Honor the refusal absolutely — even involuntarily committed patients have the right to refuse treatment.

Recognize that while the patient generally retains the right to refuse treatment, the situation may constitute a medical emergency that justifies intervention without consent. The PMHNP should assess capacity, document the clinical emergency, consult with the treatment team and potentially legal counsel, and initiate life-sustaining interventions following applicable state law and facility policy.

Administer medication covertly in food or drinks to bypass the patient's refusal.

Wait for the patient to become fully unconscious before intervening, as this removes the consent issue.