2023 Laws of Puerto Rico › TITLE TWENTY-FOUR - Health and Sanitation (§§ 1 — 15010) › PART VIII - Mental Health (§§ 4001-6151 — 6184) › Chapter 201A - Mental Health Code of 2000 (§§ 6152 — 6166g) › Subchapter IV - Mental Health Care System for Adults (§§ 6155 — 6155v) › § 6155b - Initial evaluation; adults placed in institutional providers of mental healthcare services

(1) Any adult who, voluntarily or involuntarily, begins to receive mental healthcare services at an institutional provider at an emergency room, shall receive, among others, the following services within twenty-four (24) hours:
(a) Medical record;
(b) a physical examination;
(c) laboratory tests when necessary to rule out physiological or organic conditions as part of a differential diagnosis;
(d) a psychiatric evaluation by a psychiatrist, or in default thereof, by a physician after having consulted a psychiatrist by telephone; in the latter case, the psychiatrist shall have twenty-four (24) hours to enter in the clinical record his/her decision and to fill out the corresponding certification for the court in involuntary placement cases;
(e) a psychological evaluation, if clinically indicated;
(f) a social evaluation;
(g) a psychiatric diagnosis in its five (5) axes as per the DSM-IV-TR or the clinical manual in effect at the time;
(h) an initial treatment plan;
(i) final destination, that is, after the patient has been stabilized, the referral to the corresponding level of care befitting the diagnosis and the severity of the clinical picture that the patient presents at the time; if the patient cannot be stabilized, then hospitalization shall be in order;
(2) Provided, That any adult who is hospitalized, whether voluntarily or involuntarily, in a psychiatric hospital, or psychiatric hospitalization quarters or wards in general hospitals, or addiction psychiatric or addictive medicine quarters or wards in general hospitals, shall receive within twenty-four (24) hours the following services:
(a) A medical record;
(b) a physical examination;
(c) laboratory tests, when clinically necessary;
(d) a psychiatric evaluation; in the event that the institution does not have an in-house psychiatrist, this evaluation may be made by a physician legally authorized to practice in Puerto Rico;
(e) a psychological screening, when clinically indicated;
(f) a psychological evaluation, when clinically indicated;
(g) an initial social evaluation, if clinically indicated, and
(h) a substance screening by a professional counselor, when clinically indicated to rule out or assess substance abuse and/or dependency.
(3) The results of the evaluations, analyses, and examinations shall be used to determine the individualized treatment plan, an depending on the clinical response, to determine the level of care that corresponds to the severity of symptoms and signs, in order to determine the discharge plan which accords the adult the greatest autonomy. This plan shall be formulated in writing, within the first twenty-four (24) hours following the date of hospitalization of an adult, to be reviewed weekly by the interdisciplinary team until the person is discharged from the hospital. If the person is hospitalized over the weekend or a legal holiday, the twenty-four (24) hour period shall begin as of the next workday.
History —Oct. 2, 2000, No. 408, § 4.03; Aug. 6, 2008, No. 183, § 24.