This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

II. Mental Disorder Indicators and Three Dangerousness Criteria

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

Arch Gen Psychiatry. 1988;45(8):753-758.

Abstract
• Proponents of return to a "need for treatment" standard for civil commitment contend that the current dangerousness standard forces psychiatrists to neglect severely ill patients in favor of those who are less ill but dangerous to others. Among 198 psychiatric emergency patients in five facilities, those rated as most dangerous on Three Ratings of Involuntary Admissibility, a reliable index of indicators employed by clinicians in evaluating danger to self, danger to others, and grave disability, were also most severely ill on diagnostic and symptomatic assessments of mental disorder. Clinicians' Global Ratings of patient dangerousness on the three criteria were similarly related to severity of diagnosis and symptoms. Perceived dangerousness was associated with major mental disorder and severity of most symptom types, especially impulsivity. Danger to self was the criterion related to the fewest indicators of mental disorder.

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).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Predicting community violence from patients discharged from mental health services
DOYLE and DOLAN
Br. J. Psychiatry 2006;189:520-526.
ABSTRACT | FULL TEXT  

Special Section on the GAF: Determinants of Indicated Versus Actual Level of Care in Psychiatric Emergency Services
Mulder et al.
Psychiatr. Serv. 2005;56:452-457.
ABSTRACT | FULL TEXT  

Factors in the Use of Coercive Retention in Civil Commitment Evaluations in Psychiatric Emergency Services
Segal et al.
Psychiatr. Serv. 2001;52:514-520.
ABSTRACT | FULL TEXT  

Factors Associated With Involuntary Return to a Psychiatric Emergency Service Within 12 Months
Segal et al.
Psychiatr. Serv. 1998;49:1212-1217.
ABSTRACT | FULL TEXT  

Clinicians' Decision Making About Involuntary Commitment
Engleman et al.
Psychiatr. Serv. 1998;49:941-945.
ABSTRACT | FULL TEXT  

Guidelines for Managing Domestic Abuse When Male and Female Partners Are Patients of the Same Physician
Ferris et al.
JAMA 1997;278:851-857.
ABSTRACT  

The Accuracy of Predictions of Violence to Others
Lidz et al.
JAMA 1993;269:1007-1011.
ABSTRACT  

The 1983 Mental Health Act in Five Local Authorities: a Study of the Practice of Approved Social Workers
Hatfield et al.
Int J Soc Psychiatry 1992;38:189-207.
ABSTRACT  

Civil Commitment in the Psychiatric Emergency Room: I. The Assessment of Dangerousness by Emergency Room Clinicians
Segal et al.
Arch Gen Psychiatry 1988;45:748-752.
ABSTRACT  

Civil Commitment in the Psychiatric Emergency Room: III. Disposition as a Function of Mental Disorder and Dangerousness Indicators
Segal et al.
Arch Gen Psychiatry 1988;45:759-763.
ABSTRACT  

Limitations on Psychiatrists' Discretionary Civil Commitment Authority by the Stone and Dangerousness Criteria
Hoge et al.
Arch Gen Psychiatry 1988;45:764-769.
ABSTRACT  

Civil Commitment: The Relationship Between Perceived Dangerousness and Mental Illness
Mills
Arch Gen Psychiatry 1988;45:770-772.
ABSTRACT