A comparison of Mobile Crisis and police referrals to a psychiatric emergency service: Post-PES hospitalization rates and clinical and demographic characteristics predicting admission

In San Francisco, response to a psychiatric emergency is most often handled by the police department. The responsibility of deciding who is safe to remain in the community often falls to the peace officer at the scene.; The Mobile Crisis Treatment Team is a relatively new option for psychiatric crisis intervention. Mobile crisis brings an interdisciplinary team of trained professionals to the person in crisis who may be unwilling, unable, or unsafe to travel to an outpatient clinic. The team is able to provide many of the interventions available at the psychiatric emergency service (PES).; The purpose of this study was to explore (a) if rates of post-PES admissions to psychiatric inpatient units differ between referrals made by two groups: the police and the Mobile Crisis Treatment Team, and (b) if any clinical or demographic characteristics of police and mobile crisis referrals to PES predict post-PES psychiatric inpatient hospitalization.; The demographic and clinical data for the 4,163 participants in this study were collected from the San Francisco Department of Public Health between January 1, 1997, through December 31, 2001. The demographic and clinical differences between the two referral groups, mobile crisis and the police, were measured.; Overall, the two groups were similar on the demographic and clinical variables. The rate of post-PES hospitalization was 58% for mobile crisis referrals and 41% for police referrals, a statistically significant difference. An unexpected finding showed that mobile crisis referrals diagnosed with an adjustment disorder were over three times more likely to be hospitalized (32.5% vs. 10.2%) than were police referrals diagnosed with an adjustment disorder. The Axis I diagnostic clusters were the strongest predictors of who was hospitalized.; The results of this study point to the need to incorporate a special emphasis on training the police officers to be able to identify those experiencing an adjustment disorder and how to facilitate a mobile crisis intervention in those cases in order to prevent unnecessary evaluations at the psychiatric emergency service. Additional independent variables for future research efforts to consider were discussed.