• Stephen Armstrong, D . John Pestana, Barbara Goodman
  • Published 2004 in Administration in mental health


There are a number of reasons why patients fail to follow emergency psychiatric referral dispositions and recommendations. First, the patient may not understand the emergency psychiatrie recommendations (Tischler 1966). Second, if the psychiatrist feels powerless to handle the patient 's chief complaint (Jellinek 1978), his referral to a different treatment facility may be a nonspecific recommendation that has no real impact. Third, a patient 's sense of racial or cultural differences in the psychiatrist may produce a reluctance to follow emergency recommendations (Raynes and Warren 1971; Craig et al. 1974; Wilder et al. 1977). Finally, psychiatric patients may not follow through on recommendations because they may have trouble negotiating the distance between the emergency service and the outpatient clinic to which referral was made (Sudak et al. 1977). We found no precise estimates of the incidenee of noncompliance with emergency r o o m p s y c h i a t r i c r e c o m m e n d a t i o n s , although the literature states that between 40 percent and 60 percent of psychiatric emergency patients do not follow through on further treatment recommendations (all references). Usually, these noncompliant patients do not surface again to our view and we are forced to assume that the chief complaint has resolved or the patient has declined treatment. There is an unresearched group of noncomplaint patients, however, who eome to the emergeney room time after time in psychiatric crisis, each time implicitly rejecting the recommendations

DOI: 10.1007/BF00823818

Cite this paper

@article{Armstrong2004Opinion, title={Opinion}, author={Stephen Armstrong and D . John Pestana and Barbara Goodman}, journal={Administration in mental health}, year={2004}, volume={8}, pages={214-220} }