Unit 17 Legal Issues in Mental Health Nursing

Question 1

What are the types of commitments/admissions for mental health?

Answer 1

Voluntary/Involuntary
Emergency (72 hr involuntary)
Civil or Judicial (judge sends for 72 hrs evaluation)

Question 2

Describe Emergency commitment.

Answer 2

When client’s mental illness results in immediate risk of self-harm or harm of others or is unable to provide food, clothing, shelter

• Client seen by screener that’s liscenced by state
• Examination by 2nd professional
• Clear and convincing evidence needed

Question 3

Describe Civil or Judicial Commitment.

Answer 3

Longer time than emergency

Legal basis is parens patriae
-provides time for a defense or an attorney

Question 4

What does least restrictive alternative mean?

Answer 4

Providing treatment in the least restrictive environment using the least restrictive treatment

Question 5

What is privileged communication?

Answer 5

• Certain information given to professional by clients remain secret.
• Privilege belongs to the client and can be asserted or waived only by the client

**These statues EXCLUDE, mandatory reporting of child, elder, impaired adult, domestic violence, communicable disease related to public safety, and info that could prevent commission of a felony such as a murder.

Question 6

What does “duty to warn” mean?

Answer 6

Responsibility of a mental health professional to notify of an intended, identifiable victim of whatever information was learned.

Question 7

Who can or cannot refuse Rx treatments?

Answer 7

Voluntary can refuse

Involuntary cannot

Question 8

If PT is put on restraints in an emergency, how much time do you have to obtain an order?

Answer 8

1 hour after putting restraints on an order must be obtained

Question 9

When are behavioral restraints/seclusion authorized?

Answer 9

• When behavior is physically harmful to PT or a third party
• When less-restrictive measures were ineffective
• When a decrease in sensory overstimulation (seclusion only) is needed
• When a PT requests seclusion because they believe it will be helpful

Question 10

What is the order of least to most “restrictive” restraints?

Answer 10

1. Chemical
2. Seclusion
3. Physical

Question 11

What are contraindications to seclusion and restraints and what can allow them all still?

Answer 11

• Extremely unstable medical and psychiatric conditions*
• Severe suicidal tendencies*
• Desire for punishment of patient or convenience of staff*
• Severe Rx reactions or overdoses*
• Unless close supervision and direct contact observation are provided

Question 12

What are 3 things that make restraints illegal?

Answer 12

1. Staff convenience
2. PT punishment
3. Confusion

Question 13

In general what should be followed regarding restraints and seclusion?

Answer 13

Follow policy on renewal or orders and protocols