Definitions

The Oxford Dictionary (2022) defines an emergency as; “A sudden serious and dangerous event or situation which needs immediate action to deal with it”.

A psychiatric emergency is considered as; “An acute disturbance of behaviour, thought or mood of a patient which if untreated may lead to harm, either to the individual or to others in the environment” (Sudarsanan et al, 2004).

The most prevalent psychiatric emergency situations are

• “Severe self-neglect,
• self-harm,
• suicidal behaviour,
• depressive or manic episodes,
• aggressive psychomotor agitation,
• severely impaired judgment,
• intoxication or withdrawal from psychoactive substances”

(Baldacara et al, 2021).

Intention

The PEP is structured to reflect the usual flow of events in responding to psychiatric emergencies that could happen anywhere and in many different situations. As aforementioned, this is likely to occur in a community, community hospital and/ or acute hospital environment as such these themes will be covered within the PEP. Guidance including flow charts have been developed for the most common psychiatric emergency situations.

General rule of thumb

In any scenario, where an individual is under the care of a secondary care Mental Health Service and there are increasing concerns for their wellbeing and safety, the Mental Health Service involved should take the lead in providing an appropriate response. A list of key contacts are provided on the NHS Ayrshire & Arran internet site (nhsaaa.net)

However, where there is a psychiatric emergency, which requires expedient intervention, any Medical Practitioner should take the necessary action to ensure a patient centred and safety focused management of the care that takes place.

As such, the following planning based on scenarios is provided to help guide the practitioner. As the PEP is now intended to be as live as possible should any new scenarios occur these will be explored with the intention of inclusion in updated and/ or future plans, therefore, please contact Julie Barrett and Malcolm Cameron with any helpful considerations.