Do you have any info on how a 72-hour health and welfare hold would work for a 13-year-old kidnapping victim MC who has been arrested for a crime and whose mother is several hours away? (Story takes place in CA) I assume he would go to the nearest children's hospital. Any thoughts on how things would proceed from there? Would an officer stay with him? Would he be immediately examined without a parent present? What sort of room would he wait for his mother in? Thanks for your help.
This answer comes courtesy of @gnomer-denois :
[I worked as a] Patient Assist Care Team (PACT) Security Guard where I would watch mental health holds in hospitals, usually ERs but sometimes on the floors if there was a need for inpatient medical care, and on a few occasions on mental health wards/in mental health hospitals.
If it works like CO, the child would probably be taken to a hospital, possibly children’s hospital, but the only one of those I worked at was connected to a regular hospital and I watched teenagers in regular hospitals as well. They would have a one-on-one security, probably a security guard trained just for those holds, but it could be a medic or CNA depending on the laws and who’s available. They would be checked by medical staff for physical trauma, labs, anything under their purview would be addressed first. Once they are signed off as physically ok (and if there needs to be surgery or anything, it can be over 72 hours, but any time they aren’t in the OR or recovery, they will have the on-on-one observation), then the nurse that is in charge of their case at that time will call for a mental evaluation. There is usually one or two groups that provide these per county, though more populated areas might have more (I was in Denver, and there were a couple different ones for the metro area, usually one government funded agency for a county and then one or two private groups, I think, I didn’t get a lot of information about the agencies, just occasionally heard which agency the evaluator was from).
It can take hours for the evaluator to arrive, depending on their case load. They go on first call first serve basis, except, if there are more than one at a hospital they will evaluate all the ones at that hospital before moving on rather than drive back and forth if they can help it. Some hospitals will offer “telepsych” where the evaluation is done over a video phone conference, but they probably wouldn’t offer that to a minor. The evaluators are usually Master’s level therapists, I believe. I know they aren’t MDs or PhDs. I don’t know what they ask, because I was one of the guards, and we would step out of the room during evaluation, close enough to help if there was a problem, but giving privacy. The evaluation includes determining if they would be compliant with outpatient services if they are needed, if any follow up psych care is needed (probably in this case). They will tell the patient, and probably the patient’s parent/guardian, what the plan going forward will be and give lists of resources.
If it’s determined that additional evaluation is needed, or that they would be non-compliant with outpatient visits, then they will be referred for inpatient care. The nurse in charge of the case at the hospital will call around to find a bed available on a mental health ward or in a mental health specific hospital. Once one is found (again, this can take hours, if not days) the patient is moved there for a 72 hour hold and will be evaluated by a psychologist or psychiatrist to determine what additional care may be needed. On the ward, they would generally not have one-on-one observation unless they were non-compliant in some way (actively suicidal, having a condition that impact impulse control to the point where they might do things like pull down their pants in the middle of the common area, etc). They’ll go through group meetings, do quiet activities, which they can usually opt in or out of, watch tv, read, but they aren’t allowed to touch other patients.
