Exceeding the Legal Time Limits for Involuntary Mental Health Examinations: A Study of Emergency Department Delays

Policy Polit Nurs Pract. 2015 Aug;16(3-4):67-78. doi: 10.1177/1527154415602296. Epub 2015 Sep 8.

Abstract

This study addressed delays to involuntary mental health examinations experienced by individuals in emergency departments (EDs). Florida statute specifies that involuntary mental health examinations shall take place only at state-designated facilities "without unnecessary delay"-no longer than 12 h until transfer-for individuals in hospital EDs. Individuals in EDs needing involuntary mental health examinations sometimes wait for admission to inpatient units because of unavailability of mental health services. Data collectors at two hospitals reviewed the records of 170 randomly selected ED patients requiring involuntary mental health examinations. Nearly one-half (48.8%) of participants waited longer than the 12-h maximum allowed by Florida law for transfer to an authorized facility. Factors that associated with prolonged waits were being male, increased age, being a Medicare beneficiary, and being intoxicated. State agencies responsible for the regulation of hospitals and mental health facilities should use this data and engage front-line caregivers to identify statutory remedies.

Keywords: boarding; health services; length of stay; mental; mentally ill commitment; mentally ill person; psychiatric emergency services.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Confidence Intervals
  • Emergency Service, Hospital / legislation & jurisprudence*
  • Emergency Treatment
  • Female
  • Florida
  • Humans
  • Length of Stay / trends*
  • Male
  • Mental Disorders / diagnosis
  • Mental Disorders / therapy*
  • Mental Health Services / organization & administration*
  • Middle Aged
  • Needs Assessment
  • Odds Ratio
  • Risk Factors
  • Sex Factors
  • Time Factors
  • Waiting Lists*
  • Young Adult