelmed, or unable to regulate their emotions. Sometimes this resulted in rapid interventions, including injections and sedation. The message was clear: if you lost control, control would be taken from you.

Even when those interventions were necessary, they created an atmosphere where many people felt powerless.

One of the decisions I had control over involved who would be involved in my care. Under the NSW Carers legislation, I was asked who I wanted involved and who I did not. At the time, I chose not to involve my parents. Looking back, I believe this decision was influenced by my mental state and my frustration towards my mother for recognising that I was unwell and arranging the help that ultimately led to my admission. It was a decision I later regretted. Yet it highlights another reality of involuntary treatment: people are often making significant decisions while they are still acutely unwell.

What surprised me most, however, was the isolation. When I was first hospitalised twenty years earlier, patients were taken for daily walks outside the hospital grounds. During my admission in 2023, this was no longer available. Instead, my world was largely reduced to a short hallway and a small enclosed outdoor area. There was no gym. There was little meaningful activity. Very little therapy. Few opportunities for exercise. For more than three weeks, I remained largely confined to the ward. The result was not simply boredom. It was isolation. Many people assume that psychiatric hospitals are full of therapeutic activities and ongoing support. My experience was very different. Much of the day was spent waiting. Waiting for meals. Waiting for medication. Waiting for reviews. Waiting to be discharged. And while waiting, you were often left alone with your thoughts.

This is one of the reasons I believe peer support is so important in mental health settings. During my admission, some of the most valuable support came not from formal treatment but from conversations with other patients who understood what it felt like to be there. They understood the fear. They understood the uncertainty. And they understood the loneliness.

Looking back, I understand why involuntary treatment exists. During severe mania and psychosis, people can be at significant risk to themselves and others. Treatment can save lives. But acknowledging its necessity does not mean ignoring its emotional impact. For many people, involuntary treatment is not only a clinical experience. It is also an emotional one. It can involve fear, loss of control, frustration, loneliness, and a profound sense of disconnection from the outside world.

If there is one thing I hope people understand about involuntary treatment, it is this: Being admitted involuntarily is not just about losing your freedom. It is about losing your sense of agency at a time when you are already feeling vulnerable. And that can be one of the most isolating experiences a person will ever face.