2023 14th Annual NUBE Conference

In the current United States landscape, addressing racial disparities in law enforcement and healthcare is of utmost importance. This research sheds light on the involuntary mental health commitment process, considering its potential impact on civil liberties and life preservation. Balancing the need to prevent the weaponization of the behavioral emergency system with the urgency to provide life-saving treatment for patients of color is a critical challenge faced by emergency clinicians. Certain mental illnesses impair insight, sometimes leading to life-threatening psychiatric emergencies necessitating involuntary treatment. However, initiating such treatment in the back of a police car presents significant obstacles to perceiving providers as therapeutic. Furthermore, data supports the alarming underdiagnosis and undertreatment of mental illness in the Black community, while suggesting a disproportionate reliance on law enforcement involvement and involuntary commitment for Black individuals compared to nonminority white individuals. Emergency psychiatry must grapple with these opposing realities to ethically and compassionately care for those in need. Failure to do so risks increased violence at the hands of the police for patients in mental health crises, alongside a growing reluctance among individuals to seek commitment for their loved ones, fearing that risks outweigh potential benefits. Our research team delved into data from the Greater Pittsburgh/Allegheny County area, focusing on the involuntary commitment process and the race/ethnicity of individuals receiving care. This presentation will explore the findings, exposing racial disparities within the commitment processes. By bringing attention to these issues, this research contributes to a much-needed dialogue on achieving equitable and just mental healthcare for all. Finally, the presentation will close with a brief discussion of what steps Psychiatric Emergency Services and systems can do to reduce discriminatory impact and access to care.

Learning Objectives:

1. Explore the potential challenges faced by emergency clinicians in balancing the need to prevent the weaponization of the behavioral emergency system while providing life-saving treatment for patients of color who are in need.
2. Analyze and interpret data from the Greater Pittsburgh/Allegheny County area, examining the racial disparities in the involuntary commitment process for Black individuals in comparison to nonminority white individuals.
3. Differentiate the impact of initiating involuntary mental health treatment in the back of a police car versus in a therapeutic setting, and understand the implications on patients' perceptions of care providers, as well as the potential effects on treatment outcomes and the overall therapeutic relationship.