A psychiatric patient is discharged by concerned medical officer after their relatives furnish a bond along with an undertaking that the mentally ill person shall be prevented from causing injury to self or others. The patient got discharged under which type of discharge?

Appeared in: DSSSB - 28 August 2019 (Shift-1)

Explanation

This type of discharge is specifically defined by the presence of a bond and an undertaking furnished by the patient's relatives.
The core of this process is the legal promise made by the relatives to take responsibility for the patient's care and to prevent them from causing harm to self or others.
It is used for patients who may not be fully recovered but are deemed safe enough for community living, provided this strict, legally-binding supervision is in place.

Option A: This term refers to a type of admission, not discharge. It typically involves the police bringing a person who is found wandering or is unable to care for themselves to a psychiatric facility.
Option C: A reception order is a legal document issued by a magistrate that facilitates the involuntary admission and detention of a person in a psychiatric hospital. It is a mechanism for admission, not discharge.
Option D: Discharge on a voluntary basis applies to patients who admitted themselves willingly. Such patients are generally free to leave the hospital, often by giving a short notice, and it does not require a legal bond from relatives.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Legal aspects of psychiatric nursing, specifically the types of patient discharge under mental health laws in the correct sequence, documenting the action clearly, and monitoring for the expected response.
A nurse's primary role in this process is patient and family education. The nurse must ensure the relatives fully understand the legal responsibilities they are accepting by signing the bond.
The nursing team must document the discharge instructions, the family's understanding, and the contact information for follow-up care and emergencies.
This process highlights the importance of community mental health support, as the family will need resources and guidance to manage the patient's care at home.

How to Approach the Question

First, identify the key actions in the question stem: a patient is being 'discharged'.
Next, note the specific conditions for the discharge: 'relatives furnish a bond' and an 'undertaking' to 'prevent injury'.
Analyze the options in the context of admission vs. discharge. 'Admitted by police' and 'On reception order' are primarily admission procedures, so they are less likely to be correct for a discharge question.
Compare the remaining discharge options. 'Voluntary basis' implies the patient's own will, which is not the focus here. The scenario's emphasis on a legal 'bond' and 'undertaking' by relatives directly matches the definition of a discharge 'Under special circumstances'.

Concept Tested & Keywords

Concept Tested: Legal aspects of psychiatric nursing, specifically the types of patient discharge under mental health laws.
Stem keywords: psychiatric patient, discharged, relatives, bond, undertaking, prevent injury
Lead-in keywords: under which type of discharge

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E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 116-118

E6 Nursing Fundamentals Taylor p. 296-298

Practise the full DSSSB - 28 August 2019 (Shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.