Managerial Epidemiology
Helpm31990
Chapter13.pptxChapter 13: Risk Management in Psychiatry
Psychiatric Care
Healthcare and treatment of persons with acute and/or chronic mental illness
Provided in various types of healthcare settings
Specialty facilities
Special unit in a hospital
Ambulatory centers
Private offices
Informed Consent
Psychiatric patients have the right to select their treatment (as do all patient) unless deemed incompetent.
For the patient to be considered competent to consent to treatment, they must be able to:
Communicate a choice
Understand information about the treatment
Recognize the clinical situation
Manipulate information rationally
Informed Consent and Research
Research guidelines must adhere to the general informed consent requirements
The National Bioethics Advisory Commission issued a report entitled “Ethical and Policy Issues in Research Involving Human Participants” which outlines basic principles for research studies
The Office for Human Research is another resource for guidelines on obtaining consent, especially for children
Right to Treatment
Right to the Least Restrictive Alternative
Closure of Psychiatric Facilities
Involuntary Outpatient Treatment
Medical Necessity
Insurance Coverage
Psychiatric Advanced Directives (PAD)
Right to Refuse Treatment
All patients have the right to refuse treatment, even patients with mental illness.
Psychotropic Medications
Involuntary Hospitalization
Involuntary Outpatient Treatment
Clinical Risks
Psychopharmacology and Side Effects
Electroconvulsive Therapy
Suicide
Discharge and Aftercare Planning
Seclusion and Restraint
Elopement and Wandering
Child and Adolescent Psychiatry
Confidentiality and Stigma
Public view of mental illness
Privileged Communication
Duty to Protect/Warn
High Risk Incidents
Violence and Mental Illness
Violence in the Institution
Availability of Illicit Substances
Professional Sexual Misconduct
Staff-Patient Sexual Misconduct
Other Areas of Concern
Fraud and Abuse
Public Safety
Noncompliance with treatment regimen
Summary
Patients with mental illness have the same rights as all patients unless deemed incompetent.
There are additional risk management concerns involved in treating patients with mental illness.
