NRNP 6675: PMHNP Across the Lifespan II: Legal and Ethical Issues Related to Psychiatric Emergencies

NRNP 6675: PMHNP Across the Lifespan II: Legal and Ethical Issues Related to Psychiatric Emergencies

NRNP 6675 PMHNP Across the Lifespan II Legal and Ethical Issues Related to Psychiatric Emergencies

PMHNP Across Lifespan II: Legal and Ethical Issues Related to Psychiatric Emergencies

Mental health problems are a crucial concern in any society. Mental health problems have considerable impact to the affected patients and significant others. They include loss of productivity, decline in the quality of life, and premature mortalities. Psychiatric mental health nurse practitioners play an important role in the provision of care that addresses the health needs of the affected populations. In doing so, they must provide care that align with the legal requirements in their states and their scopes of practice. Therefore, the purpose of this paper is to explore the different legal requirements that guide the different types of care given to mental health patients in the state of California.

Involuntary Psychiatric Holds in California

The state of California has adopted Code 5150, section 5150 to guide the decision to place patients with psychiatric conditions on involuntary hold. The law set by the state requires patients to be placed on involuntary hold for 72 hours. A patient is placed on involuntary hold if the patient has mental health disorder, psychosis or distress and is at a risk of harm to self and others. The patient must also be gravely disabled to be placed on involuntary hold. The individuals that can place a patient to an involuntary hold include police officers and mental health professionals(Admin, 2021). The patient must be closely observed during the period of hold and make appropriate recommendations on whether to discharge or prolong patient hospitalization beyond the 72 hours.

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The above requirements also apply to involuntary hold for minors. The law requires that minors must be provided care in the least restrictive manner that is possible to promote safety. Involuntary hold applies for minors if they have an acute mental health event, threat to self and others, and is gravely disabled. Support should be provided with a focus being on ensuring their participation in their care as much as possible. The duration for hold is like that of the adults. Psychiatric mental health nurse practitioners can only release the emergency hold(Admin, 2021). A person close to the patient such as parents, siblings or guardians can pick up the patient after release of hold.

Differences

Emergency hospitalization for psychiatric hold or evaluation in California occurs in situations where the patient is a danger to

NRNP 6675 PMHNP Across the Lifespan II Legal and Ethical Issues Related to Psychiatric Emergencies
NRNP 6675 PMHNP Across the Lifespan II Legal and Ethical Issues Related to Psychiatric Emergencies

self, others, and gravely disabled. The hold aims at ensuring patient assessment for further healthcare needs. Outpatient commitment in California applies to patients that do not demonstrate being of any threat to self and others. It works like outpatient services for patients with mental health problems. Inpatient commitment applies to patients that may be a threat to self and others(DHCS, n.d.). It also applies to those who are vulnerable to environmental threats.

Capacity vs. Competency

Capacity in mental health entails the ability of the patient to make decisions. Capacity depends largely on patient’s cognition. On the other hand, competence refers to the ability of a patient with a mental health problem to engage in activities that are needed to achieve the outcomes of the decisions made. Unlike capacity which a physician determines, a judge determines patient’s competency (Fosbre, 2022).

Selected Topic

The HIPAA privacy rule permits the disclosure and used of the patient’s protected health information without seeking their permission or authorization. The rule provides some flexibility in the use of protected health information in situations where healthcare providers must make decisions to save patients’ lives. The rule raises the ethical concern of breaching patients right to autonomous care. It also raises ethical issues related to inappropriate use of patient’s data in the care process (Fosbre, 2022). One of the evidence-based practice suicide risk assessment that I could use to screen patients is the Ask Suicide-Screening Questions and Slapped, Things and Threaten tool for violence.

Conclusion

California has developed rules to guide involuntary holds and requirements for different admissions and treatment. The police and psychiatric mental health practitioners can institute psychiatric holds. The HIPAA privacy rule raises ethical and legal concerns. Evidence-based treatments should be utilized for mental health problems.

NRNP 6675: PMHNP Across the Lifespan II: Legal and Ethical Issues Related to Psychiatric Emergencies References

Admin, W. (2021, August 15). The 5150 Hold California Code Explained. ELEVATE Wellness Center. https://elevatewellnesscenter.com/5150-hold/

DHCS. (n.d.). Rights For Individuals In Mental Health Facilities.

Fosbre, C. D. (2022). Varcarolis’ Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care. Elsevier Health Sciences.

As we begin this session, I would like to take this opportunity to clarify my expectations for this course:

Please note that GCU Online weeks run from Thursday (Day 1) through Wednesday (Day 7).

 

Course Room Etiquette:

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Discussion questions:

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