Voluntary and Involuntary Commitment.
Assignment :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? 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? Voluntary and Involuntary Commitment. 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 Maryland state’s laws concerning voluntary and involuntary commitment Voluntary and Involuntary Commitment.
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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. 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? . • Research Maryland state’s laws concerning voluntary and involuntary commitment. The Assignment (3 pages): 1. Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not? 2. Based on the laws in your state ( State of Maryland), would the client be eligible for involuntary commitment? Explain why or why not. 3. Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain. 4. 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. 5. If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client. Please writer TAKE NOTE: THIS IS ABOUT FIVE QUESTIONS. IT MUST BE ANSWERED ACCORDINGLY WITH SUBHEADING PER EACH,PLEASE PLAGIARISM FREE THANKS
Voluntary and Involuntary Commitment
- Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Given the present scenario and my position as a PMHNP concerned with the case, I would make the recommendation that the patient should be voluntarily committed. My recommendation is informed by three reasons. The first reason is that the patient is a minor and has been brought in by his parents for treatment. This means that the parents have the legal right to make care decisions for the patient. The second reasons is that the patient has expressed an intention for self-harm. This means that there is a possibility for the patient to continue self-harming himself and this could have fatal consequences. As such, there is a need to place the patient in a closely supervised environment where he would be monitored and denied the opportunity for self-harm. The final reason is that the patient is not communicative thus making it difficult to proceed with the psychiatric treatment. Committing the patient would improve the chances for communication and allow treatment to proceed (Miller & Hanson, 2016). Based on these reasons, the patient should be voluntarily committed Voluntary and Involuntary Commitment.
- Based on the laws in your state (State of Maryland), would the client be eligible for involuntary commitment? Explain why or why not.
The State of Maryland has legislation to govern the use of involuntary commitment. In fact, these set of legislation are titled ‘Mandatory Treatment Laws.’ The state legislation would support efforts to have this patient subjected to involuntary commitment. This is based on two reasons. The first reason is that the legislation is intended for use when addressing the patient’s best interest. This patient has expressed an intention for self-harm and this is best addressed by placing him in an environment where he can be closely monitored and supervised. Should the patient be released from the facility, there is a high possibility that he would continue being a danger to himself and could even harm others. The second reason is that discharging the patient without offering the required treatment would be irresponsible since medical facilities are expected to offer treatment and only discharge patients after receiving treatment. This means that it would be irresponsible to discharge the patient without addressing the suicidal tendencies and the initial case of the admission (Treatment Advocacy Center, 2018). As a result, the laws in the State of Maryland make the patient eligible for involuntary commitment Voluntary and Involuntary Commitment.
- Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
Having looked at the laws governing commitment in the State of Maryland, I believe that they confirm my initial recommendation that the patient should be committed. As a PMHNP, my primary concern is to provide the best possible medical care in a safe environment. The present patient is in need of psychiatric care and it would be imprudent to discharge the patient before he receives treatment. Given this awareness, it is clear that the patient should be committed to receive treatment. With decisions regarding commitment, the first option is to explore the possibility of using voluntary commitment. This would require that the parents be convinced to use their legal authority to have the child committed to receive treatment. Should the parents fail to act on the recommendation to have the patient subjected to voluntary commitment, then the next step would entail exploring involuntary commitment as an option while arguing that failing to commit the patient could have fatal consequences since he is suicidal (Acton, 2013; Treatment Advocacy Center, 2018) Voluntary and Involuntary Commitment.
- 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.
The patient is eligible for involuntary commitment since discharging him could have fatal consequences. However, should efforts to have the patient involuntarily committed, then medical personnel can explore other options to support the parents for or against voluntary commitment. Support for voluntary commitment would entailconvincing the parents that the patient should be committed, citing the fatal consequences that could arise if the child goes home and decides to either continue harming himself or resorts to harming others. This option should include an education session along with the advice offered to the parents with the focus being on talking about suicide. There are two options to support the parents against involuntary commitment. The first option is to explore alternative treatment approaches that could be conducted at home to include home counseling and visits. The second option is to have the patient placed under close supervision to eliminate opportunities for suicide (Stefan, 2016) Voluntary and Involuntary 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.
Should the patient be ineligible for involuntary commitment, then there area range of actions that medical personnel can undertake to begin treatment. The first action would entail assessing the patient for harm-potential. Although the patient is uncommunicative, his potential for harm can be assessed through reviewing his past actions that include the attempted suicide and note that was left. This would offer the medical personnel a perspective from which to begin treatment. The second action would entail identifying the reasons for the patient’s intention to harm himself. This would be assessed through interviews with the parents and looking at the suicide note. The third action would involve informing the parents the results of the assessment as well as the possibility that the patient would make another suicide attempt if discharged without treatment. The final action is to get approval from the parents to have the child voluntarily committed in order to receive treatment (Reamer, 2014) Voluntary and Involuntary Commitment.