The New York Office of Mental Health partnered with CTG to improve emergency psychiatric decision making. The primary goals of the project were to reduce inappropriate admissions and discharges, improve client and system outcomes, and reduce inconsistencies in emergency room decisions. To achieve these goals, the project developed decision support software and sought to apply this improved technology in a very harried, complex, and significant decision environment - an environment that deprives individuals of their liberty and consumes significant government resources.
The decision support software was designed to ensure that physicians ask all the appropriate questions needed to make an admission decision, and to help them sort and weigh the relative importance of the answers. The admission decision, however, is the province of the physician. The software was not intended to, nor can it, replace physician judgment.
Expectations for the CTG project were ambitious. OMH hoped ultimately for a psychiatric assessment product that could be sent to the 166 hospitals in New York for potential use in their emergency rooms. The complexity of the tool and the policies it represents, however, point to the need for much additional testing and revision of the prototype.