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.

 

LEARNING RESOURCES

Required Readings

· Buppert, C. (2021).  Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

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· Chapter 7, “Negligence and Malpractice”

· Chapter 8, “Risk Management”

· Chapter 16, “Resolving Ethical Dilemmas”

· National Institute for Health and Care Excellence (2019).  Br ø set violence checklistLinks to an external site. . http://riskassessment.no/

· Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015).  Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

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· 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.

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· Chapter 19, “Legal Issues in the Care and Treatment of Children With Mental Health Problems”

· Chapter 64, “Suicidal Behavior and Self-Harm”

· U.S. Department of Veterans Affairs. (2019).   VA/DoD clinical practice guidelinesLinks to an external site. : Assessment and management of patients at risk for suicide (2019). https://www.healthquality.va.gov/guidelines/MH/srb/

· Zakhari, R. (2021).  The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.

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· Chapter 15, “Violence and Abuse”

 

 

 

THE ASSIGNMENT

In 2–3 pages, address the following:

· Explain Texas 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.

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

· 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 :

a) patient autonomy,

b) EMTALA,

c) confidentiality,

d) HIPAA privacy rule,

e) HIPAA security rule,

f) protected information,

g) legal gun ownership,

h) career obstacles (security clearances/background checks),

i) 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.