DETENTION

  • It is ED policy that a registrar should be consulted prior to a detention order being placed
  • Once detention is thought to be necessary than steps should be taken to prevent the patient from leaving and the detention form should be filled in as soon as practicable.
  • It is not a requirement for a patient to refuse admission before placing a detention order
  • A psychiatrist may decide to admit a detained patient to an open ward
  • Similarly, a psychiatrist may grant leave to a detained patient if deemed appropriate

Indications

  • The person has a mental illness that requires immediate treatment
  • The treatment is available
  • The person is at risk to the safety of themselves or others

Filling in the form (Form 1)

  • 'Approved treatment centre' refers to an approved institution for psychiatric care - e.g.  TQEH, FMC, RAH, Glenside Campus. 
  • Section 1 - An accurate time and date should be provided as this also relates to the time when the detention needs to be reviewed
  • Section 4 - The medical officer should provide as much detail as necessary regarding the individuals mental state e.g. behaviour, speech, thoughts, emotions, level of insight
  • Section 5 - The address should be the doctor's work address not home address

Providing Statement of Rights (Form 7)

  • It is a legal requirement that a detained patient should be personally given his legal rights or if this is not possible (patient is sedated/physically restrained) then it be given to the next-of-kin
  • If the patient refuses to accept a copy of his rights, this should be documented
  • All details are provided in the Statement including who to contact if an appeal is requested

Arrange for a psychiatric bed

  • ACIS should be contacted once the decision for detention is made and any organic condition is excluded
  • ACIS will arrange for a bed and determine whether a psychiatric review is required in the ED or once the patient is transferred

Confirming detention

  • A patient must be firstly reviewed by a psychiatrist within 24 hours (or as soon as practicable) whereupon he may confirm the order to continue for a total of 72 hours
  • After the first confirmation and before 72 hours has elapsed since the initial detention, the psychiatrist must confirm the detention again or else it will lapse and the patient may leave of his own accord

 

Disclaimer: Note: The information described here relates solely to operational matters in the Emergency Department.  Every effort has been made to verify the accuracy of the content. However, neither the author or the hospital will take responsibility for errors resulting from its use.  Please refer to your own departmental guidelines and verify all clinical decisions with a reliable source.  

Date Last Reviewed: 05/08/2004