The nurse who initially sees a patient in the emergency room who has come in or been brought in for mental health reasons must assess the patient for acute suicide risk.

   If the patient is presently at risk for suicide, that is a medical emergency which requires that stabilizing medical care be given, regardless of the patient’s finances or insurance. As in many states, state law on this subject in Louisiana is virtually identical to the requirements of the Federal EMTALA, according to the Supreme Court of Louisiana in a recent case.

   In this case, a man’s wife phoned the hospital for a mental-health referral, someplace she could take her husband for a psychiatric examination even though he had no means to pay for psychological treatment. The nurse gave her a referral, but that agency would not see him.

   Then the wife brought her husband to the hospital emergency room. As the patient was not in immediate danger of harming himself when he got to the emergency room, the nurse acted properly in suggesting the wife take her husband to the nearest county public hospital, the court said. The court ruled that a person or the person’s spouse seeking an assessment of a psychological problem does not trigger a responsibility to provide emergency psychiatric care, assuming the person is not in serious distress, is not experiencing a medical crisis and has not expressed suicidal intent or made an overt attempt to harm himself when the person is initially seen by the nurse in the emergency room.