Social and clinical factors associated with psychiatric emergency service use and civil commitment among African-American youth.
OBJECTIVE
We examined the social and clinical factors associated with arrival status (e.g., involuntary versus voluntary) and civil commitment decisions in psychiatric emergency services (PES) to assess African-American youths' help-seeking patterns and entrée into care.


METHODS
Patient records were reviewed for 1621 African-American youth from an inner-city PES between October 2001 and September 2002. Multivariate logistic regression was used to examine the social and clinical factors associated with arrival status (e.g., involuntary vs. voluntary admission) and case disposition among youth who were involuntarily and voluntarily admitted (e.g., disposition upheld vs. dismissed).


RESULTS
Low-income youth with behavior disorders were less likely to arrive voluntarily to PES. Medical insurance, suicidality, DSM diagnosis, substance involvement, Global Assessment of Function (GAF) scores and time of day the youth arrived to PES were predictors of voluntary arrival. Older age and GAF scores significantly predicted the decision to uphold an involuntary commitment. Age (younger age less likely), higher GAF scores, insurance status, substance abuse involvement and arrival time (evening shift) significantly predicted the decision to uphold a voluntary decision.


CONCLUSIONS
Our findings suggest that psychiatric and nonpsychiatric factors influence both how African-American youth arrive to PES and the decisions made regarding their voluntary/involuntary commitment.
Lindsey
Michael A
MA
School of Social Work, University of Maryland, Baltimore, MD 21201, USA. mlindsey@ssw.umaryland.edu
Joe
Sean
S
Muroff
Jordana
J
Ford
Briggett E
BE
D000293:Adolescent; D001741:Black or African American / Q000523:psychology*; D002648:Child; D003134:Commitment of Persons with Psychiatric Disorders; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006769:Hospitals, General; D006801:Humans; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D010342:Patient Acceptance of Health Care / Q000208:ethnology / Q000523:psychology*; D015143:Philadelphia; D012923:Social Class; D055815:Young Adult