Gavin Howe
In the US, people can be forced to receive emergency treatment for mental health issues against their wishes under certain circumstances. This is known as an 'emergency hold' or 'involuntary commitment'. The laws vary from state to state, but generally, people can only be forced into treatment if they are at risk of serious harm or of seriously harming another person. If someone is receiving involuntary treatment, the facility must follow certain rules, including documenting the reasons for treatment and personally examining the patient every day.
What You'll Learn
Healthcare providers' obligations in mental health emergencies
Healthcare providers have a number of obligations in mental health emergencies. Firstly, it is important to communicate with patients about their obligations and interest in their well-being before emergency situations arise. Being upfront and transparent with clients helps set expectations. This can be done through detailed intake forms and client consents. However, it is not just a matter of having clients sign a piece of paper or check a box. Policies and procedures should be part of the informed consent conversation at the start of treatment.
In the event of a mental health emergency, healthcare providers must determine whether the danger is imminent and whether disclosure is in the patient's best interest. If a patient is in imminent danger, HIPAA's Privacy Rule allows a healthcare provider to disclose protected health information (PHI) without the patient's permission. PHI can be shared with anyone who is in a position to prevent or lessen the threatened harm to a patient, including family, friends, caregivers, and law enforcement.
During government-declared states of emergency, disaster, or public health emergency, the legal landscape changes dramatically. Emergency powers that authorise screening, surveillance, and reporting of mental health conditions can enable public and private actors to address mental and behavioural health conditions within the affected population. For example, emergency mental health surveillance laws may require health personnel to report mental or behavioural health issues among their patients or professional colleagues to public health authorities despite potential privacy concerns.
It is important to note that addressing mental and behavioural health needs associated with emergencies is a crucial element of individual, community, and societal health and productivity. Public health emergency planning, mitigation, and response efforts must consider the mental health effects of natural disasters, pandemics, and other catastrophic events.
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Sharing patient information to get help
In the event of a mental health emergency, healthcare providers have certain obligations. In the US, the HIPAA Privacy Rule allows healthcare providers to disclose protected health information (PHI) without the patient's permission if the patient is in imminent danger. This information can be shared with anyone who is in a position to prevent or lessen the harm to the patient, including family, friends, caregivers, and law enforcement. However, it is up to the provider to determine whether the danger is imminent and whether disclosure is in the patient's best interest. Information should only be shared with those who can help prevent or lessen the harm.
During government-declared states of emergency, disaster, or public health emergency, the legal landscape changes. Emergency powers may be authorised to screen, surveil, and report on mental health conditions to enable public and private actors to address mental and behavioural health conditions within the affected population. For example, emergency mental health surveillance laws may require health personnel to report mental or behavioural health issues among their patients or colleagues to public health authorities, despite potential privacy concerns.
It is important for healthcare providers to communicate with patients about their obligations and interest in their well-being before emergency situations arise. Being upfront and transparent helps set expectations. Detailed intake forms and client consents that address these issues are important, but it is also crucial that policies and procedures are part of the informed consent conversation at the start of treatment. If there is a challenge in balancing professional concerns, the patient's wishes, and legal risks, a healthcare lawyer can provide guidance.
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Emergency laws and negative mental health outcomes
During government-declared states of emergency, disaster, or public health emergency, the legal landscape changes dramatically. Some of these changes can facilitate mental health preparedness efforts. For example, emergency mental health surveillance laws may require health personnel to report mental or behavioural health issues among their patients or professional colleagues to public health authorities despite potential privacy concerns.
However, emergency laws may also contribute to negative mental health outcomes. This is particularly true for vulnerable populations, such as people with pre-existing mental and behavioural health conditions and otherwise healthy people whose mental health conditions emerge as a result of an emergency.
In the context of healthcare providers, it is important to communicate with patients about obligations and interest in their well-being before emergency situations arise. Being upfront and transparent with clients helps set expectations. This can be done through detailed intake forms and client consents that address these issues. However, it is important to note that this is not just a matter of having clients sign a piece of paper or check a box. Policies and procedures should be part of the informed consent conversation at the start of treatment.
In terms of sharing patient information, healthcare providers are allowed to disclose protected health information (PHI) without the patient's permission in certain circumstances, such as when a patient is an imminent danger to themselves. In this situation, the provider can share the PHI with anyone who is in a position to prevent or lessen the threatened harm to a patient, including family, friends, caregivers, and law enforcement.
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Emergency planning, mitigation and response efforts
In the context of mental health emergencies, healthcare providers must determine whether the danger is imminent and whether disclosure is in the patient's best interest. If so, HIPAA's Privacy Rule allows a healthcare provider to disclose protected health information (PHI) without the patient's permission. The provider can share PHI with anyone who is in a position to prevent or lessen threatened harm to a patient, including family, friends, caregivers and law enforcement.
It is important to communicate with patients about your obligations and interest in their well-being before emergency situations arise. Being upfront and transparent with your clients helps set expectations. Start by having detailed intake forms and client consents that address these issues. However, it's not just a matter of having clients sign a piece of paper or check a box. Your policies and procedures should be part of the informed consent conversation at the start of treatment.
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Informed consent
In the context of mental health emergencies, informed consent may be challenging to obtain due to the nature of the situation. However, it is essential to respect the autonomy and rights of individuals, even in emergency situations.
Mental health emergency laws, such as emergency hold laws, permit the involuntary admission of individuals with acute mental illnesses under certain circumstances. These laws vary across states, but they generally reflect the standard established in O'Connor v. Donaldson, which states that people cannot be forced into treatment unless they are at risk of serious harm to themselves or others.
If an individual is forced to receive emergency treatment against their wishes, the facility must follow specific rules and guidelines. For example, involuntary treatment should not exceed three days, excluding weekends and holidays. The facility must also document the reasons for the involuntary treatment and conduct daily personal examinations if the treatment extends beyond 24 hours.
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Frequently asked questions
Yes, you can sue your employer for emotional distress if you can prove that their actions or negligence caused severe emotional harm. You should document all of the conditions at work causing you mental harm and keep track of your symptoms. Visiting a medical professional to evaluate the mental health implications from the emotional distress is a good idea so you can obtain more evidence as to how you were affected.
There are typically two categories for emotional distress claims: “pain and suffering” and “infliction of emotional distress”. "Pain and suffering" is a broader category and includes an emotional distress claim where someone’s mental health was affected because of a physical injury.
If you are unable to obtain a written recommendation for a mental health evaluation or treatment from an authorized physician, your employer, and their insurance carrier are not obligated to authorise it. If you are having mental or emotional problems that you believe are related to your job, you should immediately seek the advice of a lawyer specialising in workers’ compensation.
If you want to sue your employer for emotional distress, the documentation must show that the employer’s actions are pervasive and intentionally inflicted and/or have a negligent infliction. The final step is to visit an employment lawyer.
