Voluntary and Involuntary Commitment

Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation?

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Voluntary and Involuntary Commitment What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice. In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment. Scenario for Week 7 Case: You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. Voluntary and Involuntary Commitment The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed? Learning Objectives Students will: Voluntary and Involuntary Commitment • Evaluate clients for voluntary commitment • Evaluate clients for involuntary commitment based on state laws • Recommend actions for supporting parents of clients not eligible for involuntary commitment • Recommend actions for treating clients not eligible for involuntary commitment To Prepare for this Practicum: • Review the Learning Resources concerning voluntary and involuntary commitment. • Read the Week 7 Scenario in your Learning Resources. • Research your state’s laws concerning voluntary and involuntary commitment. The Assignment: • Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not? • Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not. • Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain. • If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment. • If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client Voluntary and Involuntary Commitment.

Voluntary and Involuntary Admission

Individuals seek admissions into healthcare institutions to get treatment and information about better health practices. These admissions may be voluntary or involuntary, depending on the mental state of the patient. Notably, voluntary admission is when a sick victim agrees to commit oneself to a healthcare unit for treatment, by his/her own will (O’Donoghue et al., 2014). Besides, involuntary hospital commitment involves the admission of people against their will. Regularly, such individuals experience mental instabilities, or traits that display signs of harming themselves Voluntary and Involuntary Commitment.

Case Study

From the case study, I would not allow the young boy to be admitted on a voluntary basis. The 14-year old victim ingested 50 tablets of Benadryl as a result of a situation with his girlfriend. He displays actions that intend to bring self-harm, and this may be due to psychological disturbances. In the event he is left to admit himself voluntarily, he would devise a new way of killing himself Voluntary and Involuntary Commitment.

Laws about Voluntary and Involuntary Admissions and its Application

The United States provides laws that cover the rights of admission of individual in healthcare institutions. According to Rüsch et al.(2014), the Mental Act of 2001 states that for involuntary commitment, a patient ought to be examined by a psychiatrist and a physician to ascertain the levels of mental stability. A patient qualifies to be involuntarily admitted if he/she displays signs of hurting others and himself/herself (Rüsch et al., 2014).From the scenario, it was reasonable to admit the 14-year old boy, since he displayed signs of hurting himself through a suicidal attempt. Additionally, he refused to talk with doctors, a factor that would display mental instability Voluntary and Involuntary Commitment.

Support for Parents and Treatment Options incase Patient is not eligible for Involuntary Admission

The case study elaborates that the parents were divorced, and each displayed conflicting opinions on the admission of the boy. I would help them have their child stabilized first, before seeking readmission in other institutions if they desired. It is imperative that practitioners exercise involuntary admission in accordance to the law (Smith, et al., 2014). In my opinion, I would assist the patient with medical interventions that would stabilize his condition. However, upon the realization that the case was suicidal, I would ensure he is involuntarily admitted Voluntary and Involuntary Commitment.

Conclusion

Patients get admitted to hospitals voluntarily or involuntarily. Voluntary admission entails one’s will to commit to an institution for treatment. Involuntary admission happens when one displays mental instabilities. From the case study, the patient wanted to commit suicide, and therefore, the need to involuntarily commit him for health care assessment Voluntary and Involuntary Commitment.

References

O’Donoghue, B., Roche, E., Shannon, S., Lyne, J., Madigan, K., & Feeney, L. (2014). Perceived coercion in voluntary hospital admission. Psychiatry research, 215(1), 120-126. https://doi.org/10.1016/j.psychres.2013.10.016.

Rüsch, N., Müller, M., Lay, B., Corrigan, P. W., Zahn, R., Schönenberger, T., … & Rössler, W. (2014). Emotional reactions to involuntary psychiatric hospitalization and stigma-related stress among people with mental illness. European Archives of Psychiatry and Clinical Neuroscience, 264(1), 35-43. Retrieved from https://link.springer.com/article/10.1007/s00406-013-0412-5

Smith, D., Roche, E., O’Loughlin, K., Brennan, D., Madigan, K., Lyne, J., … & O’Donoghue, B. (2014). Satisfaction with services following voluntary and involuntary admission. Journal of Mental Health, 23(1), 38-45. https://doi.org/10.3109/09638237.2013.841864 Voluntary and Involuntary Commitment.

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