Definition Forensic Psychologist- Psychiatry| Learn Accuses?
Forensic Psychologist- Psychiatry, Health insurance portability, and accountability act, Involuntary civil commitment, Suspected child abuse, Habeas CorpusDefinition to Forensic Psychiatry – Psychiatry|
1)- Legal considerations?2)- Confidentiality?
3)- Health insurance portability and accountability act?
4)- Involuntary civil commitment?
5)- Suspected child abuse?
6)- Habeas Corpus?
7)- Types of hospital admissions?
8)- Online Psychiatry Course
What is the role of a forensic psychologist?
the Definition Forensic Psychologist Industry?
Now, Im going to introduce you to the topic of Forensic Psychiatry, and well see how the legal system can overlap with mental health.
There are a lot of things were going to consider here including confidentiality, civil commitment, informed consent, criminal matters.
Were going to look at competency, and versus capacity medical malpractice. So, let's get started now on the civil side of things by talking about confidentiality.
The definition between a doctor and a patient should be confidential.
The physician has to hold matters revealed by the patient in the course of treatment in strict confidence from unauthorized third parties.
Health insurance portability and accountability act?
In the United States, we have something called HIPAA, which is the Health Insurance Portability and Accountability Act.This is a federal statute that imposes several requirements on the disclosure of information and the protection of patient privacy in clinical care and research.
So, I want to introduce you to Jane were going to follow I think the story of Jane in this case study throughout this lecture.
Jane is a 33-year-old woman. She comes to the emergency room by ambulance and is in an acute state of distress.
She is sobbing uncontrollably. She has cuts on her arms that are actively bleeding.
She talks about wanting to end it all. She is unable to provide any further history to you and is very agitated.
She is so agitated that an empty bottle of pills falls out of her purse and you notice its a bottle of alprazolam.
You know that that's a controlled substance, a benzodiazepine, that's highly addictive, could be deadly in both overdose and withdrawal.
So, how would you proceed now with your assessment of this woman who is agitated and not giving you a lot of information and has arrived in the emergency room?
So, there are a lot of things that you are going to consider. So, there are emergent issues here and youre going to address them immediately.
Definition Forensic Psychologist - Psychiatry Learn Accuses
Once she is medically cleared, Forensic youre going to be thinking about wanting to get a psychiatric consult involved down the road. There are going to be then some next steps in her management and safety plan, and eventually when shes well.
youre going to be thinking about her disposition and transfer outside of the hospital. But, first things first.
the emergency room and you're assessing her for safety and also for possibly acute intoxication or withdrawal from.
she is refusing to talk to you because she is too agitated. So, what do you do next?
Well, youre going to, of course, forensics emergently treat her by checking her vital signs forth.
Youre also going to consider calling collateral information. Youll review the EMSrecord that brought her to the hospital.
So, as a provider, when you learn that this patient has a history of suicide attempts because you've reviewed previous medical records from your hospital,
you see that shes had suicide attempts, she has abused benzodiazepines, and also has an alcohol-use disorder.
Definition Forensic Psychologist- Industry
Forensic Psychologist Industry You learns from EMS that there's a small child that was in the home.You've checked her vital signs and also gotten a blood alcohol level and you've made sure to secure her ABCs and make sure shes medically okay.
Once shes medically stabilized, Forensic Psychologist youll assess her further for safety.
So, youll probably put her on the benzodiazepine I think taper because shes going to be at risk and for withdrawal, which could be deadly.
Youll treats her with thiamine and folate and you'll probably be going to admit her once shes were emergently stabilized but ready for transfer.
Shell probably goes to the intensive care unit for a little while and youre going to get a social worker involved to consult regarding what's happening with this child at home.
Once your ready, youll consider psychiatry consults to the medical unit once the patient has been stabilized in the ICU.
The purpose of the psychiatric Forensic consult is to do a more thorough and risk assessment to find out, you know,
Confidentiality- Definition to Forensic Psychiatry
what the best setting of care and for Jane will be.So, when is it okay to breach confidentiality? Well, when you don't have a lot of information about a patient.
you are in an emergent setting, that's one place where confidentiality can be breached.
A patient can waive the right to confidentiality and tell you to call whomever you like.
When a patient is found to be incompetent, then you can breach Forensic Psychologist and confidentiality.
When records are requested for legal purposes, that's sometimes okay to breach confidentiality, and whenever there's a risk of harm to a third party,
then you must intervene as a physician.
So, you learn from collateral sources who you contacted and forensic because Jane was emergently at risk.where you learn from them that Jane has a psychiatrist and that she is a single mother with a small child at home.
She has been seeking psychiatric care for a while.
The EMS team tells you that the home was in severe disarray with dirty dishes everywhere.
empty pill bottles lying around and there is a 4-year-old at home crying who appeared malnourished with bruises on her arms, legs, and abdomen.
So, what's your obligation now regarding this child? So, remember, you have to protect third parties from harm.
So, you want to also make sure that, because this is aa minor, that you have your social services team or you make sure that the child is protected.
This was probably done by EMS, but you want to confirm that Child Protective Services is involved in this case.
So, what is the physician's duty forensic Psychologist if here she suspects child abuse?
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Suspected child abuse- Forensic Psychologist
Well, although it varies by jurisdiction, the duty is to report all cases of suspected child abuse to the appropriate government entity.
the breach of confidentiality is ethically forensic permissible when there is a need to protect the patient or third parties.
That's important to remember.
The bottom line is that I think there is a basic duty to protect a potential and victim if a therapist.
knows of a patient's potential for substantial harm to an identified or readily identified the individual.
When it comes to protecting third parties, and we go back to the key case of but Tarasoff versus California.
Although this case can vary from state to state, it sets the president for the need to either warm or protect third parties from harm.
Let's talk now about commitment. So, commitment is the process of hospitalizing the person and against his or her will.
Involuntary civil commitment? Psychologist
This is referred to as an involuntary civil commitment. In the Supreme Court case of OConnor versus Donaldson ruled that a harmless patient.cannot be confined against their will without treatment if they could survive in a less-restrictive setting.
So, that's something very important to understand. When a patient is hospitalized against their will, they have a right to what is called a writ of habeas corpus.
Now, what is that? Well, it's a petition that a person can file with the court if they feel that they have been illegally deprived of their liberties.
Let's go back to the case of and Jane who appears to have made a suicide attempt. So, in the case of Ms. Jane, when she eventually sobers up and she's doing a bit better, you learn that she is feeling very suicidal.
She complains of wanting to die and she tells you that shes hopeless about her future.
You recommend to her that she go to the inpatient psychiatry unit for further treatment but Jane knows that ChildProtective Services have been called and she's very upset, and she says,
I won't follow your recommendations. I'd rather go home and die. So, how are you going to get Jane?
the psychiatric treatment that, and you now know she needs because she is threatening to harm herself?
So, Heres where you consider hospitalization and its important to know about the different types of admission to an inpatient psychiatry unit,
of course, this can vary by states and countries.
But in general, a voluntary admission is when a patient requests help and they agree to go to the inpatient unit.
They agree to the spirit of treatment, and working with their doctor's nurses to making a plan and then leaving once they feel safe.
An involuntary admission refers to, in theUnited States, what's called a commitment process, and an involuntary admission is something that happens.
when a patient is at risk of harming themselves, others, or cannot meet their basic needs of life.
So, what is a civil commitment? Well, its really the deprivation of fundamental rights guaranteed under the US constitution. So, before a state or entity.
can deprive an individual of their fundamental rights, proper procedural protections must be granted, which is called due process. All individuals.
can only be involuntarily committed only if they are a danger to themselves or others.
So, in the case of Jane, and she was harmed to herself. It's possibly her child was at harm and also there is a question if she was able to meet her basic needs of life,
the meaning was she so depressed and suicidal that she had become gravely disabled?
There was evidence of that in her home by it being in complete disarray with empty bottles lying around.
the commitment criteria or criteria to involuntarily and admit someone to an inpatient psychiatry unit requires harm to self,
harm to others, inability to meet demands of ordinary life such that they're gravely disabled.
Jane ends up getting admitted and the inpatient psychiatry unit against her will because of a risk of serious harm.
Once there, and Jane quickly sees the benefit she agrees to treatment and agrees to become a voluntary patient.
Habeas Corpus? (Forensic Psychologist)
She says I want to work with my treatment team. She forgoes her right to file a writ of habeas corpus.She forgoes her right to have a court hearing for civil commitment but rather she says,
Now, I'd like to be voluntary. I want to stay here and I want to work with my team.
So, you end up recommending, Jane that she avail herself of therapy and you also recommend she take some medication to help with her symptoms.
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