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

Determinants of the evaluation and disposition of psychiatric emergencies were studied at Detroit General Hospital. Although the decision to hospitalize an individual was based at least in part upon subjective factors influencing the emergency room resident, this initial decision to admit was generally 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 emergency setting is most useful if goals are modest and all that is required is a decision about whether to hospitalize the individual.