This study was conducted to evaluate a behavioural assessment room (BAR) as a strategy in the management of people exhibiting acute behavioural disturbance in the St Vincent's Hospital, Melbourne Emergency Department (ED). The study involved a retrospective audit of the data documented for BAR use over a 12-month period and a structured questionnaire of clinical and nonclinical emergency department staff.Patients managed in the BAR presented with various behaviours; 58% were substance induced. The median duration of stay in the room was 20 minutes, during which assessment and containment or "behavioural resuscitation" proceeded. 98.5% of questionnaire respondents believed that the BAR created a safer environment EMERGENCY DEPARTMENTS (EDs) are faced with an increasing number of patients exhibiting behavioural disturbance that interferes with health care provision and may place patients, staff and/or others at risk. Workplace violence has also been on the rise over the past few decades. 1,2 Effective containment of this escalating situation demands an innovative approach and change in attitude by health professionals. 3 The increase in behavioural disturbance may be attributed to a growing demand on EDs, changing trends in illicit drug use, 4 and the redirection of mental health care towards a "mainstream" community-based model. [5][6][7] The structural design and care pathways of EDs have traditionally been geared towards medical emergencies rather than managing adverse behaviour. With respect to the increased number of behaviourally disturbed patients within EDs and the associated difficulties in managing their care, the typical ED environment is no longer conducive to optimum safety; patient care may be compromised and undue stress is placed on staff and visitors to the department. Previous research indicates that although ED staff feel able to assess the potential for violence, they perceive themselves as being inadequately skilled to manage aggression. 7 A recent internal quality improvement survey of St Vincent' s Hospital, Melbourne (SVHM) ED staff revealed that only one third of staff felt safe to very What is known about the topic? Despite escalating demands on emergency departments there are few strategies for managing the behaviourally disturbed patient. Clinicians have struggled to provide an adequate environment for the management of aggressive behaviour, and while most hospitals have a generic response to acute aggressive incidences, this strategy is insufficient for emergency department environments. What does this paper add?This paper describes and evaluates a strategy for managing behavioural disturbance; a dedicated space in association with supported processes and policies. It is demonstrated that this formula increases the perceived safety of ED staff. What are the implications for practitioners? Providing a dedicated area to manage behavioural disturbance provides effective behavioural resuscitation, thereby facilitating a more streamlined and safe approach to health care delivery.