2.4.4 Treatment Methods in Emergency Situations Including the Use of Appropriate Legislation
Treatment Methods in Emergency Situations Including the use of Appropriate Legislation
In psychiatric emergency situations, prompt and appropriate treatment is essential to prevent harm to the patient or others. The treatment methods used in these situations may vary depending on the specific emergency but generally involve a combination of medication, psychotherapy, and other interventions to stabilize the patient’s condition and ensure their safety.
Medication:
In some cases, medication may be necessary to control symptoms or stabilize the patient’s condition. For example, in cases of acute psychosis, antipsychotic medication may be used to reduce hallucinations and delusions. In cases of severe anxiety or panic attacks, benzodiazepines may be used to reduce symptoms. However, it is important to note that medication should be used judiciously and only under the guidance of a mental health professional, as some medications may have potential side effects or interact with other medications.
Psychotherapy:
Psychotherapy can also be an important component of treatment in psychiatric emergency situations. Cognitive-behavioural therapy (CBT) and dialectical behaviour therapy (DBT) are two types of psychotherapy that have been shown to be effective in managing symptoms of mental health conditions and reducing the risk of future crises. In some cases, family therapy or group therapy may also be helpful in addressing interpersonal issues that may be contributing to the crisis.
Other interventions:
Other interventions that may be used in psychiatric emergency situations include hospitalization, electroconvulsive therapy (ECT), and crisis intervention or home treatment programs. Hospitalization may be necessary in cases where the patient is at risk of harm to themselves or others and requires close monitoring and treatment. ECT may be used in cases of severe depression or psychosis that are not responding to other treatments. Crisis intervention and home treatment programs are community-based programs that provide support and treatment to patients in crisis, with the goal of preventing hospitalization and promoting recovery.
Appropriate UK Legislation
In the UK, there are several pieces of legislation that are relevant to the treatment of psychiatric emergencies. The Mental Health Act 1983 provides a framework for the compulsory detention and treatment of patients with mental health conditions who are at risk of harm to themselves or others. The Mental Capacity Act 2005 provides guidance on decision-making for patients who lack the capacity to make decisions about their treatment or care. The Mental Health Act Code of Practice provides detailed guidance on the application of the Mental Health Act and the rights of patients who are detained under the act.
It is important to note that the use of these legal frameworks should always be guided by the principles of least restrictive practice and patient-centred care. Patients should be involved in decisions about their treatment and care as much as possible, and their rights and dignity should be respected at all times.
Mental health acts:
The Mental Health Act (MHA) is an essential piece of legislation in the United Kingdom that governs the assessment, treatment, and rights of individuals with mental health disorders. The MHA aims to ensure the appropriate care and support for people experiencing mental health crises while also protecting their rights and dignity. Among the various sections of the MHA, Sections 2, 3, 5(2), and 136 are particularly important as they outline the circumstances under which individuals can be detained and treated against their will.
Section 2 of the MHA is concerned with the assessment and short-term detention of individuals experiencing mental health crises. Under this section, an individual can be detained in a psychiatric hospital for up to 28 days for the purpose of assessment and diagnosis. This detention is authorized if the person is suffering from a mental disorder that warrants admission to a hospital, and it is deemed necessary for their own health and safety or the protection of others. Section 2 is not renewable, and once the 28 days have elapsed, the individual must either be discharged or detained under a different section of the MHA.
Section 3 of the MHA focuses on the longer-term detention and treatment of individuals with mental health disorders. Under this section, a person can be detained for up to six months initially, with the possibility of renewal for a further six months, and then annually thereafter. The detention is authorized if the person is suffering from a mental disorder that requires treatment in a hospital setting and that treatment is deemed necessary for their own health and safety or the protection of others. Additionally, it must be demonstrated that appropriate medical treatment is available for the individual.
Section 5(2) of the MHA allows for the emergency detention of a voluntary patient who is already in a hospital and is deemed to be at immediate risk of harm to themselves or others. Under this section, a medical practitioner can authorize the detention of the patient for up to 72 hours, during which time a full assessment can be conducted, and a decision can be made regarding further detention under Sections 2 or 3, or the patient may be discharged.
Section 136 of the MHA provides the police with the authority to detain a person found in a public place who appears to be suffering from a mental disorder and is in immediate need of care and control. Under this section, the individual can be taken to a place of safety, such as a hospital or a designated Section 136 suite, where they can be detained for up to 24 hours for assessment. During this period, a decision can be made regarding further detention under Sections 2 or 3, or the person may be discharged or provided with alternative support.
| Section | Purpose | Duration | Key Criteria |
| Section 2 | Assessment and short-term detention | Up to 28 days (non-renewable) | Mental disorder warranting hospital admission; necessary for the health and safety of the individual or the protection of others; assessment and diagnosis required |
| Section 3 | Longer-term detention and treatment | 6 months (renewable) | Mental disorder requiring hospital treatment; necessary for the health and safety of the individual or the protection of others; appropriate medical treatment available |
| Section 5(2) | Emergency detention of the voluntary patient | Up to 72 hours | Voluntary patient already in the hospital; immediate risk of harm to self or others; enables full assessment before deciding further detention or discharge |
| Section 136 | Detention in a public place by the police | Up to 24 hours | A person found in a public place with an apparent mental disorder; in immediate need of care and control; assessment in a place of safety (hospital or designated suite) |
In conclusion, Sections 2, 3, 5(2), and 136 of the MHA play crucial roles in the assessment, detention, and treatment of individuals with mental health disorders. These sections aim to balance the need to provide care and support to individuals experiencing mental health crises while also protecting their rights and autonomy. It is vital for mental health professionals to understand and adhere to the provisions of the MHA to ensure the appropriate and ethical management of patients in crisis.
Treatment Methods
Treatment methods in psychiatric emergency situations:
| Treatment method | Description |
| Medication | Use of medication to control symptoms or stabilize the patient’s condition |
| Psychotherapy | Use of various types of psychotherapy to address underlying issues contributing to the crisis |
| Hospitalization | Inpatient treatment in a hospital or psychiatric facility |
| Electroconvulsive therapy (ECT) | Use of electrical currents to treat severe depression or psychosis |
| Crisis intervention or home treatment programs | Community-based programs that provide support and treatment to patients in crisis |
Additionally, the Mental Health Act Code of Practice provides guidance for clinicians to assess, treat, and detain individuals under the Mental Health Act. The Code of Practice states that detention should only occur if less restrictive options have been considered and ruled out. It also emphasizes the importance of considering the patient’s wishes and involving them in the decision-making process as much as possible. The Code of Practice outlines the procedures for detention and treatment, including medication, electroconvulsive therapy (ECT), and seclusion or restraint, which should be used as a last resort.
In summary, the treatment methods in emergency situations depend on the severity of the situation and the individual’s clinical presentation. The goal is to ensure the safety of the patient and others while providing the necessary care and treatment. UK legislation provides guidance for clinicians to detain and treat individuals in emergency situations, with a focus on the least restrictive options and respecting the patient’s autonomy as much as possible.
Treatment methods in emergency situations:
| Treatment Method | Description |
| Medication | Used to manage acute symptoms such as aggression, agitation, and psychosis |
| Physical Restraint | Used as a last resort to prevent harm to the patient or others |
| Seclusion | Used as a last resort to prevent harm to the patient or others |
| Electroconvulsive Therapy (ECT) | Used to treat severe depression or psychosis in emergency situations |
| Detention under Mental Health Act | Used to detain and treat individuals who pose a risk to themselves or others |
Reference:
- Department of Health. (2015). Mental Health Act 1983: Code of Practice. Retrieved from https://www.gov.uk/government/publications/code-of-practice-mental-health-act-1983
- National Institute for Health and Care Excellence. (2016). Violence and aggression: short-term management in mental health, health and community settings. Retrieved from https://www.nice.org.uk/guidance/ng10
- Royal College of Psychiatrists. (2020). Mental Health Emergencies: A guide to crisis resolution and home treatment teams. Retrieved from https://www.rcpsych.ac.uk/docs/default-source/improving-care/ccqi/quality-networks/crisis-resolution-and-home-treatment-teams/mhe-2020-full-guidance.pdf
- National Institute for Health and Care Excellence (NICE). (2016). Acute mental health care in adult hospitals: Quality standard. https://www.nice.org.uk/guidance/qs105
- Royal College of Psychiatrists. (2017). Mental Health Act Code of Practice (4th edition). https://www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-law/2017-code-of-practice-4th-edition-for-web.pdf
- UK Government. (2005). Mental Capacity Act 2005.