Explain your state laws for involuntary psychiatric holds for child and adult psychiatric emergencies. Include who can hold a patient and for how long
Assignment: Legal and Ethical Issues Related to Psychiatric Emergencies
The diagnosis of psychiatric emergencies can include a wide range of problems—from serious drug reactions to abuse and suicidal ideation/behaviors. Regardless of care setting, the PMHNP must know how to address emergencies, coordinate care with other members of the health care team and law enforcement officials (when indicated), and effectively communicate with family members who are often overwhelmed in emergency situations. In their role, PMHNPs can ensure a smooth transition from emergency mental health care to follow-up care, and also bridge the physical–mental health divide in healthcare.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric
To Prepare
- Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
- Explain your state laws for involuntary psychiatr
ic 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.
Expert Answer and Explanation
Legal and Ethical Issues Related to Psychiatric Emergencies
Legal and ethical issues related to psychiatric emergencies are at the forefront of contemporary healthcare discussions. As the recognition of mental health issues and their impact on individuals and society grows, so does the importance of addressing the complex legal and ethical considerations that surround psychiatric crises (Stoll et al., 2020).
These issues encompass a broad spectrum, including involuntary hospitalization, patient rights, the duty of care, and the balancing act between personal autonomy and the necessity of providing treatment. Understanding and navigating these intricate matters is essential for healthcare professionals and a critical component of upholding the rights and well-being of individuals experiencing psychiatric emergencies.
State Laws for Involuntary Psychiatric Holds
In Maryland, laws regarding involuntary psychiatric holds for both child and adult psychiatric emergencies are in place to ensure the safety and well-being of individuals experiencing acute mental health crises. For adults in Maryland, an involuntary psychiatric hold is typically referred to as a “Petition for Emergency Evaluation” or “Emergency Petition” (Lee & Cohen, 2021). This process allows certain individuals, including law enforcement officers, mental health professionals, or concerned family members, to initiate an emergency evaluation for an adult who is believed to pose a danger to..
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REQUIRED SOURCES
Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
- Chapter 7, “Negligence and Malpractice”
- Chapter 8, “Risk Management”
- Chapter 16, “Resolving Ethical Dilemmas”
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)
- Chapter 23, “Emergency Psychiatric Medicine”
- Chapter 36.2, “Ethics in Psychiatry”
Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.
- Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Problems”
- Chapter 64, “Suicidal Behavior and Self-Harm”
https://www.healthquality.va.gov/guidelines/MH/srb/
Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
- Chapter 15, “Violence and Abuse”
Medication Review
Review the FDA-approved use of the following medicines related to treating psychiatric emergencies:
| Aggression | Behavioral problems | Cataplexy syndrome |
|---|---|---|
| clozapine propranolol zuclopenthixol |
aripiprazole asenapine chlorpromazine haloperidol iloperidone lurasidone olanzapine paliperidone quetiapine risperidone ziprasidone |
clomipramine imipramine sodium oxybate |
| Catatonia | Extrapyramidal side effects | Mania |
| alprazolam chlordiazepoxide clonazepam clorazepate diazepam estazolam flunitrazepam flurazepam loflazepate lorazepam midazolam oxazepam quazepam temazepam triazolam |
benztropine diphenhydramine trihexyphenidyl |
alprazolam (adjunct) aripiprazole asenapine carbamazepine chlorpromazine clonazepam (adjunct) iloperidone lamotrigine levetiracetam lithium lorazepam (adjunct) lurasidone olanzapine quetiapine risperidone sertindole valproate (divalproex) ziprasidone zotepine |
GRADING RUBRIC
| Excellent 90%–100% |
Good 80%–89% |
Fair 70%–79% |
Poor 0%–69% |
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|---|---|---|---|---|---|---|
| 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. |
14 (14%) – 15 (15%)
The response includes a thorough and well-organized explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. |
12 (12%) – 13 (13%)
The response includes an accurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. |
11 (11%) – 11 (11%)
The response includes a somewhat vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. |
0 (0%) – 10 (10%)
The response includes a vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. Or the response is missing. |
||
| • Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. | 14 (14%) – 15 (15%)
The response includes an accurate and concise explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. |
12 (12%) – 13 (13%)
The response includes a well-organized explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. |
11 (11%) – 11 (11%)
The response includes a somewhat vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. |
0 (0%) – 10 (10%)
The response includes a vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. Or the response is missing. |
||
| • Explain the difference between capacity and competency in mental health contexts. | 9 (9%) – 10 (10%)
The response includes an accurate and concise explanation of the difference between capacity and competency in mental health contexts. |
8 (8%) – 8 (8%)
The response includes an accurate explanation of the difference between capacity and competency in mental health contexts. |
7 (7%) – 7 (7%)
The response includes a somewhat vague or incomplete explanation of the difference between capacity and competency in mental health contexts. |
0 (0%) – 6 (6%)
The response includes a vague or inaccurate explanation of the difference between capacity and competency in mental health contexts. Or the response is missing. |
||
| • 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. | 14 (14%) – 15 (15%)
The response accurately and concisely explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. |
12 (12%) – 13 (13%)
The response accurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. |
11 (11%) – 11 (11%)
The response somewhat vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. |
0 (0%) – 10 (10%)
The response vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. Or, response is missing. |
||
| •Identify one evidence-based suicide risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified. | 14 (14%) – 15 (15%)
The response identifies and explains an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included. |
12 (12%) – 13 (13%)
The response identifies an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included. |
11 (11%) – 11 (11%)
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing. |
0 (0%) – 10 (10%)
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing. |
||
| • Identify one evidence-based violence risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified. | 14 (14%) – 15 (15%)
The response identifies and explains an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included. |
12 (12%) – 13 (13%)
The response identifies an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included. |
11 (11%) – 11 (11%)
The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing. |
0 (0%) – 10 (10%)
The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing. |
||
| Written Expression and Formatting – Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. |
5 (5%) – 5 (5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity. |
4 (4%) – 4 (4%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. |
3.5 (3.5%) – 3.5 (3.5%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. |
0 (0%) – 3 (3%)
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. |
||
| Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors |
4 (4%) – 4 (4%)
Contains 1-2 grammar, spelling, and punctuation errors |
3.5 (3.5%) – 3.5 (3.5%)
Contains 3-4 grammar, spelling, and punctuation errors |
0 (0%) – 3 (3%)
Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
||
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list. | 5 (5%) – 5 (5%)
Uses correct APA format with no errors |
4 (4%) – 4 (4%)
Contains 1-2 APA format errors |
3.5 (3.5%) – 3.5 (3.5%)
Contains 3-4 APA format errors |
0 (0%) – 3 (3%)
Contains five or more APA format errors |
||
| Total Points: 100 | ||||||
