Clinical decision making during assessment for involuntary psychiatric admission.

Twenty-four clinicians (five psychiatrists, five registered nurses, and 14 counselors) participated in a psychophenomenological study of the decision-making process in assessing clients for involuntary psychiatric hospital admission. In interviews, the clinicians were asked to describe a situation in which the admission assessment was especially difficult. Analysis of the interviews identified nine essential structural elements of the decision-making process: systematic and individualized process, state-mandated criteria, investigation of alternatives, decision not made alone, intuitive reasoning, connection with the client, caution, and inability to control all contingencies.