Education for Legal Professionals: Week 3
- If a person voluntarily checks themself into a mental health facility, they are not able to leave the facility unless the attending provider consents. The patient can fill out a form to formally apply to be discharged and the provider has up to 24 hours to agree or decline. IF the provider determines the person is not safe for discharge, the patient can be kept involuntarily. If the provider recommends the patient stays for treatment but is not a current danger to self or others, then the provider can permit the discharge against medical advice.
- Straightjackets are not used (and have not been) in an extremely long time.
- Patients are not kept isolated in “padded rooms.” Patients are encouraged to interact with others and discouraged from isolating themselves in their rooms.
- Cell phones, tablets, and computers are not permitted by patients or visitors.
- Restraints are only to be used as a LAST resort when a patient is actively trying to harm or is in the process of harming themselves or others, and all other attempts by staff to de-escalate the crisis have failed.
- A patient who is brought to a facility for evaluation will be discharged by the evaluating psychiatric provider if they do not meet the criteria for involuntary admission. (People often think that if someone is “Baker Acted” that they will automatically be held for 72 hours. This is not accurate as it depends on the evaluation.)
- Conversely, a person who has been “Baker Acted” can be held longer than 72 hours if they meet criteria for continued involuntary treatment. Though it is not often the case, some patients remain for months and may even be admitted to a state psychiatric hospital when all other options have failed.
- Patients cannot be administered psychiatric medications, even if they consent to taking them and have been on them for years, until the attending psychiatric provider has formally deemed them competent to consent to treatment. The patient also must sign a consent form which is signed by a witness (nurse) and kept in the chart.
- Electroconvulsive therapy (ECT), aka “shock therapy,” is still used.
- Staff cannot lawfully communicate with family or significant others unless the patient consents in writing and it is witnessed, even if the person brought the patient to the facility. The exceptions are:
- if the family member or significant other is their healthcare surrogate, proxy, or guardian, or
- if the patient is actively serving in the military. In this case, their superior would be included in the plan of care.
These are in no particular order and are in the context of adult mental health care.
This is NOT legal advice. If you need legal advice, please consult an attorney. If you have a question for a mental health nurse, ask me!