A severely psychotic individual is brought to the ER after assaulting someone in a grocery store.
She has no identification and cannot provide a residence or name. After getting medically
cleared and IV hydration at Highland Hospital, She is brought to John George on a 5150 for DT0
and
Gravely disabled. She cannot speak coherent sentences and is talking to voices in her head rather
than focusing on the mental health assessment. The M.D. has ordered Zyprexa 10 mg p.o. Can
she refuse the medication?,,
After several days of continued disorganization and med refusual and refusing to bathe or eat the
Psychiatrist petitions for a REISE.
When can you give medication against her will and why?
Risk for self-harm and risk for harm to others as evidenced by poor nutrition and sleep due to
on going mania. Some cases patients do not know that they are ill since they are in a state of
mania. Yes, but only under specific circumstances and if we have tried all other methods first.
CPI methods:
-Verbal orientation redirection
What is a REISE hearing?
-A hearing that can be held to determine whether a patient can refuse treatment with
medications. This is usually held at a facility like the hospital that patient is receiving
treatment or by a judge in court.
How is this different than emergent medication?
-This is different from reise because when emergent medication is assesses and prescribed for
immediate administration whereas for Reise hearing there has to be a hearing at the hospital to
determine and address patient’s involuntary medication and emergency medication.
-Emergency situations when a patient health is severe neglect, self-harm, suicidal behavior, maniac
episodes, are some examples of when providers may qualify for emergent meds.
-non-verbal cues angry glares, disorganized, body movements