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OtherSPECIAL ARTICLE

Diversion to the Mental Health System: Emergency Psychiatric Evaluations

Jeffrey S. Janofsky and Anthony C. Tamburello
Journal of the American Academy of Psychiatry and the Law Online September 2006, 34 (3) 283-291;
Jeffrey S. Janofsky
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Anthony C. Tamburello
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    Table 1

    Diagnoses Listed by Petitioners on the Petition for Emergency Evaluation

    DiagnosisCases, %
    Bipolar disorder14.1
    Schizophrenia10.3
    Other nonpsychotic5.3
    Major depression3.8
    Cognitive disorder1.9
    Other psychotic1.9
    Substance abuse1.6
    Mental retardation0.3
    None1.3
    Unknown59.6
    • n = 300.

    • View popup
    Table 2

    Medication Types Listed on the Emergency Petition

    MedicationCases, %
    Antipsychotic16.7
    Mood stabilizer8.9
    Antidepressant8.1
    Anxiolytic2.6
    Other11
    None5.2
    Unknown47.5
    • n = 300.

    • View popup
    Table 3

    Dangerousness Type by Emergency Petition Referral Source

    Type of DangerousnessPolice, %Health CareProvider, %Court Ordered, %Total, %
    Physical threat to self62 (35.0)*10 (18.2)*16 (23.5)88 (29.3)
    Verbal threat to self85 (48.0)*21 (38.2)19 (27.9)*125 (41.7)
    Physical threat to others32 (18.1)†18 (32.7)32 (47.1)†82 (27.3)
    Verbal threat to others29 (16.4)*17 (30.9)33 (48.5)†79 26.3)
    Physical threat to property4 (2.3)†2 (3.6)15 (22.1)†21 (7.0)
    Verbal threat to property1 (0.6)*3 (5.5)5 (7.4)*9 (3.0)
    Unable to care for self7 (4.0)†7 (12.7)15 (22.1)†29 (9.7)
    Total433 (144.3)
    • Percentages reflect rate of observed dangerousness type by that referral source.

    • * p≤ 0.05, by Fisher's exact test, when compared to other referral sources.

    • † p < 0.001, by Fisher's exact test when compared to other referral sources.

    • View popup
    Table 4

    Comparison of Reviewers' Opinions of Dangerousness

    Dangerousness per ER RecordDangerousness, per EPTotal
    Yes, ImminentYes, Not ImminentNot Dangerous
    Yes1782412214
    Not dangerous4318970
    Insufficient information84416
    Total2294625300
    • View popup
    Table 5

    Frequency of Clinical Diagnoses in the Emergency Room

    ER Clinical DiagnosisCases, %
    Substance abuse29.3
    Bipolar affective disorder14.9
    Schizophrenia13.4
    Major depressive disorder4.1
    Mental retardation3.3
    Cognitive disorder4.6
    Other psychotic8.2
    Other nonpsychotic22.1
    • n = 300.

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Journal of the American Academy of Psychiatry and the Law Online: 34 (3)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 34, Issue 3
September 2006
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Diversion to the Mental Health System: Emergency Psychiatric Evaluations
Jeffrey S. Janofsky, Anthony C. Tamburello
Journal of the American Academy of Psychiatry and the Law Online Sep 2006, 34 (3) 283-291;

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Jeffrey S. Janofsky, Anthony C. Tamburello
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