It can be difficult to know what to do when a person in severe psychological distress presents to a general practice or community clinic, particularly if they are behaving aggressively, or if they are refusing help.

Most patients who are acutely disturbed present no danger to others, however situations can evolve rapidly. Frontline staff need to know how to call for help, how to assess and manage physical risk, and how to de-escalate such situations.

In this podcast Aileen O’Brien, reader in psychiatry and education at St George’s University of London joins us to give some advice on what to do in that situation - why deescalation is useful, and who else to involve.

We also hear from someone who lives with bipolar disorder, and has had experiences of being acutely unwell in a public places, which have lead to police and psychiatric intervention.

Read the full practice article:
https://www.bmj.com/content/364/bmj.l578