Further Reading
444 Psychiatric Emergencies
(iv) The person is lacking the capacity to consent to be assessed or has
unreasonably refused to be assessed.
3 Various broad types of order or Section for regulated (compulsory) admis-
sion exist according to the MHA policy in use locally.
(i) Make sure you know details of the local policy, which varies from
country to country, and state to state.
(ii) Most include an emergency examination order signed by a
police or ambulance officer; and a short (24 h–3 day) assessment
order signed by two different persons that will include a medical
practitioner or authorized mental health practitioner.
(iii) A longer 21-day, or 28-day or more admission period usually
needs to be supported by two medical recommendations. Again
details vary locally.
4 All regulated patients admitted involuntarily are then subject to mandatory
psychiatric review according to the local MHA legislation.
5 Make certain you also know who can sign which order, when the order
lapses, and what it allows the medical practitioner to do.
(i) Make sure you understand the distinction between involuntary
detention for assessment, and administering emergency
treatment under common law without the patient’s consent if
they pose a serious threat to themselves or others.FURTHER READING
ACEP Policies Subcommittee (2006) Clinical policy. Critical issues in the diagno-
sis and management of the adult psychiatric patient in the emergency depart-
ment. Annals of Emergency Medicine 47 : 79–86.Crawford MJ, Patton R, Touquet R et al. (2004) Screening and referral for brief
intervention of alcohol-misusing patients in an emergency department: A
pragmatic randomised controlled trial. Lancet 364 : 1334–9.
Phillips G, Mason S, Baston S (2009) Mental health and the law: The Australasian
and UK perspectives. In: Cameron P, Jelinek G, Kelly A-M et al. Textbook of
Adult Emergency Medicine, 3rd edn. Churchill Livingstone, Edinburgh, pp.
751–60.
Touquet R, Brown A (2006) Alcohol misuse – Positive response. Alcohol Health
Work for every acute hospital saves money and reduces repeat attendances.
Emergency Medicine Australasia 18 : 103–7.