Legal and Ethical Issues Related to Psychiatric Emergencies

Legal and Ethical Issues Related to Psychiatric Emergencies

An emergency hold suggests a person is being detained against their will. Simultaneously, officials examine their eligibility for involuntary civil commitment. These are all synonyms for an emergency hold. The guardian must apply for residential care and assistance on behalf of the person who can make choices. However, the guardian must report on the person’s health at least once a year. To keep the individual for another year, the guardian must explain to the court why they need to keep them in a facility. Involuntary treatment of mental illness for days or weeks at a civil institute for mental illness An emergency hold is the most fundamental civil restriction of liberty in the US. It is often used in the days before a committee hearing. Involuntary commitment violates the constitutional rights to autonomy, liberty, and due process, as well as the right to a fair trial. A guardian must petition the court to commit an incapable individual to an inpatient mental health hospital in Texas.

Involuntary Psychiatric Holds

The legislation specifies the following requirements for involuntary hospitalization: The patient must be hazardous to himself or others, unable to care for themselves, and helpless. Police and healthcare practitioners may place involuntary psychiatric holds. In Texas, involuntary mental commitment patients must get basic therapy within 12 hours of admission (Jones et al., 2021). Then they may opt to stay in or go out-patient. After 48 hours, if the patient still refuses to participate, the healthcare staff must determine whether to discharge them or seek mental health help. After discharge, the individual may be picked up by a guardian who willingly admits to it if the person agrees, or they may go home if they are psychologically fine (Lee & Cohen, 2021). If it is a young individual, the court may choose a parent or guardian.

Capacity and Competence in Mental Health

This is particularly true when it comes to competence and capacity, an ethical and legal minefield that, if not properly understood or handled, may result in patient harm and legal action against medical practitioners. Capacity is a functional assessment of an individual’s ability to make a medical decision in a given situation (Whitney & Peterson, 2019). This is based on the patient’s baseline abilities, is situation-specific, and takes into account the severity of the possible consequences. On the other hand, competence is described as “an individual’s capability to engage in legal procedures. Legal competence is presumed; rebutting an individual’s ability requires a hearing and presentation of evidence (Jones et al., 2021). A judge judges someone’s competence. Never are medical practitioners the ones who make this legal determination. This phrase will not be used in this article since providers are not responsible for making this judgment.

Legal and Ethical Considerations

Confidentiality is a significant legal and ethical concern. In common law countries, solicitors (or lawyers) are required to respect the confidentiality of their client’s affairs. Solicitors may get private information about their client’s affairs, which must not be used for the benefit of anybody not expressly authorized by the client (Lee & Cohen, 2021). When the idea of confidentiality collides with other ethical requirements, such as avoiding damage to the patient or others, secrecy difficulties arise… It highlights potential committee subjects and provides some ethical and legal frameworks for deliberating on them.

Evidence-Based Violence Risk Assessment

Evidence-based violence risk assessment methods provide all healthcare practitioners with a common frame of reference and expertise, enabling them to screen patients for probable violence. This minimizes the possibility of miscommunications about an individual’s capability for violence being misconstrued. For example, the Triage Tool evaluates a patient’s potential threat to others or to himself/herself, which may manifest as a problem in the healthcare context.

References

Jones, N., Gius, B. K., Shields, M., Collings, S., Rosen, C., & Munson, M. (2021). Investigating the impact of involuntary psychiatric hospitalization on youth and young adult trust and help-seeking in pathways to care. Social psychiatry and psychiatric epidemiology, 56(11), 2017-2027.

Lee, G., & Cohen, D. (2021). Incidences of involuntary psychiatric detentions in 25 US states. Psychiatric services, 72(1), 61-68.

Whitney, D. G., & Peterson, M. D. (2019). US national and state-level prevalence of mental health disorders and disparities of mental health care use in children. JAMA pediatrics, 173(4), 389-391.

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In 2–3 pages, address the following:

Explain your state (Florida) 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.