00:01
So what kind of treatment settings
are there for inpatient care?
When we think about inpatient care,
if a patient is ill enough to be
admitted into a hospital or a unit,
it is for crisis stabilization.
00:21
It is to observe this patient.
00:25
It could be in a general hospital,
it can be in a private hospital,
it could be in a state hospital.
00:34
The way they get into the hospital
is through direct admission.
00:40
And they need to be referred.
00:44
It might be in an
emergency department.
00:46
So if you are working in ED,
you might have the patient
that comes in with a crisis.
00:54
It might be in a crisis service,
where the phone call comes in,
where the person says
I'm going to kill myself.
01:03
Also, if you are
working to in a hospital
that is specifically
for psychiatry,
they may have a
psychiatric emergency department.
01:16
Or if you're working
in a large hospital,
they may have a separate emergency
department just for psychiatry.
01:25
Patients can be
admitted voluntarily
meaning they recognize
there's a problem
and they want to come in
and they want to have
our help to recover
from whatever
they're going through,
or maybe involuntary.
01:42
The patient lacks the insight
to understand
that they are now
in a crisis situation,
and they are going to either
hurt themselves
or hurt someone else,
and they need to be admitted.
01:58
The acute inpatient
psychiatric hospitalization
is intended for individuals
whose thoughts and behaviors
are posing a substantial risk,
either to themselves or to others.
02:14
This is really important
to remember
that we don't admit persons
to the psychiatric unit.
02:23
without understanding
that level of risk.
02:27
The information provided
by the individual seeking treatment,
and the information provided by
the family or perhaps friends
can be considered when determining
the most appropriate treatment.
02:41
What kind of setting
do we want this person to be in?
Is it a voluntary admission?
Is it an involuntary admission?
We need to take all of the factors
into account.
02:53
In either case,
the person must be in need
of inpatient care and treatment,
and the facility must be suitable
to provide such care and treatment.
03:03
So this is an interesting situation
that may come to your attention
when you are working
in the hospital.
03:13
Because if you're working
in an emergency room,
and a person is coming in,
they may be looking for
voluntary admission.
03:21
So a voluntary admission
is when a patient
or if the patient is a minor
or is incompetent,
which means that they have a
person who is responsible for them,
who has been chosen and now
is court appointed as a guardian.
03:40
So the patient or that guardian
can go and sign
for a voluntary admission.
03:49
It is an acute inpatient
psychiatric hospitalization.
03:53
And it occurs when a person is going
for this psychiatric evaluation.
03:58
And the evaluating
mental health provider
and the patient together agree
that the patient would benefit
from being hospitalized.
04:08
And the patient now meets criteria
to be hospitalized.
04:14
That patient is required
to sign a consent form
that documents the patient's rights
and describes the inpatient
hospital experience.
04:24
So that's really important
that if that patient
needs to have a guardian.
04:29
For example, if that patient also
has an intellectual disability,
and has a full time guardian,
that patient is going to be
having their rights explained
and the hospital experience
explained,
but it will be the patient
and the guardian
that will sign and
understanding that says,
"This is why I'm being admitted.
This is what's going to happen."
And then by signing that form,
that patient is agreeing
to be hospitalized
on a unit
where the doors are locked.
05:10
The psychiatric unit
has the doors locked,
the patient will not be able
to walk off that unit.