A 22-year-old voluntary client has been manipulative of staff and disruptive in the milieu. Although the client is not a danger to themselves or others, the client has created challenges for other clients on the unit and is clearly not making progress. The nurse offers prescribed medication, but the client consistently refuses. The staff realizes that legally this client can:

Choice A reason: One-to-one observation for aggressive behavior is a standard safety measure to prevent harm, aligning with the right to safe care. It does not violate client rights when justified by clinical need, as it prioritizes protection without restricting autonomy unnecessarily, making it an appropriate intervention.

Choice B reason: Using physical restraints to prevent self-harm is permissible when less restrictive measures fail, aligning with the right to safety. If properly documented and justified, it does not violate rights, as mental health laws allow restraints for imminent danger, making this action compliant with client rights.

Choice C reason: Searching belongings at admission is standard in psychiatric settings to ensure safety (e.g., removing contraband). This practice, when conducted respectfully and per policy, does not violate client rights, as it prioritizes a safe therapeutic environment for all patients and staff on the unit.

Choice D reason: Lack of documentation of treatment benefits and options violates the right to informed consent. Clients must be informed about treatment rationale and alternatives to make autonomous decisions. Failure to document this breaches legal and ethical standards, undermining the client’s ability to participate in their care, making it a rights violation.

Choice A reason: Legislation changing civil commitment procedures occurred later, notably in the 1960s–1970s, with deinstitutionalization movements. In the 1950s, institutional care was still prevalent, and legislative reforms were not the primary change in mental health treatment, making this option incorrect for that decade.

Choice B reason: Community support services expanded significantly during the 1960s with deinstitutionalization, not the 1950s. While some early community efforts existed, they were not the hallmark change of the 1950s, when institutional care dominated, and psychotropic drugs revolutionized treatment approaches for mental illness.

Choice C reason: The Patient’s Bill of Rights was formalized in the 1970s, not the 1950s. While patient advocacy began to emerge later, the 1950s focused primarily on medical advancements like psychotropic drugs, not legal frameworks for patient rights, making this option incorrect.

Choice D reason: In the 1950s, psychotropic drugs like chlorpromazine were introduced, revolutionizing mental health treatment. These medications effectively managed psychosis, reducing symptoms and enabling outpatient care, decreasing reliance on long-term institutionalization. This marked a significant shift in psychiatric care, making it the key change of the decade.