Fons Elsenburg: Crisistheory and Psychiatric Consultation in a University Hospital Emergency Room
The concept of the 'precipitating event' as used in crisistheory is outlined.
This concept formed the starting point for a sociological research that was carried out at the emergency room (ER) of a university hospital. The researchpopulation, 347 persons, consisted of all those people who visisted the ER during a 3 month period and who were seen by a psychiatrist. The main research questions were:
—Is the ER visited by people in crisis, as formulated in crisis theories?
—Where are those people referred to after they have visited the ER?
—Is it possible to distinguish a crisis category in the above mentioned aspect?
First of all a crisis category was operationalised, in which the concept of the 'precipitating event' was the tentral issue. Then, in order to answer the research questions, the crisis category and the other ER-clients were compared on a number of characteristics, a.o.: age, time of arrival at the ER, referral to the ER, suicide behaviour, former psychiatric admissions, psychiatric diagnosis, referral to the ER.
An important conclusion here was that a crisis category can indeed be found among the ER-clients, but this category does not significantly differ from the other ER-clients in any of the variables except of the characteristic concerning suicide behaviour. As for the referral from the ER, some difference existed so far the crisis category is concerned. It appeared that a significantly greater number of this category was referred to the nearby crisis center. But simultaneously, it became clear that a recent psychiatric admission had more influence on the referral decision than the state of crisis. Finally it became clear from the research project that the crisis concept, as presently formulated, may not be very usefull in describing and analysing psychiatric consultation in a university hospita' emergency room.