Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients
Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
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.
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 include a brief introduction with the purpose
The references should be most recent (2-3years)
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? Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
Voluntary and Involuntary Commitment Regarding Pediatric Psychiatric Patients
Concerning psychiatric patients, voluntary commitment means the patient chooses to be admitted for treatment. On the other hand, involuntary commitment is a legal process through which the patient is ordered to go for treatment by the court (Rayesteijn et al. 2017). In either case, the care is done through an inpatient facility and sometimes through an outpatient basis. For the instance of those who cannot make decisions for themselves like children, the admission to a medical facility will be voluntary when the parents or guardians accept the voluntary (Shields, Borba, & Trinh, 2017). Most entries are often voluntary: involuntary admission is rare. This paper discusses voluntary and involuntary commitment from a scenario where I am a PMHNP.
I strongly oppose voluntary commitment of the client due to the selected reasons herein. First, the patient is overwhelmed by suicidal thoughts hence he cannot voluntarily opt for pediatric psychiatric admission. According to Pfiffner et al., admission to healthcare for suicidal thinking is the last resort and most often treating people in the community is better for such clients (2014). However, the chances of the patient being safe in the community setting are low. Additionally, the client’s parents have conflicts of interest over their son’s assistance. Notably, the mother uses threats to demand that the client be discharged while the father requires that the child be hospitalized because of the suicide. In search of a scenario, the voluntary commitment will fail thus involuntary commitment should be advocated for. Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
However, in the United States, only forty-five states have laws which authorize the use of court-ordered treatment which is in the Mental Health Care Act. In my state, the client is eligible for involuntary commitment. The criteria for one to be involuntarily committed, the client should have a mental illness, the client’s disease and the problem should be requiring instant treatment. Also, the anticipated treatment should be accessible at the accredited mental healthcare institution and that there is a looming risks that the patient may source injury to him or herself (Masood et al. 2017). In my scenario, the patient wants to commit suicide which is the mental illness. Also, his problem needs immediate attention since if left alone, he will continue taking diphenhydramine hydrochloride. Conversely, the client can cause harm since he is overwhelmed by thoughts of suicide. Not to mention, our medical facility is in a position to offer necessary treatment. Having said all these, the client qualifies for involuntary commitment Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
Accordingly, my understanding of the state laws confirms my recommendation about involuntary committing the patient. Following the client’s stunt actions, I was unable to engage voluntarily commit him having a well understanding of the factors seen from the patient. Furthermore, the patient was at imminent risk of taking away his life in which he had already taken Benadryl which suggests that when discharged from the hospital, he will continue taking the tablets. Although the mother is using her clerical staff for the state board of nursing’s position, however, she is not concerned with what the son is capable of doing with her life. Following the nursing policies, ethics and the state laws, I could not bow to pressure to discharge the son before ailment is complete.
Nonetheless, if the client were not eligible for involuntary treatment, I would suggest and take the following course of actions to support voluntary commitment. First, I would recommend a psychotherapist who will be checking on the client’s health progress as well as offering guidance and counseling while at home. When the client-therapist relationship exists, care is provided to the client at the time of the alleged wrongdoing hence reducing chances of harmful actions (Townsend & Morgan, 2017). Also, I will work with the client minimize his risk of feeling shameful and also recommend care which is in line with the principles of cultural safety and competence. Additionally, I will provide hope for the father who thinks that the son will be at risk if discharged as well as encouraging the client that I will take an initiative of talking to the parents of the girlfriend to allow him to date the girl. Doing all these gives the client hope as well as his parents Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
Conversely, my initial actions to begin treatment would be assessing the client’s mental status which includes mood and the effect along with other signs of depression. I will also determine the patient’s feeling of hopelessness as well as obtaining the suicidal behavior history which include threats and ideation, earlier attempts and lethality of these events. For instance, the patient may be experiencing impulsivity symptoms like acting and reacting to situations without putting into account the possible consequences (Davison, Mackay, & McGivern, 2017). Considering all these risk factors will aid me in accurately determining if the patients with romance relationship issues are at risk of suicide thus I can give the right medication.
In conclusion, from the scenario, the client qualifies for involuntary commitment. The client is capable of doing anything to take his life away. However, offering therapy to him is likely to improve the situation. Furthermore, the patient needs to be given hope that his parents or clinicians will take the initiative to talk to the parents of his girlfriend to sort out issues thus he should not commit suicide Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
Davison, J., Mackay, B., & McGivern, M. J. (2017). The Potential of Simulation to Enhance Nursing Students’ Preparation for Suicide Risk Assessment: A Review. Open Journal of Nursing, 7(02), 129.
Masood, B., O’Ceallaigh, S., Thekiso, T., Nichol, M., Kowalska-Beda, P., Murphy, M., … & Kennedy, N. (2017). Clinical predictors of involuntary detention among voluntary inpatients in St Patrick’s University Hospital (SPUH). Irish Journal of Psychological Medicine, 34(1), 13-18.
Pfiffner, C., Steinert, T., Kilian, R., Becker, T., Frasch, K., Eschweiler, G., & Jaeger, S. (2015). Rehospitalization risk of former voluntary and involuntary patients with schizophrenia. Social psychiatry and psychiatric epidemiology, 49(11), 1719-1727 Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.
Ravesteijn, B., Schachar, E. B., Beekman, A. T., Janssen, R. T., & Jeurissen, P. P. (2017). Association of cost sharing with mental health care use, involuntary commitment, and acute care. JAMA Psychiatry, 74(9), 932-939.
Shields, M. C., Borba, C. P., & Trinh, N. H. T. (2017). Quality of Inpatient Psychiatric Care and Consumers’ Trust in the Mental Health Care System. Psychiatric Services, 68(6), 642-643.
Townsend, M. C., & Morgan, K. I. (2017). Psychiatric mental health nursing: Concepts of care in evidence-based practice. FA Davis Voluntary and Involuntary Commitment Essay – pediatric psychiatric patients.