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I. The Assessment of Dangerousness by Emergency Room Clinicians

Steven P. Segal, PhD; Margaret A. Watson, DSW; Stephen M. Goldfinger, MD; David S. Averbuck, JD

Arch Gen Psychiatry. 1988;45(8):748-752.

Abstract
• 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.

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).

Footnotes
Accepted for publication Jan 5, 1988.

Reprint requests to School of Social Welfare, 120 Haviland Hall, University of California, Berkeley, CA 94720 (Dr Segal).

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