LEGAL AND ETHICAL ISSUES RELATED TO PSYCHIATRIC EMERGENCIES

In 2–3 pages, address the following:

Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long, who can release the emergency hold, and who can pick up the patient after a hold is released.
Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
Explain the difference between capacity and competency in mental health contexts.
Select one of the following topics, and explain one legal issue and one ethical issue related to this topic that may apply within the context of treating psychiatric emergencies: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), and payer source.
Identify one evidence-based suicide risk assessment that you could use to screen patients.
Identify one evidence-based violence risk assessment that you could use to screen patients.

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Sample Answer

 

 

 

Emergency Hospitalization for Evaluation/Psychiatric Hold:

  • Purpose: Briefly hold individuals in a mental health crisis (typically 72 hours) for evaluation and stabilization to ensure their safety and the safety of others.
  • Initiated by: Law enforcement, family members, mental health professionals, or court order.
  • Criteria: Usually involves presenting an imminent danger to themselves or others or being unable to care for their basic needs.

Full Answer Section

 

 

 

  • Rights of the person: Limited access to certain freedoms like leaving the facility, but retain some decision-making regarding treatment.
  • Duration: Temporary hold, unless court orders further evaluation or commitment.

Inpatient Commitment:

  • Purpose: Long-term involuntary hospitalization (weeks or months) for individuals posing a serious threat to themselves or others or are unable to care for themselves.
  • Initiated by: Petition filed by family member, mental health professional, or state agency, followed by court hearing.
  • Criteria: More stringent than emergency hold, requiring evidence of substantial risk or inability to care for basic needs.
  • Rights of the person: Significantly reduced, with limited control over treatment decisions and less freedom within the facility.
  • Duration: Determined by court order, with periodic reviews for possible release.

Outpatient Commitment:

  • Purpose: Court-ordered treatment plan requiring regular attendance at therapy and counseling appointments while living in the community.
  • Initiated by: Similar to inpatient commitment, but court may consider outpatient commitment as less restrictive alternative.
  • Criteria: May be ordered in place of or following inpatient commitment, indicating ongoing need for treatment but with less risk.
  • Rights of the person: More freedom than inpatient commitment, but still have limitations on independent living and choices regarding treatment.
  • Duration: Determined by court order, with periodic reviews for possible termination or modification.

Capacity vs. Competency:

  • Capacity: A person’s general ability to understand the information presented to them and make decisions about their own treatment. This can vary based on the specific decision being made (e.g., medication consent vs. financial decisions).
  • Competency: A legal term referring to a person’s ability to participate in specific legal proceedings, such as a commitment hearing. This typically requires understanding the charges, potential consequences, and ability to assist their attorney.

Remember: These are general explanations, and specific details will vary depending on your state’s laws and procedures. It’s crucial to consult with a qualified mental health professional or attorney for accurate information regarding your specific situation.

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