Legal and Ethical Issues Related to Psychiatric Emergencies
College of Nursing-PMHNP, Walden University
PRAC 6675: PMHNP Care Across the Lifespan
I Dr. Nataliya Ishkova
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Understanding South Carolina Laws for Involuntary Psychiatric Holds and Their
Implications. In South Carolina, laws governing involuntary psychiatric intervention aim to
protect individuals in crisis and the public. These laws set out who may initiate emergency
evaluation, the timelines and procedures for detention and court review, and the pathways to
inpatient or outpatient commitment for both adults and minors. In South Carolina, the
emergency admission process is used for involuntary psychiatric holds when a person with a
mental illness poses a likelihood of serious harm to self or others or is gravely disabled. A
physician’s certificate typically initiates emergency admission; law enforcement may transport
the individual pursuant to that medical certification or a court order. Any concerned person may
also apply to the probate court for an emergency order supported by medical certification (Code
of Laws - Title 44 - Chapter 17 - HEALTH, n.d.). The initial medical examination supports short-
term detention for evaluation; a second examination by a different physician should occur
promptly, generally within 24 hours.
Courts commonly hold a probable cause hearing within about 72 hours of detention,
excluding weekends and holidays. If probable cause is found, the court may order continued
detention for evaluation pending a final commitment hearing, usually within about 15 days.
Providers may release a patient at any time if the criteria for emergency detention are no longer
met or if the person accepts voluntary treatment and has decision-making capacity. After court
involvement, the probate court may order release when the criteria are not met. Upon discharge,
an adult may depart independently if safe; otherwise, release may be to a responsible adult or
guardian. For minors, release is generally to a parent, legal guardian, or custodial agency.
Differences among hospitalization types: Emergency hospitalization for evaluation is short-term
and intended to ensure immediate safety, conduct a timely assessment, and determine next steps.