The Florida Mental Health Act or is
more common name the Baker Act is a law in our state of Florida. The purpose of
this act is so that a client who is a danger to themselves or others can be
placed in confinement for a short amount of time (72 hours or more) while they
get stabilized (Florida Mental Health Act n.d). The persons who can initiate
this involuntary examination are: Judges, Police officers, Doctors, or Mental
Health professionals (Florida Mental Health Act n.d). As long as that official
has evidence to prove that the client is going to harm themselves, another
person, or is having issues with a mental illness; then that client is
transferred to a counties crisis stabilization unit.
Additionally, any client can also
voluntarily check themselves into a crisis stabilization unit. However, even
though your client may have voluntarily checked they cannot check themselves
out whenever they are ready. Since it is a crisis stabilization unit you client
has to wait for their doctor and psychiatrist to feel that they are stable enough
to not harm themselves or others in the outside world (Florida Mental Health
Act n.d). Also if the doctors in charge of their care feel that there is enough
evidence of the client’s unstable condition they can be transferred to
involuntary status after the evidence is reviewed by a magistrate (Florida
Mental Health Act n.d). This, transfer can potentially lengthen a client’s stay
in the unit.
When your client is admitted to the
unit their clock starts (the count down to 72 hours of involuntary time).
During the initial 24 hours that client will meet up with case managers,
therapists, psychiatrists, and/or a medical doctor in order to form a treatment
plan for their care while there here. Since many of these units are in
hospitals your client may have a roommate and may not be in a room by
themselves. Your client will also have access to medical care and medication
management services if they require them. However, during this time your client
will be around people of varying mental health statuses; ranging from the
functional to dysfunctional. And client are not allowed to leave the unit until
they are discharged by the psychiatrist and doctor who is in charge of their
care.
This stabilization is by no means
free of charge. Your client will have to pay for all services during their
stay. And if they do not have insurance it will be difficult for them to find a
facility. Local facilities do accept clients without insurance however they
will try to fill their beds with clients who do have insurance first before
admitting clients who do not. Your client without insurance will still receive
a bill for all services. All clients have to be admitted to a receiving
facility when they are baker acted because it is the law. So on the bright side
there is no way that your client in crisis will be turned away. Lastly, your
clients stay in a mental health facility is added to their record. Even if it
is on a temporary status. Because of this mark on their record you client will
never be able to own a firearm (Katz 2013).
During you clients short stay they
will be interacting with therapists, nurses, medical doctors, physiatrist, and
other patients. They will receive three square meals a day along with mediation
if they require it. Your client will have ample access to therapeutic groups
that are run through the day. There they can not only talk to the therapist/ co
therapists they can also socialize and meet others who may have a condition
similar to theirs. Your client can also have a family session or couple session
if they feel the need to mediate with their loved ones before returning home.
They also have access to a case
manager. If your client unfortunately lives in an environment that is
contributing to their mental status or causing them to enter a crisis stage more
often. The case manager can connect your client to a halfway house, assisted
living facility that meets the need of your client and contains a population
that is similar to them. In addition to assisting your client with their living
situation the case manager and therapist can set your client up with other
therapeutic resources.
This, article is by no means meant
to sway readers away from baker acting a client. If anything it is meant to get
future and current clinicians to consider these issues before baker acting
clients too easily. If possible before baker acting a client there are some
steps that will come in handy in making this decision on the behalf of your
client:
1. Identify the problem or dilemma.
·
Does a problem or dilemma actually exist?
·
Is this an ethical, legal, moral, professional,
or clinical problem?
2. Identify the potential issues involved.
·
How might you best evaluate the rights,
responsibilities, and welfare of all those involved and those who are affected
by the decision, including your own welfare as a practitioner?
·
What actions have the least chance of bringing
harm to your client?
·
Are there any ways to encourage the client to
participate in identifying and determining potential ethical issues?
3. Review the relevant ethical codes.
·
Are your values in agreement with the specific
ethical code in question?
·
How clear and specific are the codes on the
specific area under consideration?
·
Are the codes consistent with applicable state
laws?
4. Know the applicable laws and
regulations.
·
Are there any laws or regulations that have a
bearing on the situation under consideration?
·
What are the specific and relevant state and
federal laws that apply to the ethical dilemma?
·
What are the rules, regulations, and policies of
the agency or institution where you work?
5. Obtain consultation.
·
Do you know where to go to obtain consultation
with professionals who are knowledgeable about ethical issues?
·
What kinds of questions do you want to ask of
those with whom you consult?
·
With whom do you seek consultation?
·
What kinds of information do you document when
you consult?
6. Consider possible and probable courses
of action.
·
What are some ways that you can brainstorm many
possible courses of action?
·
Are you willing to involve your client in the
discussion of the various courses of action?
·
What might you document pertaining to
discussions with your client about probable courses of action?
7. Enumerate the consequences of various
decisions.
·
How can you best evaluate the potential consequences
of each course of action, before implementing a particular action plan?
·
What ethical principles can you use as a
framework for evaluating the consequences of a given course of action?
·
Examine the consequences of various decisions
for your client, for you as counselor, and for the profession in general.
8. Decide on what appears to be the best
course of action.
·
After carefully considering all the information
you have gathered, how do you know what seems to be the best action to take?
·
Once you have formulated a plan of action, ask
for feedback from a colleague or supervisor.
·
Once the course of action has been implemented,
evaluate the course of action.
*Adapted
from Corey, G., Corey, M, & Haynes, R. (1998). Student workbook for Ethics in Action. Pacific
Grove, CA:
Brooks/Cole.
Resources:
Katz, D. (2013) Buy a gun? You can’t if you’re disqualified.
Retrieved from: http://blogs.findlaw.com/blotter/2013/03/buy-a-gun-you-cant-if-youre-disqualified.html
Florida Mental Health Act (n.d) Retrieved from: http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&Search_String=&URL=0300-0399/0394/0394PARTIContentsIndex.html
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