Walking on eggshells.

A woman is concerned about her husband who is presenting some aggressive, erratic behaviour; he is ranting at a neighbour in the garden. In A&E, the doctor sees him without his wife. He seems angry, confused and exhibits threatening behaviour. Dr Linda Gast, Reader in Psychiatry, pauses the story and indicates that the interview hadn't gone well. The purpose of the video is to stop violence; points where discussion would be useful are indicated by 'Stop Tape'. Dr Tom Brown, Consultant Psychiatrist, talks about safety issues, beginning with the environment (the room being accessible, private and not remote with an alarm/telephone etc.). Dr Siân Koppel, Specialist Registrar in Forensic Psychiatry, discusses how to prepare for the interview and gather objective information about the case. Dr Koppel goes through how an interview should be conducted. Dr Brown advises how to identify aggressive cues. Next, discussion is around how to assess risk, especially in the patient's case (he has delusional hallucinations about his neighbour). Some of the key questions to ask are outlined. Further investigations - family and GP should be consulted. When an admission is advised, how to effect this is outlined.