Determinants of emergency room visits for psychological problems in a general hospital

Determinants of emergency room visits for psychological reasons were studied prospectively for a four month period in an Indian General Hospital. Psychiatric emergencies 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 consultation 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.