The Issue
Acute mental health presentations among AOD clients, including drug-induced psychosis and major depression/suicidality, can present assessment and management challenges in community settings. AOD workers are often unsure of their duty of care, especially in relation to the health and safety of the client, workers and the community at large. The appropriate referral pathways for acute and ongoing treatment and care are also not always clear. Case studies will be presented and sought from the audience to scope the range of challenges encountered in this regard.

The Approach
The Kirketon Road Centre (KRC) - a primary health care centre located in Sydney's Kings Cross, will present its generic clinical protocols developed in consultation with local AOD, mental health, hospital emergency, ambulance and police services to enable an effective and coordinated response to such acute mental health presentations. Barriers encountered in the development and implementation of these protocols, and how these were overcome will be discussed. These generic protocols will then be adapted to address the issues identified in the various settings cited by audience participants.

Workshop outcomes: Participants will gain an understanding of the following lessons learnt.
· A systematic and consistent approach to acute mental health presentations improves clinical outcomes among affected AOD clients. Client, worker and community health and safety are also maximised by this approach.
· When responding to issues that affect a wide range of services and individuals, a collaborative and intersectoral approach is vital to ensure a coordinated response among community and hospital-based health care workers and other sectors.
· Interventions that are developed need to be disseminated widely and frequently, and reviewed on a regular basis.
· Having structures in place to identify and respond to emerging public health issues in a timely way should be an integral part of community development efforts at the local level.