ABSTRACT
This chapter presents a case of 22-year-old young man who is admitted to a psychiatric inpatient unit under mental health legislation. On admission, he is extremely agitated and hostile. He is very upset about having been admitted. He believes that he is of royal descent and is determined to punish those who are involved in 'imprisoning' him. This man is presenting with acute agitation, aggression and grandiose delusions. National Institute for Health and Care Excellence (NICE) guidance advocates a three-step approach. Risk assessment should be a continuous process to evaluate current risk and predict future risk. In this case, the risk for violence and aggression seems high as this man has several risk factors, a recent history of violence, current psychotic symptoms, continuing agitation, history of drug use, young age and male gender. Risk of cardiac arrest or respiratory depression is increased by physical agitation, by physical interventions and by drugs used in rapid tranquillization.
