The psychiatric emergency ward has become a primary entry point into the network of mental health services for people who need help to cope with their problems of living. It is also the only source of treatment for many chronically mentally ill patients living in the community. The authors critically review the literature on emergency psychiatric services, focusing on the ways these services are used, the atmosphere in the emergency room, and the determinants of disposition decision making. On the basis of their research, they suggest a model for emergency services that includes an evaluation of the patient's and his on her community's resources and competence and minimizes subtle diagnostic considerations.