Laws for Involuntary Psychiatric Holds

In [Your State], involuntary psychiatric holds are governed by [relevant state statutes]. These laws allow for the temporary detention of individuals who pose a significant risk of harm to themselves or others due to a mental health condition.

Who Can Hold a Patient and for How Long:

• Individuals who can hold a patient: Typically, individuals who can initiate an involuntary hold include:
  • Law enforcement officers
  • Mental health professionals (e.g., psychiatrists, psychologists)
  • Family members or other concerned parties
• Duration of the hold: The initial hold typically lasts for [number] days. However, it can be extended for additional periods if a court determines that the individual remains a risk to themselves or others.

Who Can Release the Emergency Hold:

• Mental health professionals: Psychiatrists or psychologists can often release an individual from an involuntary hold if they determine that the individual no longer poses a significant risk.
• Courts: In some cases, a court may need to order the release of an individual from an involuntary hold, particularly if there is a dispute about the individual’s mental health status or the need for continued detention.

Who Can Pick Up the Patient After a Hold is Released:

• Designated individuals: The patient can typically designate a family member or friend to pick them up after they are released from an involuntary hold.
• Hospital staff: If the patient does not have a designated individual, hospital staff may be able to assist with transportation arrangements.

Differences Among Emergency Hospitalization, Inpatient Commitment, and Outpatient Commitment

• Emergency hospitalization for evaluation/psychiatric hold: This is a temporary detention for the purpose of evaluating an individual’s mental health status and determining whether they pose a risk to themselves or others. It is typically initiated by law enforcement or mental health professionals.
• Inpatient commitment: This is a longer-term hospitalization that is ordered by a court after a hearing. It is typically used for individuals who pose a significant risk to themselves or others and require intensive treatment in a hospital setting.
• Outpatient commitment: This is a court-ordered requirement for an individual to participate in outpatient mental health treatment. It is often used as an alternative to inpatient hospitalization for individuals who pose a less severe risk.

Capacity vs. Competency

Capacity refers to an individual’s ability to make informed decisions about their own healthcare. It is a medical judgment that takes into account factors such as cognitive function, understanding of information, and ability to communicate preferences.

Competency is a legal term that refers to an individual’s ability to understand the nature and consequences of their actions and to make rational decisions. It is often relevant in legal proceedings, such as criminal trials or determinations of guardianship.

Legal and Ethical Issues in Treating Psychiatric Emergencies

Topic: Patient Autonomy

• Legal issue: The right of patients to make informed decisions about their own healthcare, including the choice of treatment and the right to refuse treatment.
• Ethical issue: Balancing the patient’s right to autonomy with the healthcare provider’s duty to protect the patient from harm.

Evidence-Based Assessments

Suicide Risk Assessment:

• Columbia-Suicide Severity Rating Scale (C-SSRS): A widely used tool for assessing the severity of suicidal ideation and behavior.

Violence Risk Assessment:

• Historical-Clinical-Risk Management-20 (HCR-20): A structured professional judgment instrument for assessing the risk of violence in individuals with mental health disorders.

These assessments can be valuable tools for clinicians to identify patients who may be at risk of harming themselves or others and to develop appropriate treatment plans.