I work at a locked psychiatric hospital with acute psych, detox, and gero-psych units. We have a mix of voluntary and involuntary patients.
When working on the detox unit, nearly every patient is voluntary and, it's not uncommon to have patients request to leave AMA for various reasons (often, the patient admits they're not ready for sobriety). These are not patients that can be placed on a legal hold as they are not a danger to themselves or others and are able to care for themselves.
The problem is, as we are a locked facility, patients are forced to remain in the hospital as we process their discharge paperwork. This includes receiving a doctor's order, meeting with case management, etc. This often results in a patient asking to leave AMA early in the AM and not leaving the hospital until nearly 3pm.
We are a for-profit hospital and, at times, many employees (new nurses, non-nurse case managers, social workers) enforce the rules of the facility that to me appear to be illegal. One consent signed on admission used to state that patient's wishing to AMA must let someone know prior to 3pm in writing or else they must remain in the hospital until the next day. Other rules include requiring patients to have a medical H&P prior to discharge (even if they admitted themselves for detox and have already been assessed by a psychiatrist) and not being provided scripts on discharge if leaving AMA.
I've tried looking through my state's statutes (Nevada) to find out if this is illegal. To me, it appears to be false imprisonment as, in a non-locked facility, these patients could merely walk out the front door.
