Violence and suicide risk assessment in the psychiatric emergency room

Structured clinical rating scales covering 10 areas related to suicide and violence were constructed for use in a psychiatric emergency room (ER). Ninety-five ER patients were evaluated with the scales, 50 of whom were discharged after the visit and 45 of whom were admitted to the inpatient psychiatric wards of the hospital. The admitted patients were found to differ significantly from the discharged patients on every one of the 10 scales. Scores on the scales were also found to predict suicide precautions on the wards, harrassment of other patients as assessed from nursing notes, and indicators of violence on the wards. The scales were also found to have high internal reliability and high sensitivity and specificity. They appear to be helpful to clinicians in identifying patients in need of hospitalization and may also serve as limited predictors of hospital functioning.