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Civil Commitment in the Psychiatric Emergency Room: III. Disposition as a Function of Mental Disorder and Dangerousness Indicators

Civil Commitment in the Psychiatric Emergency Room: III. Disposition as a Function of Mental... Abstract • In 251 evaluations observed in five California public psychiatric emergency rooms, patients who were retained, whether new to the system or having histories of hospitalization, rated higher on measures of danger to self, danger to others, and grave disability than patients who were released. They were also more severely symptomatic and more often given major diagnoses. The combination of dangerousness and mental disorder predicted disposition for 93% of new patients and 88% of recidivist patients. Impulsivity was the most influential aspect of mental disorder. References 1. Doremus v Farrell, 407 F Supp 509, 514-515 (D Neb 1975). 2. Doe v Gallinot, 486 F Supp 983, (S D Cal 1979), aff'd 657 F2d 1017 (9th Cir 1981). 3. Lipsitt PD, Lelos D: Decision makers in law and psychiatry and the involuntary civil commitment process . Community Ment Health J 1981;17:114-122.Crossref 4. Mills MJ: Civil commitment of the mentally ill: An overview . Ann Am Acad Polit Soc Sci 1986;484:28-41.Crossref 5. Stromberg CD, Stone AA: Statute: A model state law on civil commitment of the mentally ill . Harvard J Legislation 1983;20:275-396. 6. Appelbaum PS: Hospitalization of the dangerous patient: Legal pressures and clinical responses . Bull Am Acad Psychiatry Law 1984;12:323-329. 7. Rabkin JG, Zitrin A: Antisocial behavior of discharged mental patients: Research findings and policy implications , in Bloom BL, Asher SJ (eds): Psychiatric Patient Rights and Patient Advocacy: Issues and Evidence . New York, Human Sciences Press, 1982, pp 148-170. 8. Segal SP, Watson MA, Nelson LS: Consistency in the application of civil commitment standards in psychiatric emergency rooms . J Psychiatry Law 1986;14:125-148. 9. Segal SP, Watson MA, Goldfinger SM, Averbuck DS: Civil commitment in the psychiatric emergency room: I. The assessment of dangerousness by emergency room clinicians . Arch Gen Psychiatry 1988;45:748-752.Crossref 10. Segal SP, Watson MA, Goldfinger SM, Averbuck DS: Civil commitment in the psychiatric emergency room: II. Mental disorder indicators and three dangerousness criteria . Arch Gen Psychiatry 1988;45:753-758.Crossref 11. Cal Welf & Inst Code, Div 5, chap 2, pt 1 (West 1980). 12. Holmes W, Solomon P: Criteria used in first admission and readmission to psychiatric hospitals . Soc Sci Med 1980;14a:55-59. 13. Mezzich JE, Evanczuk KJ, Mathias RJ, Coffman GA: Symptoms and hospitalization decisions . Am J Psychiatry 1984;141:764-769. 14. De la Torre J: Discussion of Walker WR, Parsons L, Skelton WD: Brief hospitalization on a crisis service: A study of patients and treatment variables . Am J Psychiatry 1973;130:895-896. 15. Friedman HJ: Some problems of inpatient management with borderline patients . Am J Psychiatry 1969;126:299-304. 16. Mestrovic S: Need for treatment and New York's revised commitment laws: An empirical assessment . Int J Law Psychiatry 1983;6:75-83.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

Civil Commitment in the Psychiatric Emergency Room: III. Disposition as a Function of Mental Disorder and Dangerousness Indicators

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References (14)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1988.01800320075010
Publisher site
See Article on Publisher Site

Abstract

Abstract • In 251 evaluations observed in five California public psychiatric emergency rooms, patients who were retained, whether new to the system or having histories of hospitalization, rated higher on measures of danger to self, danger to others, and grave disability than patients who were released. They were also more severely symptomatic and more often given major diagnoses. The combination of dangerousness and mental disorder predicted disposition for 93% of new patients and 88% of recidivist patients. Impulsivity was the most influential aspect of mental disorder. References 1. Doremus v Farrell, 407 F Supp 509, 514-515 (D Neb 1975). 2. Doe v Gallinot, 486 F Supp 983, (S D Cal 1979), aff'd 657 F2d 1017 (9th Cir 1981). 3. Lipsitt PD, Lelos D: Decision makers in law and psychiatry and the involuntary civil commitment process . Community Ment Health J 1981;17:114-122.Crossref 4. Mills MJ: Civil commitment of the mentally ill: An overview . Ann Am Acad Polit Soc Sci 1986;484:28-41.Crossref 5. Stromberg CD, Stone AA: Statute: A model state law on civil commitment of the mentally ill . Harvard J Legislation 1983;20:275-396. 6. Appelbaum PS: Hospitalization of the dangerous patient: Legal pressures and clinical responses . Bull Am Acad Psychiatry Law 1984;12:323-329. 7. Rabkin JG, Zitrin A: Antisocial behavior of discharged mental patients: Research findings and policy implications , in Bloom BL, Asher SJ (eds): Psychiatric Patient Rights and Patient Advocacy: Issues and Evidence . New York, Human Sciences Press, 1982, pp 148-170. 8. Segal SP, Watson MA, Nelson LS: Consistency in the application of civil commitment standards in psychiatric emergency rooms . J Psychiatry Law 1986;14:125-148. 9. Segal SP, Watson MA, Goldfinger SM, Averbuck DS: Civil commitment in the psychiatric emergency room: I. The assessment of dangerousness by emergency room clinicians . Arch Gen Psychiatry 1988;45:748-752.Crossref 10. Segal SP, Watson MA, Goldfinger SM, Averbuck DS: Civil commitment in the psychiatric emergency room: II. Mental disorder indicators and three dangerousness criteria . Arch Gen Psychiatry 1988;45:753-758.Crossref 11. Cal Welf & Inst Code, Div 5, chap 2, pt 1 (West 1980). 12. Holmes W, Solomon P: Criteria used in first admission and readmission to psychiatric hospitals . Soc Sci Med 1980;14a:55-59. 13. Mezzich JE, Evanczuk KJ, Mathias RJ, Coffman GA: Symptoms and hospitalization decisions . Am J Psychiatry 1984;141:764-769. 14. De la Torre J: Discussion of Walker WR, Parsons L, Skelton WD: Brief hospitalization on a crisis service: A study of patients and treatment variables . Am J Psychiatry 1973;130:895-896. 15. Friedman HJ: Some problems of inpatient management with borderline patients . Am J Psychiatry 1969;126:299-304. 16. Mestrovic S: Need for treatment and New York's revised commitment laws: An empirical assessment . Int J Law Psychiatry 1983;6:75-83.Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Aug 1, 1988

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