Profiling psychiatric cases evaluated in the general hospital emergency room.

Abstract

In their comprehensive review of psychiatric emergency services, Gerson and Bassuk (1980:1), concluded that: ~The psychiatric emergency ward is now a chief entry point into the network of mental heal th services for people in need of help for their problems in living. Moreover, because of the progression of deinstitutionallization, emergency wards often function as the sole source of t reatment for the chronically disabled patient living in the community. For the troubled individual the decisions made during the emergency room visit determine the choice of a subsequent treatment plan and often influence the course of the problem or illness." Bachrach (1981:885) went even further in her assessment of an emergent role for the general hospital emergency room arguing, ~Because of deinstitutionalization, the general hospital emergency room has in some instances become a substitute for the state hospital." The public's awareness of the issues has been heightened recently by the case of Juan J. Gonzalez, who ran amok in July, 1986 on the Staten Island Ferry. He killed two tourists with a sword he had purchased in a Times Square shop the day after he was