View source for Involuntary psychiatric hold

==Background==
*Involuntary hospitalization of patient threatening/attempting to leave the ED for purposes of evaluating patient's risk of harm to self/others and/or ability to safely care for self.
*'''Exact criteria and process vary by jurisdiction'''

==Evaluation==

'''"Clinical factors related to admission and release decisions in psychiatric emergency services"''' <ref>Way BB, Banks S: Clinical factors related to admission and release decisions in psychiatric emergency services. Psychiatr Serv 52: 214, 2001.</ref><ref>Tintinalli's Emergency Medicine A Comprehensive Study Guide, 9th edition Tintinalli, Ma, Yealy, Meckler, Stapczynski, Cline, and Thomas</ref>
*''in declining order of importance:''
#level of danger to self
#severity of psychosis
#ability for self care
#impulse control
#severity of depression ( [[Depression | SIGECAPS]] , [[SAD PERSONS score | SAD PERSONS]] )
<br>

'''Crisis Triage Rating Scale''' <ref>Bengelsdorf H, Levy L, Emerson R, et al: A crisis triage rating scale: brief dispositional assessment of patients at risk for hospitalization. J Nerve Mental Dis 172: 424, 1984. </ref>
*''3 is worst, 15 is best''
*''has not been validated for ED use''<ref>Tintinalli's Emergency Medicine A Comprehensive Study Guide, 9th edition Tintinalli, Ma, Yealy, Meckler, Stapczynski, Cline, and Thomas</ref>
{| class="wikitable"
|-
! Element !! Components
|-
| '''Dangerousness''' (''from most severe to least severe'') || 1. Acute SI/HI, current serious SI/HI attempt, unpredictable
|-
| || 2. History of violent/impulsive behavior but no current signs
|-
| || 3. AmbivalentSI/HI but ineffective gestures
|-
| || 4. SI/HI but desire to control behavior
|-
| || 5. No SI/HI and no history of violent/impulsive behavior
|-
| '''Support System''' (''from worst to best'') || 1. None
|-
| || 2. Some but limited effectiveness
|-
| || 3. Some but not easy to mobilize
|-
| || 4. Yes but limited
|-
| || 5. Yes and good support
|-
| '''Cooperation''' (''from worst to best'') || 1. Not able or refuses
|-
| || 2. Little interest in cooperating
|-
| || 3. Passive acceptance of help
|-
| || 4. Wants help but desire limited
|-
| || 5. Strong desire for help and will cooperate
|}

==See Also==
*[[General psychiatric approach]]
*[[SAD PERSONS score]]

==External Links==
*[http://www.samhsa.gov/ Substance Abuse and Mental Health Services Administration (SAMHSA)]

==References==
<references/>

[[Category:Psychiatry]]