87 Kids and the Law If the clinician determines that a child needs hospital level of care, how can the child be hospitalized? If the child is under 18 and the parent is willing to have the child hospital- ized, the child can have a “voluntary admission” to the hospital. By signing the necessary papers, the parent or guardian gives the hospital the right to treat the child. If the parent does not agree to in-patient treatment or the child refuses to go and the mental health professional’s evaluation is that the child needs to be in a hospital due to risk of harm to self or other, the clinician will proceed to arrange for the hospitalization and the child is still hospitalized; this is consid- ered an “involuntary” hospitalization. Children who are 16 or older have the same rights as adults to consent to or refuse hospitalization. The child may be transported to the hospital by a parent or guardian, or in an emergency, the clinician or teacher or parent will call an ambulance to have the child transported to the nearest hospital. If necessary, the police will trans- port the child to the emergency department of the closest hospital where the child will be evaluated. What happens once the child gets to the hospital? Typically a child is evaluated again upon arriving at the hospital. If the appli- cant is a “designated physician,” who performed the psychiatric evaluation of the child, the child can be admitted without any additional examination. If the evaluator is not a “designated physician,” but is a qualified psychiatric nurse mental health clinical specialist, qualified psychologist, licensed independent clinical social worker, or a police officer, the child must be examined within two hours of arriving at the hospital by a “designated physician.” If hospitalization is determined necessary, the 16-year-old child or the parent or guardian on the child’s behalf, is given the opportunity to agree to the hospi- talization.The length of stay is determined by how long it takes for a child to no longer be considered at risk of harm to self or others and the number of days covered by insurance. The hospital will most likely be a locked facility. Mental Health and Substance Use Issues 8