Q.

My center has a client in a transitional housing program who experienced chest pains and was admitted to the hospital for treatment of a heart condition.  She left the hospital against medical advice.  Because of her deteriorated mental status she was then admitted to a psychiatric hospital suffering from psychosis. The patient refused to sign a release allowing the psychiatrist attending her in the hospital to review the medical records of her treatment for her heart condition.  Consequently the psychiatrist refused to prescribe medication for bipolar disorder.

The patient is being held by the hospital for involuntary examination and is pending a "45 day hearing" for involuntary treatment. I believe that the patient is currently a danger to herself constituting a medical emergency under our state law.

My center and the hospital are unrelated and the attending psychiatrist is not providing services to the patient through the center.
 

A.

I suggest that you contact your center's attorney regarding the possibility of asking the judge who will be presiding over the "45 day hearing" to issue an order consenting to release of the heart treatment records and the psychiatric hospital records to your center and to the attending psychiatrist.  By the nature of your patient's mental illness she is not competent to provide that consent and it is in her best interest that the consent be given.