Demographic and Clinical Correlates of Police-Involved Admissions to Psychiatric Emergency Services

Introduction: Police officers are often responsible for determining whether persons in crisis are brought to psychiatric emergency services (PES) for assessment; officers in San Francisco respond to nearly 900 mental-health-related calls each month and are thus important partners to the public mental-health system. This study's goals were to better understand the role of the San Francisco Police Department (SFPD) in involuntary admissions to San Francisco General Hospital (SFGH) PES by examining demographic and clinical patterns associated with SFPD involvement. Methods: Demographic, clinical and referral source data were extracted from SFGH PES records from 1/1/2005-3/1/2005. Results: Of 1,265 PES admissions, 668 (53%) involved the SFPD. SFPD involvement was not associated with patient functioning or racial/ethnic background (47% White, 28% Black, 13% Asian, 10% Latino). Compared to admissions that did not involve the SFPD, patients in SFPD-involved admissions were more likely to be male (66.5% vs. 60.6%, OR=1.3), to have used alcohol/drugs (OR=1.8) and exhibited violence (OR=2.5) and were less likely to report suicidal ideation (OR=0.50). Patients with SFPD-involved admissions were more likely to be placed in restraints in PES (OR=2.8). Conclusions: Police-involved admissions are racially/ethnically similar to admissions from other sources, but are more likely to be of men and to involve complicating factors such as violent behavior and substance use. These attributes suggest the need for more resources devoted to substance abuse services and enhanced support and collaboration from mental health providers in community settings where police encounter individuals in psychiatric crisis.