Racial Disparity in the Clinical Risk Assessment

Implicit bias has been shown to impact care in many medical specialties. However, few studies examine its impact on psychiatry. Psychiatrists, especially in the Emergency Room, must assess patients’ level of dangerousness when determining an appropriate disposition. For a variety of reasons, clinical understanding of dangerousness may be highly vulnerable to implicit bias. This study aims to determine if there is implicit bias in a psychiatric emergency room setting when determining disposition. Patients were included if their race was recorded as White or Black and if their disposition was either admitted to the inpatient psychiatric unit or discharged to the community (N = 743). Analyses were performed to evaluate associations between race, age, gender and disposition. No statistically significant difference in admission rates between races was found. While this could indicate genuine racial parity, there are many factors that may have masked racial disparity and could warrant further study.