Where I live there is an involuntary commitment process (separate from the common 72-hour hold) for people with severe and persistent mental health issues wherein the client is court ordered to participate in recommended treatment (usually including medications and therapy). There is typically a 30 day review process as well, which includes a review by another professional (not the ongoing therapist and/or psychiatrist) to assess mental status, compliance with treatment, etc. Eventually, if the individual is stable for a given period, the commitment can be lifted, but only by the court and only after a period of demonstrated compliance.