Cpse Ch 7 Clients Who Are Danger To Self/others

Front 1

duty to warn does not apply to

Back 1

1. someone other than client is the dangerous party
2. someone other than family mem reports that client has threatened to harm someone else (but do address w/ client)
3. no reasonably identifiable victim or victims (can hosp. though)
4. client threatens suicide (Bellah vs. Greenson= no duty to warn if suicide)
3.

Front 2

Who can disclose HIV status?

Back 2

Only surgeons and physicians, NOT shrink. They can disclose after telling client the results that they will disclose, but cannot tell the client's name. Also remind clients that by law, the client has to warn their partners; if shrink doesn't warn the client to warn their partners, it could be negligence.

Front 3

If an HIV pos. client poses a generalized danger to others as a result of a mental disorder

Back 3

try to tx the mental disorder. legal interventions (hosp, or quarantine) should be a last resort when tx has shown to be ineffective and is unlikely to alter their beh.

Front 4

Involuntary hosp. should be considered only when...

Back 4

1. the danger they pose is imminent or client is gravely disabled
2. the danger or grave disability is a result of a mental disorder or chronic alcoholism
3. client has refused or is unable to comply w/ a recommendation to enter hosp. voluntarily.

Front 5

72-hr hold aka 5150

Back 5

danger to self, others, gravely disabled.

Front 6

5230

Back 6

similar to 5150, but for those impaired as a result of alcohol or drug use

Front 7

"gravely disabled"

Back 7

a. unable to provide for basic needs for food,clothing,shelter due to mental disorder
b. found to be mentally incompetent

Front 8

the law does not define "mental disorder" for involuntary hosp...

Back 8

but CA courts usually interpret it for any sig. mental dis. in the DSM

Front 9

who can institute an involuntary hold?

Back 9

police, attending staff, mobile crisis team (particular members), or other professional designated by the county

Front 10

if a prof. believes they should be released but the attending psychiatrist doesn't agree...

Back 10

referred to medical director for final decision

Front 11

At the end of 72 hrs...

Back 11

either they release the individual, refer for voluntary tx, certify for additional involuntary, or begin the process of appointing a conservator.

Front 12

5250--14 day hold

Back 12

1. the result of a mental disorder or chronic alcoholism, danger to self/others
2. person has been advised that tx is required but they didn't voluntarily consent

Front 13

5250 certification

Back 13

the certification must be signed by 2 people (person from facility and a psych who participated in the eval) and a copy of the letter sent certified to patient, their attorney, or advocate designated on the certificate. Must also inform client they are entitled to a certification review or judicial review by writ of habeas corpus.

Front 14

certification review hearing

Back 14

occurs unless the client requests a judicial review; is held within 4 days of the date when they became certified. can be postponed 48 hrs. they can waive their right to a hearing or the right to be present.

Front 15

at the end of the 5250...

Back 15

either release them, refer for voluntary tx, certify for additional involuntary tx ("postcertification hold) or begin process of appointing a conservator.

Front 16

Postcertification Hold-Suicidal. 5260.

Back 16

can be held an additional 14 days if they threatened or attempted si. A certification review is not required for this time. Release of the patient is approved by the psych responsible for tx or a psych who collaborated. If they disagree, medical director makes final call.

Front 17

Postcertification Hold--Gravely Disabled

Back 17

may be certified for not more than 30 days of intensive tx following the 14-day hold. They have the right to habeas corpus and certification review hearing.

Front 18

5260: Serious Danger to Others

Back 18

After 14 days, a person may be confined for further tx for an additional period not to exceed 180 days if..
1. the person has attempted/inflicted harm/made serious threat while in custody
2. has demonstrated a danger of inflicting harm prior to custody
3. made a serious threat within 7 days of being taken into custody.

Front 19

5260 Danger to Others cont...

Back 19

the D.A. must file a petition with the court for this hold, and hearing must take place within 4 days after the petition was filed or within 10 days when the patient requests a jury trial.They can request a habeas corpus trial at any time.

Front 20

Conservator

Back 20

appt. by cour for 30 day (temp) or long-term (renewable one-yr periods)

Front 21

What is NOT gravely disabled?

Back 21

1. can survive safely w/out involuntry detention with the help of responsible family, friends or others who are willing and able to help. and specifically indicate in writing their willingness to do so.

Front 22

within 10 days of conservatorship...

Back 22

an individualized tx plan should be in place unless tx is specifically found to not be appropriate by the court. When the goals have been reached and they are no longer gravely disabled, the conservatorship shall be terminated by the court.

Front 23

involuntary commitment of a minor

Back 23

auth. is usually required from parents/guardian.The exception to the rule is if auth is not available, they can be committed for 72 hrs. The facility should make every effort to contact the parent.

Front 24

gravely disabled minor=

Back 24

nable to use the elements of life which are essential to health, safety, and dev. including food, clothing, and shelter, even though provided by others. MR, epilepsy, and other dev. disabilities, etoh, drug use, or repeated antisocial beh do not, by themselves, constitute a mental disorder.

Front 25

goal of minor tx

Back 25

least restrictive placement alternative. If the parents won't consent, they can still be held.