We will discuss the challenges and limitations faced while treating a 30-year-old male with major depressive disorder with psychotic features who severely restricted food and drink with resultant life-threatening weight loss. He refused to consent to medical and psychiatric treatments and interventions. We outline the clinical course and the care coordination among various medical, psychiatric, and correctional staff that resulted in a positive outcome for the patient.

Educational Objectives

• Discuss the important medical complications associated with prolonged starvation in a patient exhibiting psychosis
• Review the Washington state Department of Corrections policy for involuntary hydration and tube feeding
• Describe the multidisciplinary team approach to providing effective medical and mental health treatment

Level Advanced