Involuntary hospitalization and police referrals to a psychiatric emergency department.

Abstract

This study compares the demographic and clinical characteristics of police referrals with referrals from other sources to the psychiatric emergency department of a university hospital and the demographic and clinical characteristics of police referrals who were involuntary hospitalized with police referrals who were discharged from the emergency department (ED). In our study, 182 cases were seen in the psychiatric ED over the one-month period; 32 (17.6%) were police referrals. Police referrals were not more frequently hospitalized than referrals from other sources. Police referrals were, however, more likely to have been violent towards others preceding admission (59.4% versus 20.0%; chi 2 = 20.8; df = 1; p < .01) and to be intoxicated on presentation (31.3% versus 10.7%; chi 2 = 91; df = 1; p < .01). Police referrals also were significantly more likely to be violent in the psychiatric ED than referrals from other sources (37.5% versus 3.4%, chi 2 = 36.5, df = 1, p < .01) and to be restrained or secluded (34.4% versus 4.0%; chi 2 = 28.8; df = 1; p < .01). Involuntarily hospitalized police referrals were significantly more likely to be suffering from a major psychiatric disorder than police referrals not hospitalized (83.3% versus 11.8%; chi 2 = 14.7; df = 1; p < .01). They also were significantly more likely to have been violent towards other ED (66.7% versus 23.5%; Fisher test, p < .05) and to have been restrained or secluded in the ED (58.3% versus 23.5%; Fisher test, p < .05) than police referrals who were not admitted.