Full Answer Section

Who can release the emergency hold?

A 5150 hold can be released by a mental health professional who determines that the person is no longer a danger to themselves, a danger to others, or gravely disabled.

Who can pick up the patient after a hold is released?

The patient can be picked up by anyone they designate, or they can be released to themselves.

Differences among Emergency Hospitalization for Evaluation/Psychiatric Hold, Inpatient Commitment, and Outpatient Commitment

Emergency hospitalization for evaluation/psychiatric hold: This is a temporary hold that allows a person to be held in a hospital for up to 72 hours for evaluation.

Inpatient commitment: This is a longer-term commitment that allows a person to be held in a hospital for up to one year. An inpatient commitment can only be ordered by a court after a hearing.

Outpatient commitment: This is a commitment that allows a person to be treated in an outpatient setting. An outpatient commitment can only be ordered by a court after a hearing.

Difference between Capacity and Competency in Mental Health Contexts

Capacity: Capacity is the ability to make and understand decisions.

Competency: Competency is the ability to stand trial or participate in a hearing.

Legal and Ethical Issues Related to Psychiatric Emergencies

Patient autonomy: Patients have the right to make their own decisions about their care, including whether or not to accept treatment. However, if a patient is deemed to be incompetent, their autonomy may be limited.

EMTALA: The Emergency Medical Treatment and Labor Act (EMTALA) requires hospitals to provide medical screening and stabilization to anyone who comes to the emergency department, regardless of their ability to pay. This includes people who are experiencing a psychiatric emergency.

Confidentiality: Mental health professionals have a duty to keep their patients’ information confidential. However, there are some exceptions to this duty, such as when a patient is a danger to themselves or others.

HIPAA Privacy Rule: The HIPAA Privacy Rule protects the privacy of patients’ health information. However, there are some exceptions to the Privacy Rule, such as when a healthcare provider believes that a patient is a danger to themselves or others.

HIPAA Security Rule: The HIPAA Security Rule requires healthcare providers to protect the security of patients’ health information. This includes implementing safeguards to protect electronic health information.

Protected information: Protected information is any information that can be used to identify a patient, such as their name, address, date of birth, and Social Security number.

Legal gun ownership: People who have been involuntarily committed to a psychiatric hospital are generally prohibited from owning firearms.

Career obstacles (security clearances/background checks): People who have been involuntarily committed to a psychiatric hospital may have difficulty obtaining a security clearance or passing a background check.

Payer source: The payer source for psychiatric emergencies can vary depending on the patient’s insurance coverage. Some patients may be covered by Medicaid, Medicare, or private insurance. Other patients may be uninsured.

Evidence-based Suicide Risk Assessment

One evidence-based suicide risk assessment that can be used to screen patients is the Columbia-Suicide Severity Rating Scale (C-SSRS). The C-SSRS is a brief interview that assesses a patient’s suicide risk in several domains, including suicidal ideation, intent, and behavior.

Evidence-based Violence Risk Assessment

One evidence-based violence risk assessment that can be used to screen patients is the HCR-20 Violence Risk Assessment Scale. The HCR-20 assesses a patient’s risk of violence based on historical factors, clinical factors, and risk management factors.

It is important to note that no risk assessment tool is perfect, and all risk assessments should be used in conjunction with clinical judgment.