Legal & Ethical Basis for Practice

Question 1

Admission to Hospital - Mental Hlth

Answer 1

• Olmsted v. L.C. (1999): US Supreme Court
  > pts w/ mental hlth illness are to be placed in less restrictive comm settings rather than in institiutions
• Psychiatric problem must be based on Diagnostic & Statistical Manual of Mental Disorders
• Illness must be present an immediate crisis
  > other, less restricitve alternatives are inadequate or unavailable
  > the expectation exists tht hospitalization & treatment will improve the immediate problem

Question 2

Involuntary Addmission
(commitment)

Answer 2

• Judicial determination
• Administrative determination
• Agency determination

Question 3

Restraint & Seclusion

Answer 3

• Most state laws prohibit the use of unnecessary physical restraint or isolation
• Behavorial restraint & seclusion are authorzied as interventions if:
  > pt must be protected from harm
  > documentation: behavior leading to restraint, time pt is placed in & released from restraint or seclusion

Question 4

Restraint/Seclusion Order

Answer 4

• Must have a written order
  > good for 24hrs
  > original order may be extended after a review & reauthorization
  > must specific type of restraint
• Removed from restraints when safer & quieter behavior is observed