Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention

What are your outpatient facility and state policies regarding an inpatient hold?

An inpatient hold is a situation in which an individual is held involuntarily in a psychiatric facility for a treatable mental health illness. It is a legal process (Fariba & Gupta, 2022), i.e., the detention must be legally justified. My outpatient and state policies regarding inpatient hold include;(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

1. Inpatient hold by court order; where a judge can recommend an inpatient hold based on petitions from other people. The petition should be filed in a circuit court of the county where the mentally ill patient (respondent) resides and describe the individual’s mental health status and risks of physical harm when not admitted (Illinois General Assembly, 2022).(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)
2. Inpatient hold by certification; where an individual may be admitted to a psychiatric facility in an emergency where person proposes immediate harm to others or himself/herself (Illinois General Assembly, 2022).

Does the patient have to be suicidal/homicidal, or are there other criteria to place someone on a hold?

I believe that suicidal/homicidal ideation alone is not enough for an inpatient hold in Illinois. The existing legal provisions allow relevant entities to place an individual to be placed on hold under the different circumstances; when an individual’s mental illness requires inpatient treatment to prevent physical self-harm or harm to others, or when an individual does not adhere to or refuses prescribed treatment and cannot understand the need for treatment, or when an individual’s problem prevents them from providing for his/her basic physical needs to safeguard himself/herself or others from physical harm.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

How long are these holds for your state, and to have them extended, what is required?

Inpatient holds in Illinois can last up to 90 days or more depending on subsequent court petitions based on mental health reassessment which happens (Illinois General Assembly, 2022). 

Think about either your current place of employment or current clinical site. What are some potential biases you may have with a patient making suicidal statements?

The potential bias I could expereince when making a suicide statement is heuristics. Heuristics are cognitive processes that promote quick conclusions even in complex issues that require comprehensive evaluation (Hadlaczky, 2020). For instance, I might search for information to confirm suicide ideation when writing suicidal statements, which is often insufficient.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

If you have dealt with this, how did it go? If you have not yet, how do you think it will go?

I have not dealt with irrational decisions founded on heuristics. However, more decision-making efforts rather than automatic decisions are crucial in avoiding heuristics. Doing so requires more clinical data, consultation, and rational choices.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

Review the previous six entries and evaluate your progress in reflective practice over the course of the term.

Throughout the reflective practice, I have evaluated various aspects of practice. In the previous entries, I have reflected on the role of a DNP-prepared nurse, appraisal of a global health issue, literature evaluation, and research ethics. I have also reflected on the appraisal and synthesis of evidence, collaborative practice, translation, and dissemination of evidence.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

References

Fariba, K. A., & Gupta, V. (2022). Involuntary Commitment. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK557377/# 

Hadlaczky, G. (2020). Cognitive biases in suicide risk assessment. In Oxford Textbook of Suicidology and Suicide Prevention, 15(1), 363-368. https://doi.org/10.1093/med/9780198834441.003.0043

Illinois General Assembly. (2022). Illinois Compiled Statutes Available at: https://www.ilga.gov/legislation/ilcs/ilcs4.asp?DocName=040500050HCh.+III&ActID=1496&ChapterID=34&SeqStart=8000000&SeqEnd=19600000(Accessed 31 October 2022)

Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention

Introduction:

Ambulatory care facilities play a vital role in delivering diverse medical services, diagnostics, and interventions to non-admitted patients. Nonetheless, instances can emerge where individuals exhibit a risk to themselves or others due to factors like mental health concerns, substance misuse, or related issues. In such occurrences, the utilization of an inpatient hold, referred to as involuntary commitment, becomes necessary to ensure the safety and welfare of the individual and the broader community. This essay aims to delve into the protocols of ambulatory care facilities and state stipulations concerning inpatient holds.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

Ambulatory Care Facility Protocols on Patient Retention:

Ambulatory care facilities, encompassing mental health centers, addiction rehabilitation centers, and general medical clinics, typically have guidelines in place to address scenarios involving patients who might present a threat to themselves or others. These guidelines intend to balance individual rights and communal safety. Key elements of ambulatory care facility protocols on patient retention encompass:(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

1. Appraisal and Evaluation: Trained healthcare professionals, such as psychiatrists, psychologists, and social workers, are commonly tasked with assessing and evaluating the mental and emotional condition of patients. If a patient’s condition is determined to endanger their own safety or that of others, these professionals initiate the process of contemplating an inpatient hold.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)
2. Criteria for Patient Retention: Distinct criteria are defined to ascertain the necessity of a patient’s retention as an inpatient. These criteria might encompass specific behaviors, statements, or conditions that hint at an impending danger. Common criteria include expressions of suicidal or homicidal tendencies, intense substance abuse, severe exacerbation of mental health issues, or extreme agitation.
3. Informed Consent and Legal Protocol: Patients are informed about the potential requirement for an inpatient hold upon seeking treatment at ambulatory care facilities. While respecting patients’ autonomy, facilities elucidate the process, its duration, and patients’ rights. Legal procedures are meticulously followed to guarantee due process and preserve individual rights.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)
4. Collaboration with Emergency Services: Ambulatory care facilities liaise with local emergency services and law enforcement bodies to ensure a seamless transition from the ambulatory setting to an inpatient facility. This cooperation assures the safety of patients and the professionals involved in the procedure.

State Guidelines on Patient Retention:

State guidelines pertaining to patient retention display notable divergence, as mental health regulations are predominantly within the purview of state governance in numerous jurisdictions. These guidelines serve to offer a legal framework for involuntary commitment while upholding individuals’ civil liberties. Some prevalent aspects of state guidelines include:(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)

1. Duration of Patient Retention: States delineate the maximum timeframe for an inpatient hold, often spanning from a few days to several weeks. This duration permits stabilization, assessment, and determination of the most suitable care level.
2. Criteria and Procedural Approach: States institute legal prerequisites for initiating an inpatient hold, encompassing a proven risk of self-harm or harm to others. The procedural approach generally entails the participation of mental health experts, emergency services, and legal entities to guarantee an equitable and just assessment.
3. Judicial Review and Due Process: Many states mandate a judicial review of the inpatient hold within a stipulated timeframe. This review assures the observance of individual rights and the validity of the decision to detain based on the furnished evidence.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)
4. Least Intrusive Alternative: States often prioritize providing care in the least restrictive environment. Where feasible, alternatives like outpatient treatment or less restrictive measures are considered before resorting to an inpatient hold.

Conclusion:

Ambulatory care facilities and state guidelines work collectively to ensure that individuals posing potential risks to themselves or others receive suitable care through inpatient holds. These protocols and guidelines mirror the equilibrium between upholding public safety and respecting individual rights. While the details of ambulatory care facility protocols and state guidelines may vary, their overarching intent remains unswerving: to provide timely and compassionate care for those in need while upholding lawful and ethical benchmarks.(Comprehensive Essay Example on Policies on Outpatient Treatment and State Guidelines Concerning Patient Retention)