OUTCOME FOR PSYCHIATRIC EMERGENCY PATIENTS SEEN BY AN OUTREACH POLICEMENTAL-HEALTH TEAM

Objective: The study examined whether outreach teams of mental health professionals and police officers could assess and make appropriate di spositions for psychiatric emergency cases in the community, even in s ituations involving violence or potential violence. The study also ass essed whether such teams could reduce criminalization of mentally ill persons. Methods: One hundred and one consecutive referrals to law enf orcement-mental health teams in Los Angeles were studied through recor ds review. Subjects' status during a six-month follow-up period was al so examined. Results: Referrals had a high rate of past criminal arres ts, violence, and major psychopathology. Sixty-three had a history of violence against persons, 59 had a criminal arrest history, 79 had pri or psychiatric hospitalizations, and 66 were serious substance abusers . At referral 70 manifested severe psychiatric symptoms, 20 were overt ly violent, and 29 others exhibited threatening behavior. However, onl y two of the group were arrested 80 were taken to hospitals. At six-mo nth follow-up of 85 referrals, 22 percent had been arrested (12 percen t for crimes of violence), and 42 percent had been rehospitalized. Con clusions: Outreach emergency teams composed of a police officer and a mental health professional are able to deal appropriately with persons who have acute and severe mental illness, a high potential for violen ce, a high incidence of substance abuse, and long histories with both the criminal justice and mental health systems. Such teams apparently avoid criminalization of the mentally ill.