The subject was obviously intoxicated, and the level of intoxication appeared to be a major factor in his refusal to accept the statement that qualified psychiatric personnel were not free to deal with his situation instantly.
Other than aggressive behaviour and a refusal to accept any explanation for not granting his demand for instant access to qualified psychiatric personnel, the subject did not appear ot be in any imminent danger in relation to either mental health risk or physical health risk. The subject's behaviour, however, did indicate that he posed a threat to his onw physical safety, the physical safety of the clinical staff present, and the physical safety of other patients in the clinic at the time.
Because of the subject's behavior and because of the threat that I perceived that he posed to the physical safety of himself and to others, I summoned security personnel to remove the subject from the patient waiting area. I did not instruct security personnel as to others actions to take with respect to the patient (detention or release). I did, however, inform the psychiatric nurse of the incident, along with providing the subject's identification to the psychiatric nurse.
Upon retelling the details of the clinical encounter, I feel that a better approach to the situation might have been to place the subject in a treatment room where he would not have posed as great a threat to the physical safety of himself and others while he waited to see qualified psychiatric personnel. As the situation actually transpired, he patient left the clinic facility without ever being seen by qualified psychiatric personnel on the day of the clinical encounter. At the same time, however, I am not certain that the alternative approach would have been effective unless it would have been possible for qualified psychiatric personnel to have seen the subject relatively quickly. A