Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example

Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example

Psychiatric emergency predisposes individuals and those closest to them to harm. Psychiatric-Mental Health Nurse Practitioners (PMHNPs) are not equally immune to the challenges associated with acute behavioral disturbances that arise from psychiatric emergencies. Different states have different approaches to psychiatric emergencies, including care coordination, resource availability, and legal implications, with similar goals of protecting individuals from themselves and others. This paper examines psychiatric emergencies, the ethical and legal issues surrounding the associated events, and explains evidence-based suicide and violence risk assessments.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

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.

Florida Baker Act provides the guidelines for involuntary psychiatric holds. The Baker Act allows health care personnel, including doctors, mental health experts, law enforcers, and judges to commit an individual to a mental health intervention for a maximum of 72 hours (Florida Legislature, n.d.). The Baker Act dictates that individuals show certain violent or suicide ideation signs of mental health. The 72 hours allow time for psychiatric evaluation to de-escalate the crisis. The psychiatric evaluation is critical in determining the underlying mental health issues and individuals released upon determining that they are not a danger to themselves or others. However, when the individual is deemed dangerous, they are admitted to a psychiatric facility. The court, law enforcement, medical personnel, or mental health experts can enforce the Baker Act.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.

Emergency hospitalization for evaluation refers to a medical stay usually up to 72hrs in a psychiatric facility or hospital to allow an individual’s mental state to be evaluated by a psychiatrist or clinical psychologist (Hedman et al., 2016). Impatient commitment refers to the involuntary hospitalization of a mental health patient who is deemed dangerous for themselves and others following 72 hours of psychiatric hold (Fariba & Gupta, 2020). In Florida, mental health experts, judges, or law enforcement officers can initiate the process, and there must be evidence of danger to self and others. Outpatient commitment refer to a legal procedure that compels an individual diagnosed with severe mental health illness to comply with an outpatient treatment plan intended to prevent psychiatric deterioration or recurrence (Swartz et al., 2017). In Florida, individuals may be subjected to involuntary psychiatric examination and held for 72 hours if they fail to comply with court-ordered outpatient treatment.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

Explain the difference between capacity and competency in mental health contexts.

In a psychiatric context, capacity refers to an individual’s ability or competency to make a medical decision relative to a patient’s abilities of their present situation, the severity of their condition, and potential repercussions (Libby et al., 2018). On the other hand, competency refers to an individual’s ability to play a role in legal proceedings (Libby et al., 2018). Individuals are deemed legally competent until proven through the presentation of evidence and hearing.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

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.

The selected topic is confidentiality. Nurses are legally required to keep safe and private patient health information, which is crucial in building a robust psychiatrists-patient relationship (Tariq & Hackert, 2018). However, moments of breaching confidentiality for a third party’s benefit is a critical ethical challenge associated with respecting a patient’s right to confidentiality. For instance, other health care personnel can access electronic health recordings. In psychiatric health, health care personnel are obliged to protect patients. However, when a mental health patient is at risk to self or others, her mental health conditions can be shared with other mental health personnel to establish mitigation strategies and protect other patients.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

Identify one evidence-based suicide risk assessment that you could use to screen patients.

I can use the Columbia-Suicide Severity Rating Scale (C-SSRS) to screen patients for suicide risk. C-SSRS is an evidence-based scale used nationally and internationally in assessing suicidality (Interian et al., 2018). The scale is available in over 103 different languages and can be used successfully in various settings. The C-SSRS is a validated and reliable tool to identify suicide attempts, present, and future suicidality, and self-injury behaviors. The scale has specific behavior indicative of suicide ideation.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

Identify one evidence-based violence risk assessment that you could use to screen patients.

I can use the Violence risk appraisal guide (VRAG-Revised) tool to assess the risk of violence among individuals. VRAG-Revised assesses the risk of violent recidivism depending on maladjustment and an individual’s age (Helmus & Quinsey, 2020). The tool is well-validated and reliable in assessing violence. (Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)

References

Fariba, K., & Gupta, V. (2020). Involuntary Commitment(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example). https://www.ncbi.nlm.nih.gov/books/NBK557377/

Florida Legislature. (No date). The 2021 Florida Statutes: The Baker Act. Available at: (Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)http://www.leg.state.fl.us/statutes/index.cfm?App_mode=Display_Statute&URL=0300-0399/0394/0394.html (Accessed March 17, 2022)

Hedman, L. C., Petrila, J., Fisher, W. H., Swanson, J. W., Dingman, D. A., & Burris, S. (2016). State laws on emergency hold for mental health stabilization. Psychiatric Services, 67(5), 529-535.(Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example) https://doi.org/10.1176/appi.ps.201500205

Helmus, L. M., & Quinsey, V. L. (2020). Predicting violent reoffending with the VRAG‐R: overview, controversies, and future directions for actuarial risk scales. The Wiley handbook of what works in violence risk management: Theory, research, and practice, 119-144. http://dx.doi.org/10.1002/9781119315933.ch6   

Interian, A., Chesin, M., Kline, A., Miller, R., St. Hill, L., Latorre, M., … & Stanley, B. (2018). The Columbia-Suicide Severity Rating Scale (C-SSRS) is used to classify suicidal behaviors. Archives of Suicide Research, 22(2), 278-294. (Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)https://doi.org/10.1080/13811118.2017.1334610

Libby, C., Wojahn, A., Nicolini, J. R., & Gillette, G. (2018). Competency and capacity. https://www.ncbi.nlm.nih.gov/books/NBK532862/

Quinsey, V. L. (2019). Violence risk appraisal guide (VRAG) and the violence risk appraisal guide-Revised (VRAG-R). (Legal and Ethical Issues Related to Psychiatric Emergencies Comprehensive Nursing Essay Example)http://dx.doi.org/10.4135/9781483392240.n531

Swartz, M. S., Bhattacharya, S., Robertson, A. G., & Swanson, J. W. (2017). Involuntary outpatient commitment and the elusive pursuit of violence prevention: a view from the United States. The Canadian Journal of Psychiatry, 62(2), 102-108. https://dx.doi.org/10.1177%2F0706743716675857

Tariq RA, & Hackert P.B. (2018). Patient Confidentiality. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2021. PMID: 30137825. https://europepmc.org/article/nbk/nbk519540