February 28, 2011

Flow Rider and the Baker Act

I made it to Florida! And besides the weather in the 80s, the sweet park across the street that runs through tons of golf courses and

During our orientation today we learned that much of our work in inpatient psychiatry will be related to Florida's "Baker Act" - the Mental Health Act of 1971 that allows physicians to involuntarily hold someone for psychiatric examination if they:

A) have a mental illness,
B) indicate any reason to suspect that they will harm themselves or someone else

After someone is "Baker Act-ed", as they say in our world right now, they are sent to our inpatient psych institute where a psychiatrist must evaluate them within 24 hours to see if they A) are competent to make decisions about their own treatment and B) need psychiatric or any other type of medical treatment.

After this, there are a few things that can happen. The first assessment is to determine if the person is competent to make decisions. The word "competent" carries a lot of weight in the medical (and legal) world, so it's a very important assessment. It's hard to be deemed competent if you are having a psychotic episode and think aliens are coming to get you - but you can be determined to be competent and suicidal.

If someone is determined to be incompetent, a surrogate decision maker is found - this can be a family member, close friend, or in the worst case scenario, a court-appointed surrogate decision maker.

If someone is determined to be competent they have some more decisions to make. They can decide to voluntarily consent to treatment and stay temporarily on an inpatient psychiatric floor for evaluation and treatment. This means the system accepts them as a patient and will either place them back at home, find them a home if they didn't have one when they came, or find them long-term psychiatric care, if it's determined that that's what they need.

If someone is determined to be competent but does not consent to treatment, practitioners can petition for involuntary placement either in an inpatient facility or an outpatient (community) placement. This language was only added in 2005. We'll see how it all goes tomorrow - we start with admitting at 9 and go from there.

"diseases of the soul are more numerous - and more dangerous - than diseases of the body"

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