can anyone tell me what the regs are for admitting some one to a psych unit?

Bjo · Jan 22, 2005

An example of a court commitment is when a patient has been in a general hospital on the psychiatric ward for more than 24 hours. The law states that a patient can't be involuntarily admitted from one hospital to another. So they go to the judge to get a temporary order of detention to have them sent to the state hospital. The local mental health board handles the bill for most of our patients, if they live in that county, but for a court commitment, it is picked up by the state. I guess it is a little different at the state hospital than it would be in a private hospital.

If we have someone sent to us from out of our "catchment" area then the mental health board from that county has to agree to pay for the hospital stay.

We also have patients who are admitted involuntarily (pink slipped) who then agree to sign a voluntary. If patients are at the hospital involuntarily and they refuse to take meds and they are not improving the doctor fills out what is called a capacity assessment and they take the patient to court to see if they are a danger to themselves or others. If they are they can be given a committment of up to 90 days. They may or may not leave within that time period. If they don't get better the commitment can be renewed for up to 2 years. If they are probated (that's what it is called in this case) then sometimes they get forced meds ordered by the court through the psychiatrist.

medpsychRN · Jan 23, 2005

What is a court committment and if that happens, who pays for the hospital stay?

In Illinois, if a patient has insurance, public aid or medicare and presents to the emergency room, they cannot be sent to a state hospital. Thus, involuntary admissions are sent to the floor and a certificate and petition is completed. It is very possible they will not see the judge for a week as hearings are scheduled (for us) once a week and if the docket is full, the patient must wait till the following week.

The patient, regardless if he wanted to be admitted is responsible for the bill. His insurance company is billed.

Forced medication or treatments (eg. ECT) is another story and getting a judge to sign off on it takes awhile. Usually, the patient is so agitated, that we end up giving "emergency" medication. This requires completion of a restriction of rights form. Patients always have the right to call the advocacy commission and they have access to the telephone and phone number.

nurseT · Jan 23, 2005

Do you ever get a Pt directly from a jail? It's my understanding that since many sates have cut back on their mental health programs, many mental pts end up in jails instead of the hospital. If they come from a jail, does the state mental health board pay for the stay, or is the jail expected to pay?

medpsychRN · Jan 23, 2005

Do you ever get a Pt directly from a jail? It's my understanding that since many sates have cut back on their mental health programs, many mental pts end up in jails instead of the hospital. If they come from a jail, does the state mental health board pay for the stay, or is the jail expected to pay?

I did get patients from jail when I worked in substance abuse. The circumstances of being released was different mainly because the crime they committed was not a violent crime. The patient had to pay for his own treatment.

In psych, we usually get them before they go to jail. I think people want to try to get things in order before they are confined! If they are being held in the county jail, there are 2 choices. One hospital in the city has a wing for criminals and the state also runs an excellent forensic program about 50 miles from me. This is for women and it is the only one in the state. They undoubtedly have one for men as well and I'm not sure if it is at the same state facility. Unfortunately, not all who need psychiatric treatment actually get it. Really a shame as they suffer needlessly while in jail.

marylyn_91604 · Jan 23, 2005

Dear Matt,It sounds like you had a bad experience.If one of your friends said they were suicidal,the police can pick them up and bring them to an ER.In ER a doctior would see them.If cause to admit was found,person would be admitted on a temporary hold--most states its a 72 hr period.Are you sure you got all the facts?The patient has to be seen in 24 hours.Wouldnt you rather your friend be examined and inconveinienced than to kill themself?The laws are to protect the people w psychiatric problems.I think patients' rights are a big focus in all the states I've worked.I think your fri

end is lucky-they got a chance to decide not to be suicidal--probably were offerred treatment for depression.