27-65 Involuntary Hospitalization
Decision Tree for Involuntary Hospitalization. The decision tree begins when a patient presents with suicidal/homicidal ideation or is gravely disabled due to a major mental illness. Settings would be the ED or OP clinics.
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Patient is under the influence of drugs/ETOH
(positive screen for alcohol or other drugs)
| YES
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Assessment protocol:
ETOH-assessment less than 40 or 0.04BAC
Other intoxicants-
minimum of 12 hours detox from time of call
| YES
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Referral to Crossroads for detox and MH assessment when clear.
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| YES
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Detox will notify ES when clear to assess
| YES
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Clinician determines if patient meets criteria (27-65) when clear.
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NO
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NO
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NO
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YES
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YES
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NO
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YES
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Clinician determines if patient meets criteria for 27-65. If so,
patient will be referred to IP.
| NO
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A safety plan is made with patient and support system
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Patient is allowed to detox in ED and assessed when clear.
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A safety plan is made with patient and support system
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Medical clearance and labs at ED
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YES
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YES
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YES
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YES
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Medical clearance and labs at ED
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Services are offered to support patient through crisis
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Services are offered to support patient through crisis
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M1 paperwork completed and signed by licensed clinician or MD on duty
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YES
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YES
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YES
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YES
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M1 paperwork completed and signed by licensed clinician or MD on duty
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Care coordination with primary care provider or other providers
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Care coordination with primary care provider or other providers
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Hospital bed located and transport team dispatched for transport
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YES
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Hospital bed located and transport team dispatched for transport
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**Locating bed space could take hours to days**
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