Acute episodes of mental illness temporarily destroy the capacity required to give informed consent and often prevent people from realizing they are sick, causing them to refuse intervention. Once a person refuses treatment, the only way to obtain care is as an involuntary patient. Even in the midst of acute episodes, many people do not meet commitment criteria because they are not likely to injure themselves or others and are still able to care for their basic needs. Left untreated, the episode will likely spiral out of control.
Judy A. Clausen,
Making the Case for a Model Mental Health Advance Directive Statute,
Yale J. Health Pol'y L. & Ethics
Available at: https://digitalcommons.law.yale.edu/yjhple/vol14/iss1/1