Health27-65 Involuntary Hospitalization
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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.

                 
Patient is under the influence of drugs/ETOH (positive screen for alcohol or other drugs)
YES
Assessment protocol: ETOH-assessment less than 40 or 0.04BAC Other intoxicants- minimum of 12 hours detox from time of call
YES
Referral to Crossroads for detox and MH assessment when clear. .
YES
Detox will notify ES when clear to assess
YES
Clinician determines if patient meets criteria (27-65) when clear.

NO



NO

NO

YES

YES

NO

YES
Clinician determines if patient meets criteria for 27-65. If so, patient will be referred to IP.
NO
A safety plan is made with patient and support system
Patient is allowed to detox in ED and assessed when clear.
A safety plan is made with patient and support system
Medical clearance and labs at ED

YES


YES




YES


YES
Medical clearance and labs at ED
Services are offered to support patient through crisis
 
Services are offered to support patient through crisis
M1 paperwork completed and signed by licensed clinician or MD on duty

YES


YES




YES


YES
M1 paperwork completed and signed by licensed clinician or MD on duty
Care coordination with primary care provider or other providers
 
Care coordination with primary care provider or other providers
Hospital bed located and transport team dispatched for transport

YES








Hospital bed located and transport team dispatched for transport
 
**Locating bed space could take hours to days**