By Marcy Phipps, RN

(Identifying details of the patient and clinician mentioned in this post have been changed to protect their anonymity.)

Last week I took care of a woman who’d shot herself in the abdomen. This was the third suicide attempt she’d survived. She was physically compromised, to say the least, and was looking at a long recovery. Her despondence was palpable. 

A clinical psychologist came to evaluate her and determined that she was experiencing major depression with suicidal ideations. 

Red For Danger/via RichardO, Flickr

Usually, such patients are “Baker Acted.” In accordance with the Florida Mental Health Act, commonly referred to as the Baker Act, individuals who are deemed to be a danger to themselves or to others are held involuntarily and transferred to a treatment facility.

But because this patient stated to the psychologist that she was not only willing to seek mental health treatment, but also planned on checking herself into a facility near her home, she didn’t qualify to be involuntarily hospitalized. She was free to leave at any time.

As the psychologist explained to me, the first criterion of the Baker Act only considers whether or not the person in question is refusing treatment. According to Florida Statute 394.463, as long as said person does not refuse to be examined, the Baker Act does not apply.          

Although the psychologist assured me that he would find a way to provide the patient with a “safety net,” I found it ironic and slightly shocking that the only thing stopping her from leaving the hospital and carrying out her intentions was the physical self-harm that she’d already inflicted.

 Towards the end of the day my patient suffered a coughing fit that left her gasping for breath. When I asked her if she was alright, she seemed to forget herself for a moment and replied, “I hope so.”

It seemed a strange thing for her to say.

And since she doesn’t qualify for the Baker Act, I hope so, too.

Marcy Phipps is an RN in St. Petersburg, Florida. Her essay, “The Soul on the Head of a Pin,” appeared in the May issue of AJN, and she has contributed several posts to this blog in recent months (here’s the most recent).

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