Adjunct Professor David E. Schweighoefer has taught a Psychiatry and the Law class at Cleveland-Marshall College of Law for more than a decade. In that class, students learn about situations regarding mentally ill patients, what happens to get to the point where a person needs a civil commitment and how the process for establishing the civil commitment takes place. They also learn about problems hospitals face in getting people to the right place in a timely fashion that complies with the law. Three Cleveland-Marshall students now have been given the opportunity to put their knowledge from this class to real-world use as they work on an independent study with Schweighoefer and St. Vincent Charity Medical Center with hopes to amend the Ohio Revised Code.
“Prior to taking (Professor Schweighoefer’s) class, I was already interested in the area law that deals with the rights of persons with mental illnesses,” explained C|M|LAW student Joe Caborn, one of the three students working on the project along with Sharon Baden and Brian Harper. “When I learned of what was at issue early in the semester — how a statutory defect is threatening the rights of the psychiatric patient while simultaneously hampering ability of medical professionals to help the patient — I knew that I wanted to be a part of the solution.”
Schweighoefer, chair of Day Ketterer’s Health Care Law Practice Group and former Regional Director at The Cleveland Clinic and Chief Operating Officer at Mount Sinai Health System, discovered an issue with the Ohio Revised Code that was putting hospitals in a difficult position while administering services to psychiatric patients. Ohio’s Code requires hospitals to transfer a patient that needs psychiatric care to a licensed inpatient psychiatric unit. The problem comes when a patient is not medically stable to be transferred due to an active physical issue. This can be particularly troublesome with elderly patients who are experiencing mental difficulties, though it is not their primary reason for receiving care.
Schweighoefer set up the relationship for a collaborative project with C|M|LAW and St. Vincent Charity Medical Center to tackle this problem, with St Vincent receiving grant funding to conduct the work.
The students have had the opportunity to talk with doctors, staff and their general counsel at St. Vincent to get a greater understanding of how the problem of required inpatient psychiatric transfers manifests itself in practice. They have also met with Behavioral Medicine Work Group of the Ohio Hospital Association to learn about the issue from the perspective of a variety of care providers.
“Talking to hospital personnel, I have learned more about the tremendous pressure that hospital staff are under to meet the needs of mentally ill patients,” said Harper. “These professionals are often between a rock and a hard place, forced to choose between what could be termed involuntary imprisonment and being liable for wrongful death or injuries to others if unhealthy individuals are released before they have an opportunity to stabilize.”
The next steps are for the students to meet with the Ohio Department of Mental Health and select Ohio legislators to generate support for drafting a bill that would amend the statute. They then anticipate working with a supporting party and St Vincent on drafting proposed legislation.
“We want to change the law in such a way that gives general hospitals the ability to provide the best possible treatment and care to persons experiencing symptoms of mental illness who simultaneously may not be in a medically stable condition in certain circumstances, and in such a way that recognizes and protects the rights of such persons,” explained Caborn.