Historical Framework
Emergency Detention
Order of Protective Custody
Temporary Commitment
Extended Commitment
100
The process which starting in the 1950s led to increasing need for formalized commitment?
What is "deinstitutionalization"
100
You are a PGY-2 resident rotating on the psychiatry consult service and are paged late in the day by the medicine service in regards to a patient admitted to the hospital on an emergency detention. The medicine resident asks you, “How long is the emergency detention valid in Texas?”
What is 48 hours?
100
The physician's certificate of mental illness must be submitted along with this form to be considered a valid motion for the order of protective custody
What is the application for temporary court ordered mental health services? (aka the applicants' portion)
100
If a patient receives an order for temporary commitment, what is the maximum length of time this patient may be held under this order?
What is 90 days?
100
The maximum amount of time that a patient may be committed for after having served temporary commitment and still considered danger to themselves.
What is 12 months?
200
What forces were prominent in leading to deinstitutionalization?
What is "the passing of the Community Mental Health Centers Construction Act of 1963, the advent of antipsychotic medications, Medicare and Medicaid establishment, the Civil Rights Movement?"
200
Who has the authority to drop the emergency detention in the State of Texas?
What is "any physician." Not necessarily a psychiatrist but does have to be a physician, not a PA, nurse practitioner or other allied health professional.
200
A "probable cause hearing" must be scheduled within this time frame as dictated by Texas Law?
What is 72 hours
200
A temporary commitment hearing must be held within this time frame of the application's submission?
What is 14 days (barring any continuances, inclement weather, extenuating circumstances)-- true maximum is 30 days?
200
What level "burden of proof" is required for this commitment hearing?
What is "clear and convincing evidence" As a reminder, the hierarchy of evidence is reasonable suspicion (traffic stop, search and seizure), probable cause, preponderance of evidence, clear and convincing evidence, beyond a reasonable doubt (criminal proceedings).
300
For much of the 19th and 20th centuries, mental health care for the seriously mentally ill (SMI) was provided in this setting?
What is large federally funded institutions?
300
Who may file for a mental health warrant?
What is "any concerned adult who believes that a person evidences signs of mental illness and represents a substantial risk of harm to self or others"
300
Physician are free of liability for physician's certificate if these conditions are met?
What is filled out in good will and free of malice?
300
What "burden of proof" is necessary for temporary commitment?
What is "clear and convincing evidence?"
300
IOPC or involuntary outpatient commitments are typically handled through these organizations?
What is the local mental health authorities (ie MHMR in many Texas counties or CHCS in San Antonio)
400
This constitutional amendment states that no "State shall deprive any person of life, liberty, or property, without due process of law" What year was this amendment created?
What is the 14th Amendment in 1868?
400
Which authorities are qualified to file an emergency detention on patients?
What is "a peace officer" As defined by the Texas Code of Criminal Procedure, "sheriff and their deputies; constables and deputy constables; marshals or police officers of an incorporated city, town, or village; rangers, officers, and members of the reserve officer corps commissioned by DPS, and officers commissioned by the Bexar County Hospital District (Protective Services)"
400
True or false. You may seek a court compelled medication order on a patient under OPC?
What is false? Patient must be at least under temporary commitment status.
400
Temporary commitment requires this number of physician certificates and from which types of physician.
What is two physicians certificates of mental illness, at least one of which must be from a psychiatrist.
400
This level "burden of proof" is required for extended commitment?
What is "clear and convincing evidence."
500
This Supreme Court Case set the main precedent for hospitals not being allowed to confine a non-dangerous individual if they are capable of surviving by themselves or with the help of willing family members?
What is "O'Connor vs. Donaldson" in 1975? Kenneth Donaldson (confined patient) had been held for 15 years in Florida State Hospital at Chattahoochee, due to needs of "care, maintenance, and treatment." He filed a lawsuit against the hospital and staff members claiming they had robbed him of his constitutional rights, by confining him against his will. Donaldson won his case (including monetary damages) in United States District Court, won the appeals, and in 1975 the victory was reaffirmed by the Supreme Court.
500
In certain states, physicians may initiate an order for emergency detention. True or false?
What is true?
500
You are called at 1 am for an evaluation of a patient who has threatened to commit suicide on a medical floor. The primary team asks you if you want to proceed with emergency detention or OPC since psychiatry is already involved
What is emergency detention? Emergency detention is immediately actionable and does not need to be filed with the court like the OPC. Rule of thumb- after hours, ask for emergency detention. If protective services gives you trouble, ask for officer in charge.
500
True or false. Patient has the right to a jury with the temporary commitment trials.
What is true?
500
The length of time required to be in temporary commitment to stand trial for extended commitment.
What is 60 days?
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