Diversion to the mental health system: Emergency psychiatric evaluations

In Maryland, any citizen may petition to have individuals brought against their will for an examination by a physician. In this retrospective chart review, we evaluated the characteristics of 300 persons referred to the Johns Hopkins Hospital on emergency petitions. Sixty-one percent of petitions described individuals who made verbal or physical threats of self-harm. Forty-seven percent of the petitions described individuals who could have been arrested based on dangerousness to others or property, but were instead diverted to the emergency room for psychiatric evaluation. Although not promoted as a jail diversion program, this process has the potential to direct mentally ill citizens appropriately from the criminal justice system into the mental health system. Greater involvement of mental health professionals at all stages, including police training and participation in crisis response teams in the community, may improve this process.