Medical Screening Guidelines

Psychiatric Medical Clearance Screening Guidelines

In 2018, the Virginia College of Emergency Physicians (VACEP), the Virginia Department of Behavioral Health and Developmental Services (DBHDS), and the Virginia Hospital & Healthcare Association (VHHA) collaborated to produce a standardized process for evaluating the medical condition of hospital patients to determine the proper setting for psychiatric patients to receive care.

The goal of those guidelines is to standardize processes for medically assessing and clearing a patient for mental health admission; to avoid using limited staff and resources for unnecessary testing in young, otherwise healthy patients; to encourage and reinforce doctor-to-doctor communication; and collaboration through the establishment of procedures for amicably resolving concerns around psychiatric admissions; to ensure patients with capacity are not forced to undergo unnecessary labs/urine tests; to outline admission limitations of state psychiatric hospitals and crisis stabilization units (CSUs) through a list of exclusionary criteria.

In addition to the guidelines, this group established a five-member Protocol Review and Monitoring Committee (PRMC) to assess adherence to the medical assessment standards and to promote proper, uniform implementation. The PRMC is empowered to review cases of disagreement between emergency department physicians and psychiatrists that were escalated under the protocols to improve the resolution process. This group has representatives from the Virginia Department of Behavioral Health and Developmental Services (DBHDS), Virginia College of Emergency Physicians (VACEP), Psychiatric Society of Virginia (PSV), the Virginia Hospital & Healthcare Association (VHHA), an emergency services representative from a local Community Services Boards (CSB), and a representative from a private hospital. Links to guidance documents are provided below.

Admissions Guidelines (Updated March 2024)

Adult Medical Screening Guidelines (Updated March 2024)

Pediatric Medical Screening Guidelines (Updated March 2024)