Psychiatric admission typically requires a patient intake interview, review of documentation from other care providers, and evaluation to determine if the patient meets a facility’s criteria. If the patient cannot be hospitalized at a given facility but could still benefit from inpatient treatment, a referral may be offered. The requirements can depend on a facility’s policy, limitations from the patient’s insurance, and certain legal requirements, depending on the situation. For involuntary admissions, standards are higher to protect the safety and privacy of patients.
In an intake interview, a psychiatrist, nurse, or other trained mental health professional can meet with the patient to discuss the situation. The patient’s current symptoms can be discussed, along with any existing mental health diagnosis. Special attention is paid to concerns that the patient may be a danger to self or others, could experience acute psychosis, or might need complex therapy. A patient with drug addiction, for example, might require supervised inpatient detoxification for safety.
Any documentation on the patient can be reviewed, if possible, to collect more information to support a psychiatric admission. Some facilities accept patients by referral only and expect to see a letter from a primary care provider. Documentation can also provide information about history and may highlight particular issues that could exclude the patient. For example, some facilities don’t accept people with cognitive or intellectual disabilities because they lack the services to support them, and thus patients with dual diagnoses might be referred elsewhere.
The facility’s admission criteria are considered during review of the patient’s situation. Psychiatric admission may be granted automatically, if possible, in the wake of suicide attempts and psychiatric crises. In other cases, it may be necessary to triage to make sure enough beds will be available. Waitlisting is a possibility for patients who are not in immediate crisis, although they may be reevaluated in the future to determine if their situation has changed.
Input from both patients and family members may be considered in psychiatric admission. Patients electing to seek treatment can discuss why they believe they would benefit from inpatient care. In cases of involuntary hospitalization, law enforcement, social workers, and other people who interact with the patient may be asked to provide information. Detailed information gathering is critical to determine if the patient meets the legal standard for compulsory admission, as otherwise the situation might be considered a civil rights violation. Part of the psychiatric admission process also includes a discussion of goals and a discharge plan to limit the chances of remaining in inpatient care indefinitely.
