The emergency department (ED) is at the heart of the health system for responding to urgent health needs. In addition to patients with psychiatric emergencies, many patients attending ED with medical emergencies have concurrent mental health needs. Given the urgency, variety and need for clinical skills and systems leadership in a fast-paced environment, this area of liaison psychiatry is both challenging and rewarding as a field in which to develop specialist expertise.

Violence is a global problem. Although popular perception may regard people with mental disorders as perpetrators of violence, the reality is that people with mental disorders are far more likely to be victims of violence when compared to people without disabilities. Safeguarding and protecting adults and children from violence is a core clinical and professional responsibility. This chapter describes types of violence to which people with mental disorders may be subjected, including institutional abuse, disability hate crime, domestic violence and abuse, stalking, harassment, sexual violence, physical violence, gang-related violence, radicalisation and child abuse. Preventative approaches to reducing violence towards adults and children at risk are discussed, including approaches to reducing use of force against people with mental disorders. Barriers to disclosure and approaches to facilitate disclosure are described, along with risk factors and warning flags for violence among victims, perpetrators and institutions. Guidance is given on responding to disclosure and an example is given of multi-agency working via multi-agency risk assessment conference arrangements.

PAIDEUMA

A neologism derived from the Greek and borrowed by Ezra Pound from the work of German ANTHROPOLOGIST Leo Frobenius, ‘paideuma’ designates the deep-rooted ideas and moods specific of a historical moment. Characterised by its complexity and locality in time and space, it is akin to the Romantic zeitgeist, but Pound uses a different term to add a dynamic dimension to the notion: far from being passively absorbed, ‘paideuma’ is at the roots of ‘ideas that are in action’ (Pound 1952: 58). It is constantly being actualised into a combination of behaviours that could be deliberately changed. Thus ‘paideuma’ is closely tied to Pound's volitionist approach to culture in the 1938 Guide to KULCHUR. His interest in the concept also lies in its etymological relation to paideutics, the science or art of learning and education. For Pound, ‘paideuma’ is part of a general didactic project that is embodied in the variety of his writings, from the prose of the political and economic essays to the poetic arcanes of the Cantos. From Frobenius then, Pound derives a pedagogy based on a morphology of culture that he rewrites into his theory of the luminous detail. Paideuma is also the title of the journal devoted to Pound scholarship published by the National Poetry Foundation (University of Maine at Orono) since 1972.

READING

Pound, Ezra (1952) Guide to Kulchur. New York: New Directions.

Tryphonopoulos, Demetres P. (ed.) (2005) The Ezra Pound Encyclopedia. Westport, CT: Greenwood Press.

PARATAXIS

Although the term itself is drawn from classical rhetoric, naming the grammatical arrangement of words, phrases or clauses in sequence but without the presence of connecting terms, parataxis has been seen by critics as a characteristic technique of modernist and EXPERIMENTAL literature. At the level of the sentence the effect of the lack of conjunctions is to leave unclear relations between phrases, where we might expect a text to indicate hierarchies of significance, cause and effect or even temporal sequence. Techniques such as COLLAGE, the juxtaposition of unexpected or unrelated images, and repetition might all be described as paratactic. In the critical writing of Walter Benjamin and Theodor W. Adorno, parataxis is attributed particular significance as a technique which suspends some traditional expectations of philosophical or discursive prose, in which the subject under discussion is subordinated to the logical and narrative unfolding of an argument.

DEFINITION OF ‘ESSAY’

The essay is a short non-fictional prose composition, characterized by an exploratory approach to its subject. In its archetypical form in Montaigne it follows the line of the writer's thought, built in part out of quotation and reference to earlier authorities, often about some overlooked everyday phenomenon, adopting a confidential relationship with the reader and creating a distinctive personality for the writer. The genre excludes the long narratives of history and autobiography, as well as prose with the practical aim of persuasion or denunciation.

Such archetypal essays are often called ‘familiar’ or ‘personal essays’. In contrast, the ‘formal essay’ has less focus on the writer and style, personal memories and observations. Nevertheless, the formal essay is still exploratory and is therefore distinct from the more methodologically rigorous treatise or the scientific paper.

Stevenson himself applies the term to a variety of writing, including the short pensée (in ‘Essays, Reflections and Remarks on Human Life’), the paper for debate read to a university debating society, the treatise-like ‘Lay Morals’, his planned study of ‘The Transformation of the Highlands’ after 1745 (which he thinks will turn into ‘a long essay’; Letters 3: 129), and a planned work of comparative literary history (‘Ramsay, Fergusson and Burns: An Essay’; Letters 2: 165). He even uses the word to describe Kidnapped, meaning an experiment, a sketch: it is ‘no work, only an essay’ (Letters 5: 314).

Nevertheless, his normal use of ‘essay’ corresponds to the consensus definition. It is true that he sometimes makes a distinction between ‘essays’ and ‘studies’: freely wandering familiar essays and more focussed literary and historical studies. The former type, familiar essays proper, include those collected in Virginibus Puerisque and Memories and Portraits, which he considered re-issuing together in 1887 as Familiar Essays I and II (Letters 5: 436), implicitly distinguishing them from the essays in the 1882 volume Familiar Studies of Men and Books. These he refers to in the Preface to the volume only as ‘studies’, never as ‘essays’, and elsewhere refers to such works as ‘critical essays’ or ‘critical papers’ (Letters 2: 165, 5: 217, 6: 142), and the distinction of familiar essays and studies continues in his planning for the Edinburgh Edition (Letters 8: 225).