[Skip to Content]
[Skip to Content Landing]
August 1988

Civil Commitment in the Psychiatric Emergency Room: I. The Assessment of Dangerousness by Emergency Room Clinicians

Author Affiliations

From the Mental Health and Social Welfare Research Group, School of Social Welfare, University of California, Berkeley (Drs Segal and Watson); the Department of Psychiatry, University of California, San Francisco (Drs Watson and Goldfinger); and Institute for Scientific Analysis, Berkeley (Drs Segal, Watson, and Goldfinger, and Mr Averbuck).

Arch Gen Psychiatry. 1988;45(8):748-752. doi:10.1001/archpsyc.1988.01800320064008

• Critics of the dangerousness standard for civil commitment contend that there is no professional standard for the evaluation of dangerousness. We used Three Ratings of Involuntary Admissibility, a reliable index of behavioral indicators of danger to self, danger to others, and grave disability, and found that when combined into weighted patterns these indicators predicted disposition decisions of 70 clinicians in five psychiatric emergency rooms over 251 cases. A concurrent measure of perceived dangerousness, Clinician's Global Ratings of patients on these criteria, yielded similar results. We conclude that clinicians in California psychiatric emergency rooms apply a shared concept of dangerousness that can be described in behavioral terms.