Key principles

• It is incumbent upon all statutory services to act in the best interests of patients, to deliver high quality care and to treat patients with compassion, respect and dignity at all times.
• All procedures should be directed towards the best overall interests of the patient, be based on the principle of least restrictive practice to achieve a desired outcome, and be carried out in a safe, professional and competent manner.
• A person centred approach should always be taken to ensure the rights and protections of persons with a mental disorder subject to Mental Health (Care and Treatment) (Scotland) Act (2003 and 2015).
• In all psychiatric emergencies clinicians should be mindful of the application of Adult Support and Protection Legislation and Child Protection Procedures.
• The Adults with Incapacity (Scotland) Act 2000 should also be carefully considered in order to safeguard for those who lack capacity to make some or all decisions for themselves.
• Managing a psychiatric emergency may require a whole team approach, across service and professional boundaries. The ‘team’ working together should ensure that all staff are cared for, safe guarded and respected.

Additional principle

The PEP is predicated on the ability to safely assess and manage a situation.

Where individuals cannot be safely assessed either due to environmental or physiological factors influencing the presentation; i.e. acute intoxication of unknown substances, careful consideration must firstly be made in relation to the appropriate placement for the individual in the immediate term. And secondly, as to whether follow up assessment or support is required in the longer term.

For complex situations, this will likely require a whole team approach. Immediate and longer term considerations must be based on each individual’s needs.

** For staff that are unable to access hyperlinks to internal NHS Ayrshire and Arran guidelines, policies and resources it is suggested that they contact the respective locality mental health service.