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Mental Health Law
Terms in this set (25)
Based on state law in this scenario, when will Mr. Seib need to be evaluated by a psychiatrist?
Before 0930 the next day.
Most state laws require evaluation within 24-48 hours of admission. In Mr. Seib's state the requirement is 24 hours.
Mr. Seib tells the nurse that he does not understand why he is being admitted to the hospital. What is the best response by the nurse?
Explain the legal process of his involuntary admission in simple and direct terms
When the patient is involuntarily committed, the nurse may explain the legal process in simple and direct terms. This may promote a positive reaction and acceptance by the patient.
Why are laws needed to govern the care of patients with mental illness?
Laws are established for the protection of the patient and the public.
Because many patients with mental illness suffer from problems with disorientation and reality testing, it is essential that nurses are aware of and follow the laws designed to protect these patients.
What is the purpose of an emergency hospitalization for a patient with a mental illness?
Cares for patients who are a danger to self or others and refuse voluntary treatment
Patients are admitted on an emergency basis when they are considered a danger to self or others or cannot meet his or her basic needs.
A patient on a 24-hour emergency psychiatric hold is believed to need further treatment. In order to keep the patient in the facility, what legal action is required?
Filing of a probable cause statement
A probable cause statement is written, indicating that the person is a danger to self or others or is gravely disabled. This statement is then filed with the court and a hearing takes place to determine if there is just cause to keep the person for treatment.
Mrs. Gilbert is admitted to the geriatric psychiatric unit for medication adjustment. Who should sign the admission paperwork?
As the legal conservator, Mr. Jones should sign all paperwork for Mrs. Gilbert.
During the course of treatment, Mrs. Gilbert's husband calls to obtain information regarding her condition. This information can be released under which circumstance?
If the conservator has authorized release of information to Mr. Gilbert
Information can be released to only parties authorized by the conservator.
What legally qualifies a person to be placed in conservatorship?
The person is gravely disabled because of a mental illness.
A person must be declared gravely disabled by the court system in order to be placed in a conservatorship. This means that they cannot provide food, clothing, or shelter for themselves based on their mental illness.
What are the criteria needed to plead guilty by reason of insanity?
The inability of the individual to understand the charges filed against him or her.
The individual must be able to understand the charges in order to face criminal charges. A person with mental incompetence would not be able to understand the legal system.
The individual does not have the mental capacity to advise an attorney and defend the charges.
A mentally incompetent person would not be able to adequately assist an attorney to defend themselves against criminal charges and may be unable to stand trial by reason of insanity.
The individual does not have the mental ability to understand legal processes and the consequences of the charges.
The individual must be able to understand the legal process and the consequences of the charges. A person declared mentally incompetent would have difficulty understanding consequences.
Match the term with the definition.
Inability of mentally ill to provide for self despite means - Gravely disabled
Prevents recurrent admissions for those in drug therapy - Involuntary outpatient commitment
Incarceration of person who pleads guilty by reason of insanity - Civil commitment
Person appointed to make decisions for gravely disabled - Conservator
Which behavior would qualify for an emergency inpatient psychiatric evaluation?
A young man is threatening to hurt himself.
Behavior that is a threat to self is an indicator for emergency admission.
A woman is threatening to hurt her employer.
Behavior that is a threat to self or others is an indicator for emergency for admission.
A young woman who is gainfully employed has not been caring for herself.
Gravely disabled, as determined by the inability to care for oneself despite having the means to do so, is an indicator for emergency admission.
The nurse is caring for an angry patient on an involuntary emergency hold refusing antianxiety medication. Which is the best response by the nurse?
"I understand you are angry about your admission. This medication can help you relax and we can sit and talk about what brought you here."
The nurse advocates for the patient by explaining the benefits of medication and treatment to the patient during involuntary commitments.
The nurse is caring for a patient with suicidal ideations who has a plan with a high level of lethality. The patient's inpatient psychiatric managed care benefits have expired. Which is the best action by the nurse?
Maintain the patient on inpatient psychiatric care with a high level of suicide observation.
The patient requires high-level inpatient psychiatric care, despite managed care benefits. The nurse could be held liable if the patient harms self or others if discharged based on insurance criteria.
A patient admitted on involuntary status is now calm, cooperative, alert, oriented, and is requesting to be discharged. What is the best response by the nurse?
"You will be evaluated by a psychiatrist shortly and she will work with you to make a determination about your discharge."
Depending on state law, a patient on an involuntary hold will be evaluated within 24-48 hours. Depending on the findings, the patient may be released or kept for further treatment.
A nurse is providing education on the psychiatric involuntary commitment process. Which is true of involuntary commitment?
It is time-limited. The length of an involuntary commitment is time-limited and this time is stated in the legal documentation provided to the patient.
It is determined by state law. The length of time for emergency commitment is determined by state law and is usually 24-48 hours.
The person must be a threat to self or others. A person must be determined to be a danger to self, others, or gravely disabled.
The nurse receives orders from a new resident psychiatrist for a patient being held on an involuntary short-term commitment petition. Which order should the nurse question?
Allow patient to be accompanied by staff to attend son's graduation.
Patients on court order petitions are not allowed to leave the facility, even if accompanied by staff.
A patient presents to the local behavioral health facility requesting admission for severe depression. What type of admission status will this patient fit?
When a patient consents to be admitted and treated, it is considered a voluntary admission.
A patient has been admitted to the inpatient mental health facility after being placed on involuntary status for being gravely disabled. After the involuntary treatment period has expired, the patient is asked to remain in the facility voluntarily. What is the next course of action if the patient refuses to stay?
Ask the patient to sign out against medical advice.
Patients might be asked to remain voluntarily in the facility for further treatment, and if they refuse, they may be asked to sign out against medical advice.
Which situation would indicate a patient might need long-term involuntary outpatient treatment?
The patient is in a court-mandated drug treatment program.
Long-term involuntary outpatient treatment is often used for court-mandated drug treatment programs. This allows regular drug testing, counseling, and group therapy.
The patient had 3 admissions within 2 months due to psychiatric treatment noncompliance. Patients who have proved to be a persistent danger to themselves or others due to noncompliance may be ordered to receive outpatient care to better maintain stabilization and prevent re-hospitalization.
The patient requires a long-term injectable antipsychotic to manage his condition and has demonstrated noncompliance in the past. In order to protect the patient and the public, it is important that psychiatric patients receive scheduled medications. Many will be court-mandated to keep scheduled appointments for psychiatric treatments.
The nurse is evaluating a patient's chart for evidence that supports the need for a long-term involuntary commitment of an inpatient psychiatric patient. Which evidence supports the need for a court petition?
The patient continues to require 1:1 care due to suicidality on day 10 of inpatient care.
Patients who are at a direct risk to self and others and do not respond to short term inpatient treatment are candidates for long-term involuntary treatment petitions.
The patient ranks his depression as a 10 on a scale of 1-10 with 10 being the worse and is actively suicidal.
Severe depression and suicidality indicate a danger to self that may be an indicator for a long-term commitment.
The patient has threatened to harm people at her place of employment if she leaves the hospital and has verbalized a working plan.
Patients who are a danger to others are candidates for long-term involuntary commitments.
A patient in inpatient psychiatric treatment has a conservatee who is not one of her sons or daughter. The nurse receives a call from her son requesting his mother be moved to a different facility. Which is the priority action of the nurse?
Do not discuss the care of Mrs. Smith with her son without the consent of the conservator.
When a patient is on a conservatorship, the conservator speaks for the conservatee on matters involving their mental health treatment. Therefore, the nurse must obtain consent from conservators for decisions that are otherwise made by patients.
A patient who was found wandering in the community, disoriented, and not wearing proper clothing for the weather conditions was brought to the ED. She was also not carrying any identification. Once she is cleared medically, it is determined that she suffers from mental illness. Which type of legal procedure is most appropriate for this patient?
Conservatorship is used for naming a guardian for a gravely disabled person.
A patient in the mental health facility has been charged with a crime. The psychiatrist must evaluate the patient to determine competency to stand trial and the individual indicates that a plea will be entered as not guilty by reason of insanity. Which criteria are used to determine the plea of insanity?
Does the individual understand the criminal charges?
One of the criteria for the plea of insanity is whether or not the individual understands the criminal charges.
Does the individual understand the consequences of the charges?
One of the criteria for the plea of insanity is whether or not the individual understands the consequences of the charges.
Can the individual advise the attorney and defend the charges?
One of the criteria used to determine the plea of insanity is whether or not the individual can advise the attorney to defend the charges.
A conserved older adult is admitted to the acute hospital for an emergent surgical procedure. The patient appears alert and oriented and verbalizes understanding of the need for surgery. How is consent obtained for the necessary procedure?
Conservator is contacted for consent.
When a patient is on a conservatorship, the conservator speaks for the conservatee on matters involving the patient's mental health treatment. Therefore, the nurse must obtain consent from conservators for decisions that are otherwise made by patients.
The nurse is working in the local jail and cares for a number of prisoners with underlying mental illness. What is the focus of the nurse working in the justice system?
Monitoring for compliance with treatment
The nurse working in the justice system must monitor for compliance with treatment.
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