Please can I ask for some advice?
I have dealt with a S136 case where the patient was assessed as volatile.
The advice given by colleagues was that health staff are unable to restrain or sedate at the person on the S136 is only a member of the public and not a patient until formally detained under the Act. (And that the only option around restraint was to use Police officers)
Can I ask – is there Health and Safety, NICE or any other guidance around managing volatile patients before an assessment has taken place?
It depends what you mean by restraint and why —
• Any staff who are a party to the detention at the PoS can restraint in the sense of keeping the exit closed, moving the person away from attempting to leave, etc.
• Staff also have a right to self-defence in any context where their safety is threatened and can rely on common law to stop anything happening which is an imminent risk of serious harm.
• I realise of course that such answers beg health and safety questions about training and competence to do such things safely but my answer is the legal aspect of it in principle.
That all said, in terms of restraining specifically to sedate someone, that would have to be justified legally and would be most likely under the MCA, because s136 is not a treatment provision allowing for sedation.
Does that help?!
Don’t want to sound too unhelpful here, but ‘volatile’ feels a pretty evidence-free word, which can be used to describe a multitude of presentations, including someone who is pretty p1ss3d off at being held against their will. I’m sure the actual circumstances are significantly more complex than that, but I think consideration of restraint or sedation outside the MHA would need considerably more critical examination than this description provides.
The description of volatile is a bit dubious, but re NICE guidance (rather than legal advice)- NG 10 management of short term aggression, or possibly- Acute_Behavioural_Disturbance_Final.pdf (rcem.ac.uk)