An algorithm for managing adults with mental health complaints who present to New South Wales emergency departments accompanied by law enforcement officers

Objectives Provision of psychiatric assessment and treatment to patients accompanied by police or correctional officers in New South Wales (NSW) emergency departments can present complex legal, ethical, and logistical challenges. These challenges may be faced by clinicians whilst working outside of normal working hours, when legal advice may not be immediately available. We aimed to develop a resource for clinicians that distilled the relevant legislation, policies, and agreements into a readily available and usable algorithm. Methods We reviewed the relevant literature, legislative instruments, guidelines and memoranda of understanding and consulted with the NSW Police Force, the NSW Ministry of Health and medicolegal practitioners. Results We developed an algorithm to support decision-making when adult patients with mental health complaints present to NSW emergency departments accompanied by law enforcement officers. In text accompanying the algorithm, we address frequently asked questions and areas that often give rise to uncertainty among clinicians. Conclusion This algorithm outlines the legal and practical steps for managing adult patients brought to hospital by law enforcement officers.