EM · Behavioural and mental health emergencies

Mental health and behavioural emergencies

Also known as Psychiatric emergency · Medical clearance of the psychiatric patient · Suicide risk assessment · Acute agitation and rapid tranquillisation · Acute psychosis in the emergency department · Mental Health Act and involuntary detention

Mental health and behavioural emergencies — the medical clearance of the psychiatric patient (excluding the organic cause: hypoglycaemia, hypoxia, sepsis, intracranial lesion, toxidrome, delirium), the structured risk assessment for self-harm, suicide and violence to others, the Mental State Examination, and psychiatric referral. The specific presentations: the suicidal patient (SAD PERSONS, means, plan, intent, safe disposition), the acutely psychotic patient (schizophrenia versus drug-induced; haloperidol 5 mg IM, olanzapine 10 mg PO), and the anxious or agitated patient (de-escalation, lorazepam 1 to 2 mg IV or PO, rapid tranquillisation ladder with droperidol and midazolam). Includes the Mental Health Act framework, involuntary detention, and the four-stage test of capacity. ACEM-primary, globally tagged.