Mental health-related visits to emergency departments are growing. Research on the decision making process in psychiatric emergency services (PES) has focused on the severity of symptoms and dangerousness as predictors of admission or discharge. Patient requests have been understudied in this predominantly medical approach.

The main objective of this study was a standardized evaluation of patient requests in PES.

The ‘Hulpvragenlijst’ (HVL), a 61-item self-rating questionnaire was administered to 102 consecutive patients attending the PES of a general hospital. The HVL assesses 7 different components of patient requests: psychological, relational, problem-oriented, medical, information-oriented, and psychiatric. Exclusion criteria were disturbed consciousness and severe psychomotor agitation.

Data processing following the rules of HVL aggregation was performed. Ridit analysis was further used for refined data aggregation. This is a method for comparing ordinal-scale responses. Patient requests were looked at in different subgroups (according to diagnosis and disposition).

Data processing following the rules of HVL aggregation showed that the main request of patients was information-oriented, less relational or medical. Ridit analysis showed a more refined pattern of requests in different diagnostic and dispositional categories: each category characterized by a distinct profile of requests.

Patient requests, besides the severity of symptoms and dangerousness, are a supplemental view on the needs of patients attending PES. These different components should be entered into a “negotiation” that ultimately results in a treatment decision. If confirmed in other studies these data could be used for the future development of PES service delivery.