title: Police referrals at the psychiatric emergency service in Taiwan.
abstract: BACKGROUND
  The police are the frontline workers in crisis situations involving patients with severe mental illness and act as a primary referral source for psychiatric emergency services (PES) in the community. The aims of this study were to investigate the distribution and characteristics of police referral among psychiatric patients in Taiwan.
  
  
  METHODS
  The study cohort consisted of patients who visited the PES of Taipei City Psychiatric Center from January 2009 to December 2010. The associations between the factors of demographics, clinical characteristics, and psychiatric service utilization and police referral were evaluated.
  
  
  RESULTS
  Among the 7656 psychiatric emergency visits, 3029 (39.6%) were referred by the police. These patients referred by police were more likely to be male and aged between 30 to 49 years. Clinical factors related to police referrals including a higher triage assessment level, chief problems included violence, disturbance, substance use, less anxiety, and a diagnosis of unspecified psychosis. The triage assessment level and chief problems assessed by nurses were major predictors. These patients tended to be referred from the catchment area and during the nighttime shift, were discharged during the daytime shift, and stayed longer in the PES. Disposition arrangements such as discharge against medical advice and involuntary admission were also associated with police referrals.
  
  
  CONCLUSIONS
  Patients referred by the police to the PES were those with more severe psychiatric problems and illnesses assessed by psychiatric nurses and psychiatrists. They tended to have more complex service utilization at the PES.
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.|Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei City, Taiwan.|Department of Healthcare Management, National Taipei University of Nursing and Health Sciences, Taipei City, Taiwan.
authors.forename: Jen-Pang
authors.initials: JP
authors.lastname: Wang
authors.affiliation: Department of Nursing, College of Medicine, National Taiwan University, Taipei City, Taiwan.
authors.forename: Chia-Yi
authors.initials: CY
authors.lastname: Wu
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.|Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei City, Taiwan.
authors.forename: Chih-Chiang
authors.initials: CC
authors.lastname: Chiu
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.|Medical Affairs Division, Department of Health, Taipei City Government, Taipei City, Taiwan.
authors.forename: Tsu-Hui
authors.initials: TH
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei City, Taiwan.
authors.forename: Tzong-Hsien
authors.initials: TH
authors.lastname: Liu
authors.affiliation: Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
mesh_terms: D000328:Adult; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data*; D004637:Emergency Services, Psychiatric / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data*; D016495:Police / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013624:Taiwan
keywords: Taiwan; police; psychiatric emergency services; referral; risk factor