Emotional Wellbeing

Mental Health


Mandy Kloppers

What is Acute Behavioural Disturbance?

An Acute Behavioural Disturbance doesn;t happen on it’s own. It usually occurs or results from intoxication (from drugs or alcohol), a physical illness (such as hypoglycaemia or a head injury) or a mental health disorder – for example a personality disorder or psychosis.

Many health staff are unaware of the added risk of someone who is suffering from an acute behavioural disturbance. They need to be treated as a higher priority than someone who is engaging in antisocial behaviour. Due to the secondary consideration, their bodies are under far more stress than usual and as such, need to treated accordingly.

The most extreme form of acute behavioural disturbance (ABD) is referred to as “excited delirium” and it can be life threatening.

If someone presents with the following symptoms, they could possibly be treated a medical emergency:

Agitation, violence aggression, insensitivity to pain, lack of response to irritant sprays (eg pepper spray), hostility and sweating.

If untreated, the mortality rate is as high as 15-30%. . The clinical picture is similar: dehydration, seizures, hypotension
and hyperthermia are poor prognostic signs.

Someone with ABD should absolutely be transferred to hospital and NOT to a police cell.

Unfortunately, if staff aren’t appropriately trained, the behaviour will be seen as antisocial and no regard will be given to the individuals dire need to medical assistance.

A man from Poole, Douglas Oak sadly died recently. Douglas Oak, 35, had taken cocaine when he threw himself on to a police car in the Branksome Park area of Poole, Bournemouth Coroner’s Court heard.

He suffered a cardiac arrest as officers restrained him and died the following day on 12 April 2017.

A post-mortem examination found Mr Oak, from Poole, died from “cocaine intoxication, excitement, exertion, restraint and hyperthermia with terminal bronchopneumonia”.

An inquest jury was told it would examine the roles of Dorset Police, South Western Ambulance Service and Poole Hospital in the death.

The Royal College of Emergency Medicine describes ABD (pdf) as a medical emergency often involving the presentation of violence and aggression and says affected individuals may suffer “sudden cardiovascular collapse and/or cardiac arrest with little or no warning”.

The basic message to take away from this post is that someone who is presentingas erratic and agitated or violent may have a secondary issue that is causing the behaviour. Never assume that someone is choosing that behaviour, there might be more to consider.

Mandy X

Photo by Sweet Ice Cream Photography on Unsplash