NRNP-Class-WK-8-Assignment

According to Maryland’s state laws for involuntary psychiatric admissions, individuals can be involuntarily admitted if one psychologist and two or more physicians complete involuntary admission certificates. Several factors have to be true. Individuals should have a mental illness, need treatment or inpatient care, present danger to oneself or others, and be unwilling or unable to be admitted involuntarily. Also, there should be less restrictive or no available form of treatment or needs that meets the needs of the person. For older adults above 65 years old, the geriatric evaluation team has to determine that the State’s hospital is the most effective place where the individuals can get needed treatment or care. Maryland law provides parents permission to involuntarily admit and authorize treatment for their children even if the minor objects. Psychiatrists have the right to hold an individual for 24 hours after they are admitted into the hospital (Sadock, Sadock, & Ruiz, 2015). However, individuals can change their admission status to voluntary at any time. If not, they can be provided involuntary admission hearing in 10 days. Only psychiatrists are allowed to release the emergency hold after making a critical evaluation and ensuring that an individual is okay. If the admission is voluntary and an individual wishes to be discharged, the individuals have to express their desire to leave in writing. Only family members are allowed to pick up individuals after their involuntary hold has been released.

One legal issue about patient confidentiality is that individuals must give permission before their caregivers, relatives, or friends can access their information. This means that individuals are under no obligation to allow professionals to disclose information to their caregivers, family, or acquaintances (National Institute for Health and Care Excellence, 2019). A professional should respect a patient’s desires if they instruct them not to disclose information to anyone. One ethical issue is that information crucial to treatment and evaluation may be withheld by clients who don’t believe professionals will handle their information confidentially (Zakahri, 2021). Most clients often suffer clear or covert harm when pros disregard their privacy.

The crucial difference between capacity and competence is that mental capacity only pertains to decision-making ability. The capacity to conduct the responsibilities essential to make choices is known as competence, on the contrary hand. In the mental health context, competency is when a judge in court makes a comprehensive evaluation and legal judgment about someone (Buppert, 2021). On the other hand, capacity means that any clinician who is familiar with the situation of a patient can make a functional assessment and clinical determination.

There are several differences between psychiatric evaluation, outpatient commitment, and inpatient commitment in Maryland’s emergency hospitalization. In psychiatric evaluation, an individual who visits one of the aforementioned facilities will be assessed by a mental health expert who will decide whether the patient is a good candidate for an inpatient psychiatric unit.  People whose ideas and actions pose a significant danger to themselves and/or others should be admitted to an acute inpatient psychiatric hospital (Thapar et al., 2015).  Involuntary outpatient commitment involves a judge ordering a person with serious mental illness to follow a treatment schedule that includes outpatient care to avoid relapsing and dangerously deteriorating. On the other hand, Maryland has commitment laws, that specify standards for figuring out when involuntary care is suitable for persons with serious mental issues who are unable to pursue treatment voluntarily. Only a few states, including Maryland, forbid community-based forced treatment, also known as “outpatient commitment.”

To screen patients with suicidal ideation, I can use the Columbia Suicide Severity Rating Scale (C-SSRS). The C-SSRS is effective in gathering data on the complete variety of suicidal actions and ideation (U.S. Department of Veterans Affairs, 2019). This tool is reliable since it can be used to assess patients of all ages. Nonetheless, it is a screening tool that can be administered by other health professionals like social workers. People can also use this tool in case of any concerns about their health. Besides assessing every type of ideations and actions supported by information, the C-SSRS observes identified suicidal attempts. It may be utilized as a part of a comprehensive examination or in preliminary screenings.

References

Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.

National Institute for Health and Care Excellence (2019). Brøset violence checklistLinks to an external site.. http://riskassessment.no/

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer. (For review as needed)

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (Eds.). (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

U.S. Department of Veterans Affairs. (2019). VA/DoD clinical practice guidelinesLinks to an external site.: Assessment and management of patients at risk for suicide (2019).
https://www.healthquality.va.gov/guidelines/MH/srb…

Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.