26 Tex. Admin. Code § 320.69 - Psychiatric Emergencies
(a) Nothing in this
subchapter is intended to preclude the administration of psychoactive
medication to any patient in a psychiatric emergency.
(b) If a physician issues an order to
administer psychoactive medication to a patient without the patient's consent
because of a psychiatric emergency, then the physician will document in the
patient's clinical record in specific medical or behavioral terms:
(1) why the order is necessary:
(2) other generally accepted, less intrusive
forms of treatment, if any, that the physician has evaluated but rejected;
and
(3) the reasons those
treatments were rejected.
(c) Treatment of the patient with the
psychoactive medication will be provided in the manner, consistent with
clinically appropriate medical care, least restrictive of the patient's
personal liberty.
(d) A brief
physical hold is not considered restraint for purposes of this subchapter
provided that:
(1) the individual currently
exhibits behavior that meets the definition of psychiatric emergency as defined
in this subchapter, or the individual is currently under a court order allowing
the facility to administer medication without consent of the individual, the
individual is refusing medication, and the medication ordered is permitted by
the court order;
(2) the purpose of
administering medication is active treatment to reduce symptoms of a diagnosed
mental illness;
(3) using
medication to reduce specified symptoms of a diagnosed mental illness is
standard clinical practice;
(4) the
specific medication and dosage ordered can be clinically justified as in
keeping with standard clinical practice and are appropriate for reduction of
specified target symptoms; and
(5)
the physical hold is terminated as soon as the medication is
administered.
(e) When
the psychiatric emergency is no longer imminent or present, medication
prescribed without consent on an emergency basis must be safely discontinued.
If continued use of medication is recommended on a regular basis, the physician
must comply with provisions outlined in § 414.406 of this title (relating
to Patients Admitted Under Texas Statutes), § 414.407 of this title
(relating to Patients Committed to Mental Health Facilities Under Provisions of
the Texas Health and Safety Code), or § 414.408 of this title (relating to
Patients Committed to Mental Health Facilities under Provisions Other than
Those Found in the Texas Health and Safety Code (i.e., Code of Criminal
Procedure, Family Code)), as appropriate.
(f) In no case may inappropriate designation
of a situation as a psychiatric emergency be used to circumvent the process of
obtaining consent or applying to the court for an order authorizing
administration of psychoactive medication.
Notes
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