Psychiatric Emergencies: Dispositional Determinants and the Validity of the Decision to Admit

Determinants of the evaluation and disposi-tion of psychiatric emergencies were studied at Detroit General Hospital. Although the decision to hospitalize an individual was based at least in part upon subjective fac-tors influencing the emergency room resi-dent, this initial decision to admit was gen-erally well supported by later observations made about the patient on the ward. Other judgments made in the emergency room, such as diagnosis and prognosis, were not later validated. The authors conclude that the brief psychiatric interview in an emer-gency setting is most useful if goals are modest and all that is required is a decision about whether to hospitalize the individual. T HE NATIONWIDE trend toward extend-ing the responsiblity for psychiatric ad-missions from mental hospitals to com-munity and general hospitals has increased the importance of understanding those social and individual factors which influence the evaluation and disposition of patients pre-senting themselves as psychiatric emergen-cies. Studies have already been reported that illustrate the relationship between so-cial phenomena and mental illness; studies of the admission process itself have exam-Read at the 123rd annual meeting of the Amer