Temporal aspects of emergency room psychiatric evaluations.

The use of emergency room time by medical and psychiatric clinicians evaluating psychiatric patients was studied. The amount of time to the completion of the medical and the psychiatric evaluation and the actual amount of time of the psychiatric evaluation were compared over demographic, admission, diagnostic, and referral factors. Evaluations were completed closer to admission with patients admitted during the day and evening shifts and with patients having more obvious psychiatric problems, i.e., brought involuntarily, with a known psychiatric history, given a psychotic diagnosis in the emergency room, or subsequently sent to a psychiatric hospital. Such factors failed to affect the actual length of the psychiatric evaluation. The multiple time pressures in an emergency room setting appeared to affect when, but not how long, clinicians evaluated psychiatric patients. The time that emergency room clinicians take to begin evaluations of psychiatric patients may reflect important observational data that affect their temporal, diagnostic, and recommended treatment patterns.