Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
2 min synopsisUK scopeSources checked 27 Aug 2026Clinical review pending
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Uncertainty cannot postpone protection
The final diagnosis may be unclear while suicide risk, severe self-neglect, delirium, mania, catatonia or danger to others still requires a time-critical plan.
Action: Explain what is known, the immediate feared harm and why action is necessary. Treat urgent physical causes, arrange proportionate safety and specialist review, and state which diagnostic questions remain open. Use supported decision making and document capacity and legal authority for any restriction.
Synopsis
Explain working diagnoses, evidence, alternatives and uncertainty in language the person can use, preserving hope and autonomy while agreeing treatment, safety-netting, information sharing and a defined route for diagnostic review.
Ask what the person already understands, what language they prefer and how much detail they want now before offering a diagnostic explanation.
State whether the label is a confirmed diagnosis, a working hypothesis, a syndrome awaiting cause clarification or one of several reasonable alternatives.
Explain the observations and timeline supporting the view, the important contradictory evidence and what further information could change it.
Key red flags
Presenting a tentative diagnosis as fact can cause stigma, inappropriate treatment and copied-record error that persists after evidence changes.
Investigation priorities
01
Evidence and uncertainty reviewFirst step
Separate established facts, clinical inferences, leading hypotheses, alternatives and information still needed.
Management branches
Diagnostic conversationExplain evidence and degree of certainty
An assessment has produced a working or confirmed psychiatric explanation that should be discussed.
Check what the person understands and wants to know, arrange communication support and describe the current problems before naming a label.
Explain supporting and conflicting evidence, alternatives, implications and what remains unknown in plain, non-deterministic language.
National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 27 Aug 2026; clinical approval remains outstanding.