EM Cases · Mental Health Act and compulsory treatment
Involuntary assessment — least-restrictive care and the detained agitated patient
ACEM Fellowship communication/clinical station on Mental Health Act criteria vs capacity, least-restrictive care, medical exclusion, and safe sedation if required.
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Target exams
ACEMFRCEMABEMFRCPCCCFPEMEBEEM
Prompt
Police bring a young adult with first-episode psychosis who refuses assessment and wants to leave. Family report threats and no sleep for days.
Stem
All persons, presentations and observations in this station are fictional and invented for teaching assessment; they do not describe a real person.
References3ShowHide
- [1]Large MM, Nielssen O, Ryan CJ, Hayes R. Mental health laws that require dangerousness for involuntary admission may delay the initial treatment of schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 2008.PMID 18060340
- [2]Large MM, Nielssen OB, Lackersteen SM Did the introduction of 'dangerousness' and 'risk of harm' criteria in mental health laws increase the incidence of suicide in the United States of America? Social Psychiatry and Psychiatric Epidemiology, 2009.PMID 19099169
- [3]Ryan CJ, Callaghan S The impact on clinical practice of the 2015 reforms to the New South Wales Mental Health Act. Australasian Psychiatry, 2017.PMID 27558219