Modules 6 and 7: Health Promotion and the Involuntary Emergency Admission (IEA) Process

Reflect on your readings from modules 6 and 7 addressing health promotion and patients in a mental health crisis.  Consider how you as a PMHNP can impact those areas through mental health promotion, education, and advocacy. As you expand your vision of mental health promotion to the global level, think about how global mental health can impact your practice in your community or state.  Global mental health is not just limited to geography, it includes all settings.  

One of the NP Core Competencies indicates that the NP should provide a full spectrum of healthcare services including health promotion, preventive medicine, health protection, anticipatory guidance, counseling, and disease management. For the PMHNP this would stretch across the lifespan, for both men and women, and in all communities or settings where there is a need for mental health services. 

Step 1:

After completing the required readings and reviewing the applicable websites please  answer the questions below:

1.  What are the key components to promoting good mental health in individuals, families, and communities?  As you think about these key components, address the issue from one of the three viewpoints below.  Include evidence-based support and guidance in your response.

• If you are an FNP currently providing full-spectrum primary care across the lifespan how do you feel your practice will change as a PMHNP in regards to assuring adequate health promotion, preventive medicine, health protection, anticipatory guidance, counseling, and disease management working with those with mental health issues including those who are severely mentally ill, pregnancy, pediatrics, geriatrics, adults and those with substance abuse issues? What do you envision the barriers to preventive medicine will be and how could you work to enhance primary care/preventive medicine services for your patient population?
• If you are a WHNP, CNM, APN, GNP, or PNP who has predominantly practiced within one specialty area how do you envision integrating full-spectrum care to both men and women providing adequate health promotion, preventive medicine, health protection, anticipatory guidance, counseling and disease management working with those with mental health issues including those who are severely mentally ill, pregnancy, pediatrics, geriatrics, adults, and those with substance abuse issues? What do you envision the barriers to preventive medicine will be and how could you work to enhance primary care/preventive medicine services for your patient population?
• If you are an RN who is not in an advanced practice role, why do you think it is important for a PMHNP to have an eye on health promotion, preventive medicine, health protection, anticipatory guidance, counseling & disease management of mental health issues as well as physical health needs.   How do you feel you could stay up to date with those areas of primary care when your primary focus is psychiatry? 

Step 2:

Read: Exceeding the Legal Time Limits for Involuntary Mental Health Examinations- A Study of Emergency Department Delays.pdfDownload Exceeding the Legal Time Limits for Involuntary Mental Health Examinations- A Study of Emergency Department Delays.pdf

Here is a website that lists the state statutes on IEA (Involuntary Emergency Admission) for each state: https://www.treatmentadvocacycenter.org/storage/documents/state-standards/state-standards-for-civil-commitment.pdfLinks to an external site.Links to an external site.

This article outlines who can sign IEA papers for each state:  https://ps.psychiatryonline.org/doi/full/10.1176/appi.ps.201500205Links to an external site.

Step 3: 

From time to time, patients with severe mental health issues may require a higher level of care than can be provided in the community setting.  This may require the implementation of the emergency admission process. 

It is important to understand the IEA process in your state,  When you are in a crisis situation, you may have to respond quickly to the patient’s need for safety and you will not have time to look up the process for involuntary emergency admission (IEA).  The purpose of this assignment is for you to investigate the process, understand how to initiate the process, and understand the consequences of involuntary commitment in your state.  Please respond to the items below and keep this information as a reference when you begin to practice.  USE THIS TEMPLATE to record your information Download USE THIS TEMPLATE to record your information.  

• Outline the process for involuntary emergency admission, starting with the identification of a patient at risk who is in need of emergency mental health services all the way through admission to the facility, treatment, and discharge.  
• What types of situations would necessitate the initiation of the involuntary emergency admission process?
• What are the resources for follow-up after the patient has been released?  Give an example of how you would implement a health promotion plan for the patient who returns to the community.
• What are your thoughts on the IEA process in your state? Do you think it is reasonable, necessary, and accessible?
• How could you apply the TeamSTEPPS Model before, during, or after commitment to facilitate the best care for the patient?.  Remember to refer to your readings on TeamSTEPPS to give you some guidance on making your team choices.
• Identify a culture other than your own and discuss the implications of receiving a mental health diagnosis as well as being admitted to a psychiatric facility based on their cultural view of mental health/mental illness.

Step 3:

Upload your completed assignment to the grading area by 11:59 PM on Sunday of this week.