Who brings patients to the psychiatric emergency room? Psychosocial and psychiatric correlates.

In a sample of 311 consecutive psychiatric emergency room patients, 133 (43%) were accompanied by relatives, friends, or others, 113 (36%) came with the police, and 65 (21%) came by themselves. There were more males in the group brought in by police or who came by themselves than in the group accompanied by family or others. Aggression was the presenting problem in about 40% of police referrals. Half the aggressive patients who were brought in by the police were diagnosed with psychotic disorders. Poor social functioning was found in patients who came with police and by themselves, this finding was more pronounced in males. High rates of substance abuse, as suggested by positive toxicology, were found in police referrals and patients who came by themselves. This was mostly due to alcohol in males and cocaine in females. Findings indicate that gender, diagnosis, and psychosocial status contribute independently to who brings patients to the psychiatric emergency room. It is suggested that this information is clinically useful for diagnostic assessment and management. Clinical and research implications are discussed.