Psych Court Holds

Reminder

APPs cannot sign the Mental Health Petition (certificate) but they can sign the Application for Emergency Hold. Only a licensed physician, licensed psychologist, or a “qualified mental health professional” can sign the MHP.

Reference this PDF for important details!

KS legal holds

Scenario 1 - Psych Hold Already Placed

Location: SF (or ST)
Situation: Patient arrives with psychiatric complaint and a 24hr HOLD is already placed prior to arrival (usually this is because they are coming from Comcare Crisis)
Actions:

1. Call Comcare Crisis.

2. Give patient info (name and DOB), see if they are open to Comcare (won’t make a difference in this process, but since you called, might as well check).

3. Ask if patient has had a screen done on them…
   A. If yes…ask what their recommendation was and if MHP was filed. Then ask them to fax to SF ED so the full screen can be placed in the pt file.

   B. If no…request a screen.

4. Do regular work-up as indicated and request admission from appropriate team (this will stop the clock for you but not negate the need for screen).

5. Contact Leanndra Flemming (7-7002) and leave a message saying 24hr hold has been filed and waiting on Screen. (This way someone can follow up on this as days go on).

---

Scenario 2 - Hold Placed After Arrival in ED

Location: SF (or ST)
Situation: Patient arrives with psychiatric complaint. At some point during their time in the ED, you place a 24hr hold due to patient not wanting to stay but is still a danger to self or others, or during patients visit they required administration of medications against their will (which requires 24hr hold to be placed at that time).
Actions:

1. Call Comcare Consortium (800-466-2222) - (you might be able to call comcare crisis to request screen as well)

2. Give patient info (name and DOB), verify if they are open to comcare. (If admission orders are already placed for AMG and it turns out they are open to comcare, please contact Comcare on call to get admission acceptance!)

3. Request a screen for the patient and inform them that 24hr hold was placed (give date and time) and ask that screen be completed before next business day at 11am or HOLD will expire. They are supposed to do screens in 3-4hrs. We don’t want to have the hold expire.

4. Continue current management or request admission to appropriate service as indicated while waiting for screen.

5. Contact Leanndra Flemming (7-7002) and leave a message saying 24hr hold has been filed and waiting on Comcare screen (this way someone can follow up on this as days go on).

Tips

• Screen can be done on any patient regardless of Comcare status.

• Screeners will automatically complete the MHP if they feel patient requires involuntary admission.

• Notifying Leeandra will ensure that someone is tracking each case, and that she will know to contact Comcare if patient has court while still in the ED. Leeandra handles court and holds for BH. She is M-F, so if you don’t reach her to let her know, you can leave a message.