The only time medications are forced is if the patient is an at that moment a danger to themselves or others (throwing things, causing self harm, etc) and the patient refuses any medications. In which case the doctor can declare a psych emergency. It is used as a last resort. In that case the patient is give the choice to take the psych medications orally or they are given an IM. Again it is used as a last resort and if we can't calm the patient down with seclusion, redirection, etc.