Discretionary Use of Involuntary Commitment by Case Managers of Mental Health Clients: A Case Study of Divergent Views

In an exploratory study, case managers held divergent views about their appropriate roles in involuntarily committing clients to psychiatric care. In light of vague organizational guidelines about appropriate use of involuntary commitment, case managers drew on professional social work values to form views about commitment. These values supported client self-determination, but did not clearly delineate ways for case managers' use of power and discretion concerning involuntary hospitalization, resulting in a range of understandings among case managers. This article provides a history of discretionary choices in the helping professions, cases illustrating divergent views about commitment among case managers and consequences for clients, and a discussion of ways this range may be narrowed in the future.