The effects of race on diagnosis and disposition from a psychiatric emergency service

S M Strakowski, H S Lonczak, K W Sax, S A West, A Crist, R Mehta, O J Thienhaus
Journal of Clinical Psychiatry 1995, 56 (3): 101-7

BACKGROUND: Previous studies have reported that racial differences exist in patterns of clinical psychiatric diagnoses as well as the distribution of mental health services resources. The psychiatric emergency service serves as an entry point into the mental health system, so it plays a potentially important role in addressing racial disparities in diagnosis and disposition. To address this disparity, the authors studied two specific questions: (1) are there racial differences in diagnosis and (2) are there racial differences in disposition of patients visiting a psychiatric emergency service?

METHOD: Demographic and clinical data were obtained by retrospective chart review of 490 patients randomly selected from 9500 visits to a large psychiatric emergency service during a 1-year period. All clinical information had been recorded by the primary treaters who had no knowledge of this study.

RESULTS: Black patients were significantly more likely to be diagnosed with schizophrenia and substance abuse than similar white patients, although less likely to be diagnosed with a personality disorder. Black patients were significantly more likely to be hospitalized, particularly at a public hospital, although there were no significant differences in insurance coverage or measures of suicidal or homicidal ideation.

CONCLUSION: Despite the availability of DSM-III-R criteria, black patients continue to be disproportionately diagnosed with schizophrenia. In this sample, this diagnosis may have been given in lieu of a personality disorder or affective illness diagnosis. Black patients are also more likely to be hospitalized. These observations suggest that further research is needed to clarify the effects of race on the decision-making process in diagnosis and disposition from the psychiatric emergency service.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"