NRNP 6675 Week8 Assignment Legal and Ethical Issues Related to Psychiatric Emergencies Essay

 NRNP 6675 Week8 Assignment Legal and Ethical Issues Related to Psychiatric Emergencies Essay

 Legal and Ethical Issues Related to Psychiatric Emergencies Essay

Laws for Involuntary Psychiatric Holds in the State of Georgia

The state of Georgia has developed rules that guide involuntary psychiatric holds. The state laws require that involuntary psychiatric holds to be applied when the patient cannot make conscious decisions due to their mental disorder and cannot be cared for without hospitalization. The involuntary holds also apply in cases where delays in psychiatric care act as a source of danger to the patient and other persons and patient actions cause significant material damage to self and others. Patients, relatives, or legal representatives provide consent for involuntary psychiatric care in Georgia. A physician of urgent medical aid or those holding an appropriate certification is responsible for defining involuntary psychiatric care and making the needed request (Matsne.gov., n.d.). The responsible law enforcement agencies undertake patient hospitalization upon request.

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Psychiatrists are required to undertake patient assessments within 48 hours to determine the advisability of involuntary psychiatric care. The commission of psychiatrists uses a majority of votes to make decisions. A clinical head of the psychiatric facility makes the final decision in case when votes are equally divided. A patient is immediately discharged if the involuntary psychiatric admission is deemed unreasonable. The psychiatry institution applies for a court request for the patient admission if found appropriate for involuntary inpatient psychiatric care. The court is obliged to consider the requests within 24 hours of application; otherwise, patients are also immediately discharged (Matsne.gov., n.d.). The significant others of the patient such as relatives or spouses are required to pick up the patient once the hold is released.

Differences among Emergency Hospitalizations for Psychiatric Hold, Inpatient Commitment, and Outpatient Commitment

Differences exist among emergency hospitalization for evaluation/psychiatric hold, outpatient commitment, and inpatient commitment in the state of Georgia. Emergency hospitalization for evaluation/psychiatric hold in Georgia is considered a crisis response that aims at ensuring patient and population safety. Patients with psychiatric illnesses are admitted to a psychiatric facility for psychiatric evaluation for a short period, usually less than 72 hours. Inpatient civil commitment in the state refers to a situation where the court ordered a psychiatric treatment facility to continue treating a patient meeting the state’s civil commitment requirements following the emergency evaluation period. Patients should meet the criteria for involuntary hospitalization for inpatient civil commitment (LegalAid.org, 2022). Outpatient civil commitment is a treatment option where the court orders a person suffering from a mental illness to adhere to the prescribed treatment while residing in their community.

Difference between Capacity and Competency

Capacity and competency in contexts of mental health differ. Capacity is the clinical determination and functional assessment concerning a decision that a physician familiar with a patient with a psychiatric illness. Capacity also entails the determination of an individual’s ability to make decisions in a given situation. Competency in the mental health context is the individual’s ability to take part in legal proceedings (Libby et al., 2022). The judge determines competency and not medical providers.

Selected Topic

The selected topic is patient autonomy. Patient autonomy entails ensuring the protection of the patients’ right to make decisions on issues related to their healthcare needs. Healthcare providers are not expected to influence the decisions that patients make. However, they are expected to educate the patients about their health needs and not make decisions on behalf of their patients. Patient autonomy is an issue associated with legal and ethical issues in mental health practice. Patients with mental health disorders such as schizophrenia and severe depression may not have the ability to make informed decisions about the care that they need. They may also lack insight into their care needs. In such situations, healthcare providers face the ethical dilemma of violating the right of the patients to make informed decisions. Violating this right may predispose providers to ethical and legal issues in healthcare. Therefore, psychiatrists should make decisions based on the stated legal provisions when caring for patients that are unable to make informed decisions.

Evidence-Based Suicide Risk Assessment

One of the evidence-based suicide risk assessments that I may use in my practice is the Zero Suicide Model. The zero Suicide model is a framework that was developed in the USA for use in suicide prevention. The model offers a system-wide, integrated strategy for preventing suicide. It has components that include treating, engaging, identifying, and transitioning to address the clinical aspects of clinical care and improve, training, and lead components for administrative interventions for suicide. Risk assessments and screening, collaborative safety planning, risk reduction, and support for those at risk are core protocols guiding suicide prevention (Brodsky et al., 2018). Therefore, the effective use of the model reduces rates and risks of suicide significantly in communities.

Evidence-Based Violence Risk Assessment

An example of an evidence-based violence risk assessment that I may use in my practice is the Broset Violence Checklist and Violence tool. The Broset violence checklist is a violence prediction instrument that assesses for symptoms of violence patients may be experiencing. It assesses symptoms that include verbal threats, irritability, boisterousness, physical attacks, and treats if present or absent (Anderson & Jenson, 2019). The tool allows for early identification and management of violence among patients suffering from mental health problems.

References

Anderson, K. K., & Jenson, C. E. (2019). Violence risk-assessment screening tools for acute care mental health settings: Literature review. Archives of Psychiatric Nursing, 33(1), 112–119. https://doi.org/10.1016/j.apnu.2018.08.012

Brodsky, B. S., Spruch-Feiner, A., & Stanley, B. (2018). The Zero Suicide Model: Applying Evidence-Based Suicide Prevention Practices to Clinical Care. Frontiers in Psychiatry, 9, 33. https://doi.org/10.3389/fpsyt.2018.00033

LegalAid.org. (2022). GeorgiaLegalAid.org | A guide to free and low-cost legal aid, assistance and services in Georgia. https://www.georgialegalaid.org/resource/what-should-i-know-about-involuntary-treatment-for-mental-health-and-substance-abuse-issues

Libby, C., Wojahn, A., Nicolini, J. R., & Gillette, G. (2022). Competency and Capacity. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK532862/

Matsne.gov., (n.d.).Law of Georgia on Psychiatric Care. https://matsne.gov.ge/en/document/download/24178/12/en/pdf

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FOR THE PURPOSE OF THIS ASSIGNMENT I AM IN GEORGIA STATE**

Assignment: Legal and Ethical Issues Related to Psychiatric Emergencies

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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.
In this week’s Assignment, you explore legal and ethical issues surrounding psychiatric emergencies, and identify evidence-based suicide and violence risk assessments.
To Prepare
• Review this week’s Learning Resources and consider the insights they provide about psychiatric emergencies and the ethical and legal issues surrounding these events.
The Assignment
In 2–3 pages, address the following:
• 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.
• Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.
• 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: patient autonomy, EMTALA, confidentiality, HIPAA privacy rule, HIPAA security rule, protected information, legal gun ownership, career obstacles (security clearances/background checks), 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.

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Rubric Detail

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Name: NRNP_6675_Week8_Assignment_Rubric

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		Excellent 90%–100%	Good 80%–89%	Fair 70%–79%	Poor 0%–69%
In 2–3 pages, address the following: • 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.		14 (14%) – 15 (15%) The response includes a thorough and well-organized explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.	12 (12%) – 13 (13%) The response includes an accurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.	11 (11%) – 11 (11%) The response includes a somewhat vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies.	0 (0%) – 10 (10%) The response includes a vague or inaccurate explanation of student’s state laws for involuntary psychiatric holds for child and adult emergencies. Or the response is missing.
• Explain the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.		14 (14%) – 15 (15%) The response includes an accurate and concise explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.	12 (12%) – 13 (13%) The response includes a well-organized explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.	11 (11%) – 11 (11%) The response includes a somewhat vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state.	0 (0%) – 10 (10%) The response includes a vague explanation of the differences among emergency hospitalization for evaluation/psychiatric hold, inpatient commitment, and outpatient commitment in your state. Or the response is missing.
• Explain the difference between capacity and competency in mental health contexts.		9 (9%) – 10 (10%) The response includes an accurate and concise explanation of the difference between capacity and competency in mental health contexts.	8 (8%) – 8 (8%) The response includes an accurate explanation of the difference between capacity and competency in mental health contexts.	7 (7%) – 7 (7%) The response includes a somewhat vague or incomplete explanation of the difference between capacity and competency in mental health contexts.	0 (0%) – 6 (6%) The response includes a vague or inaccurate explanation of the difference between capacity and competency in mental health contexts. Or the response is missing.
• 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.		14 (14%) – 15 (15%) The response accurately and concisely explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.	12 (12%) – 13 (13%) The response accurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.	11 (11%) – 11 (11%) The response somewhat vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies.	0 (0%) – 10 (10%) The response vaguely or innacurately explains one legal and one ethical issue related to the selected topic, within the context of treating psychiatric emergencies. Or, response is missing.
•Identify one evidence-based suicide risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.		14 (14%) – 15 (15%) The response identifies and explains an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.	12 (12%) – 13 (13%) The response identifies an appropriate, evidence-based suicide risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.	11 (11%) – 11 (11%) The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.	0 (0%) – 10 (10%) The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
• Identify one evidence-based violence risk assessment that you could use to screen patients. Attach a copy or a link to the assessment you identified.		14 (14%) – 15 (15%) The response identifies and explains an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.	12 (12%) – 13 (13%) The response identifies an appropriate, evidence-based violence risk assessment that could be used to screen patients. A copy of or a link to the assessment is included.	11 (11%) – 11 (11%) The risk assessment identified is somewhat inappropriate for the intended use or dated. A copy of or a link to the assessment may be missing.	0 (0%) – 10 (10%) The risk assessment identified is inappropriate for the intended use, not evidence based, or dated. Or, response is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.		5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment are vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation		5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors	4 (4%) – 4 (4%) Contains 1-2 grammar, spelling, and punctuation errors	3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 grammar, spelling, and punctuation errors	0 (0%) – 3 (3%) Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.		5 (5%) – 5 (5%) Uses correct APA format with no errors	4 (4%) – 4 (4%) Contains 1-2 APA format errors	3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 APA format errors	0 (0%) – 3 (3%) Contains five or more APA format errors
Total Points: 100

Name: NRNP_6675_Week8_Assignment_Rubric