5150 Evaluation Questions Guide
Written on February 8, 2022 by
F. Garrett Warrick, P.H.N., B.S.N., R.N.
When gathering background information, use these questions as a guide.
Behavior and Compliance with Treatment
- What is the recent change in behavior to warrant interviewing the client?
- How long has this behavior been taking place?
- Is the client taking medication as prescribed?
- Is the client refusing any treatment or care?
- Is the client eating full meals?
- Is the client physically aggressive? If so, describe.
- Is the client currently conserved? If so, note the conservator’s full name and contact information.
- What is the client’s mental health history?
When interviewing the client for a 72-hour hold petition, these questions below are to help a clinician decide if the client meets criteria for admission – danger to self, danger to others, or gravely disabled.
- What is your full name and birthdate?
- Why are you at the hospital? (If the client can’t tell you, then state why you’re interviewing.)
- What is today’s date?
- What town are you in right now?
- Who is the current President of the United States of America?
- Are you experiencing hallucinations? If so, describe.
- Are you feeling depressed? Rate 0 out of 10, where “10” is the worst imaginable.
- Are you feeling anxious? Rate 0 out of 10, where “10” is the worst imaginable.
- Do you feel like you want to hurt yourself? If so, describe.
○ What’s your plan to hurt yourself?
- How are you getting along with other people where you live?
- Do you feel like you want to harm someone else? If so, describe.
○ What’s your plan to harm someone else?
Gravely Disabled Questions
- When is the last time you ate a full meal?
- When is the last time you had a shower or bath?
- When is the last time your clothes have been washed?
- How would you provide clothing, food, and shelter for yourself outside of the healthcare setting?