CHANGES IN physician and community attitudes over the past decade have been accompanied by a steady increase in the use of the general hospital emergency room for a wider range of problems.1,2 These changes have stimulated research interest in the emergency service—an intrest shared by the psychiatrist. Studies concerning psychiatric care in the general hospital emergency room have delineated relevant sociocultural, personal, and diagnostic characteristics of the population.3,6 As a result, a growing awareness of the complexity of the interaction between patient, family, and the psychiatric consultant has emerged. The end-point of the encounter, the disposition, reflects the influence of these multidetermined forces. By examining the interaction through the eyes of the psychiatric consultant, in this case ten second- and third-year psychiatric residents, the present study aims at achieving a firmer understanding of the influence that various subjective and objective factors exert upon the decision-making process in the