BRETT BUCHANAN
LAW
Protecting patients, society State mental health hold law “antiquated”
BY CRYSTAL ZUZEK When Temple emergency physi- cian Robert Daniel Green- berg, MD, encounters sui- cidal or homicidal patients, he doesn’t have the legal authority to temporarily hold them. For example, if the parents of an unre- sponsive 19-year-old pa- tient fear he’ll commit sui- cide once he wakes up, Dr. Greenberg says he’s power- less to temporarily detain him. He has to wait for a judge to issue an emergen- cy detention order. Generally, Texas law al- lows people who pose a significant risk of harming themselves or others to be detained for up to 48 hours with a judge’s order. Dr. Greenberg, chair of
the Texas Medical Associa- tion Interspecialty Society Committee, describes Texas’ law on mental health holds as “antiquated,” adding that it assumes all psychi- atric care occurs in an inpa- tient setting.
Chapter 573 of the
Texas Health and Safety Code addresses emergency detention of people with mental illness by a peace officer, judge, or magis- trate; transportation of de- tainees to a health facility; release from emergency detention; and rights of those apprehended, de- tained, or transported for emergency detention. To read the full statute, visit
http://bit.ly/1eC4bel. The law’s requirements for temporary mental health holds are especially problematic in a hospital emergency department when a police officer is not available, Dr. Greenberg adds.
“This is clearly not the case, nor is it optimal. Often times, psychiatric emergencies are managed in emergency departments throughout the state by emergency physicians. The additional burden of requiring a peace officer or judge to become in- volved before any action can be taken prevents timely treat- ment of these potentially dangerous patients and complicates the patient interaction,” Dr. Greenberg said.
Security guards and nurses detain patients who are a danger to themselves or others in Scott & White Healthcare’s psychiatric unit. Emergency physician Robert Greenberg, MD, is one of many Texas physicians calling for legislation to authorize physicians to place temporary mental health holds on patients pending a medical evaluation.
“The physician has no choice in such situations but to let the patient leave. It seems counterintuitive that a physician is the ex- pert needed to release pa- tients with mental illness, but a physician can’t initi- ate a mental health hold,” he said.
Arlington psychiatrist
Les Secrest, MD, a consul- tant to the TMA Council on Legislation, says he often
can persuade patients in crisis to cooperate and agree to tem- porary detainment.
“Nobody signed up for mental illness. Situations do arise in which physicians think a patient with mental illness poses a significant danger. In those cases, physicians need to be able
November 2013 TEXAS MEDICINE 29
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