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, Ole J Thienhaus

Research output: Contribution to journalArticle

135 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)101-107
Number of pages7
JournalJournal of Clinical Psychiatry
Volume56
Issue number3
StatePublished - 1995
Externally publishedYes

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Psychiatric Emergency Services
Personality Disorders
Schizophrenia
Insurance Coverage
Health Resources
Public Hospitals
Mental Health Services
Mental Disorders
Diagnostic and Statistical Manual of Mental Disorders
Substance-Related Disorders
Decision Making
Mental Health
Demography

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Strakowski, S. M., Lonczak, H. S., Sax, K. W., West, S. A., Crist, A., Mehta, R., & Thienhaus, O. J. (1995). The effects of race on diagnosis and disposition from a psychiatric emergency service. Journal of Clinical Psychiatry, 56(3), 101-107.

The effects of race on diagnosis and disposition from a psychiatric emergency service. / Strakowski, S. M.; Lonczak, H. S.; Sax, K. W.; West, S. A.; Crist, A.; Mehta, R.; Thienhaus, Ole J.

In: Journal of Clinical Psychiatry, Vol. 56, No. 3, 1995, p. 101-107.

Research output: Contribution to journalArticle

Strakowski, SM, Lonczak, HS, Sax, KW, West, SA, Crist, A, Mehta, R & Thienhaus, OJ 1995, 'The effects of race on diagnosis and disposition from a psychiatric emergency service', Journal of Clinical Psychiatry, vol. 56, no. 3, pp. 101-107.
Strakowski SM, Lonczak HS, Sax KW, West SA, Crist A, Mehta R et al. The effects of race on diagnosis and disposition from a psychiatric emergency service. Journal of Clinical Psychiatry. 1995;56(3):101-107.
Strakowski, S. M. ; Lonczak, H. S. ; Sax, K. W. ; West, S. A. ; Crist, A. ; Mehta, R. ; Thienhaus, Ole J. / The effects of race on diagnosis and disposition from a psychiatric emergency service. In: Journal of Clinical Psychiatry. 1995 ; Vol. 56, No. 3. pp. 101-107.
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