Determinants of Emergency Room Visits for Psychological Problems in a General Hospital

Determinants of emergency room visits for psychological reasons were studied pro spectively for a four month period in an Indian General Hospital. Psychiatric emergen cies constituted only 2% of all emergency visits. Most of the patients were new except for 7.4% who were already registered with the outpatient services of the psychiatry department. Males outnumbered females in a ratio of 2:1. Self-referrals constituted 77% of the samples; 21 % of patients were brought by police. Two-thirds of the patients were brought owing to the severity of their clinical condition and the rest, one-third, for medico-legal and social reasons. Approximately 80% of the patients sought con sultation within one month of the onset of illness episode. First episode of mental illness was within last one year of the emergency room visit in 60% patients. Past history of hospitalization for mental illness was obtained only in 10% of cases. The pattern suggested that there was no misuse of emergency services by psychiatric patients although 20% of the patients presented with social problems only which required social rather than psychiatric intervention.