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The Texas law on involuntary commitment states that a physician must examine a patient within 12 hours of arriving at the healthcare facility. A person should not be detained for over 48 hours after they arrive at the facility except if a judge signs an Order of Protective Custody (Texas Public Law, n.d.). In addition, the law states that a person can only be admitted to the facility if the physician who examines them establishes that the individual has a mental illness. One can also be involuntarily admitted if they pose a considerable and imminent risk of serious harm to themselves or others, and emergency detention is the least restrictive method to control one from harm.
Emergency hospitalization for evaluation in Texas occurs when a peace officer or a physician detains an individual for a short period without a court order if the individual poses an immediate threat to themselves or others (Texas Public Law, n.d.). A person can be involuntarily committed to an inpatient unit if they have a mental illness or are suffering severe and abnormal emotional, mental, or physical distress and cannot make logical decisions concerning their need for treatment (Texas Public Law, n.d.). Outpatient commitment occurs when, after a mental health hearing for a patient who was under emergency detention, the court dismisses the case, and the judge issues a court order for outpatient treatment.
Capacity refers to a person’s autonomy and ability to make their own decision and is usually based on a clinician’s assessment. When evaluating a patient’s capacity, the clinician assesses the following four components of decision-making: understanding, communicating a choice, appreciation, and reasoning (Dalal, 2020). On the other hand, competency refers to having the mental ability to make a decision in line with one’s goals, concerns, and values. A person is considered competent unless determined otherwise by a court of law.
Emergency Medical Treatment and Labor Act (EMTALA) establishes guidelines for accepting an appropriate transfer from another facility or providing an appropriate transfer to another facility for a patient with an emergency medical condition who requests or requires a transfer for further medical care and follow-up to a receiving facility (Shenoy et al., 2022). Legal issues related to EMTALA include its obligations on the appropriate transfer of an individual determined to have an emergency medical condition to any ED or dedicated ED of a hospital, whether located on or off the hospital campus and all other departments of the hospital (Shenoy et al., 2022). Ethical issues concerning EMTALA entail hospitals with specialized capabilities or facilities being required to accept from a transferring hospital an appropriate transfer of a patient with an emergency medical condition who requires specialized capabilities if the receiving hospital can treat the individual.
The Ask Suicide-Screening Questions (ASQ) tool can be used to screen patients across the lifespan for risk of suicide. It is intended to screen medical patients eight years and older for risk of suicide. It is free and available in various languages (Horowitz et al., 2020). Patients found positive for suicide risk on the ASQ should undergo a brief suicide safety assessment (BSSA) carried out by a trained clinician to establish if there is a need for a more comprehensive mental health assessment.
The Historical Clinical Risk Management-20 (HCR-20) is the most commonly used violence risk assessment tool globally, and I can use it to screen patients for risk of violence. The tool is available in 20 languages and has been adopted and evaluated in over 35 countries. The HCR-20 would be the tool of choice because it offers a structure to the risk assessment process and guides clinical practice with regard to case prioritization (De Beuf & De Vogel, 2023). It also helps monitor a patient’s risk over time, given the periodical reassessment of the risk factors.
The Texas law allows for involuntary holding if a person poses a risk of serious harm to themselves or others and requires emergency hospitalization. After a mental health hearing following emergency hospitalization, a patient can be involuntarily committed to an inpatient facility if they cannot make logical decisions conce
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