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Chapter 44 - Assessing capacity, involuntary assessment, and leaving against medical advice

from Section 6. - Administration of psychiatric care

Published online by Cambridge University Press:  05 April 2013

By
Susan Stefan
Edited by
Leslie S. Zun
Edited in association with
Lara G. Chepenik  and
Mary Nan S. Mallory
Leslie S. Zun
Affiliation:
Department of Emergency Medicine, Mt Sinai Hospital, Chicago
Lara G. Chepenik
Affiliation:
Yale University School of Medicine
Mary Nan S. Mallory
Affiliation:
University of Louisville, School of Medicine
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Summary

This chapter discusses the differences and similarities, clinically and legally, between medical patients and psychiatric patients that wish to leave against medical advice (AMA). It reviews the legal landscape relating to departures AMA, the essential elements of a hospital policy relating to AMA departures by psychiatric patients who arise from this landscape, and practical ways that emergency department (ED) staff can respond to patients with potential psychiatric presentations who wish to leave AMA. Patients who leave without being seen are far more common than patients who leave AMA. At least some psychiatric patients are brought to the ED involuntarily, so they never wanted to be at the ED in the first place. If an individual arrives for help with psychiatric issues, and desires to leave before being evaluated, the ED staff to whom the request is communicated should immediately notify the nurse responsible for the patient's care.

Keywords

telepsychiatryrisk assessmentrural emergency psychiatric caresuicidal riskmental illnessbehavioral health assessmentmedical clearance
Type
Chapter
Information
Behavioral Emergencies for the Emergency Physician , pp. 324 - 334
Publisher: Cambridge University Press
Print publication year: 2013

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