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Study objective. The goal of this study was to evaluate demographic factors associated with increased emergency department use among people with psychiatric conditions. Methods. This was a retrospective cohort study of all patients presenting to an urban, academic emergency department with a history of at least one mental health-related final diagnosis. Results. A total of 569 people with psychiatric conditions were included in the study. Of this group, 22.1% had four or more visits within 2009. People with more than four annual visits were more likely to be over age 40, to have at least one chronic condition, to have Medicaid, and to be Black compared with those with fewer than four annual visits. Discussion. The frequent-user group had fewer visits with a final psychiatric diagnosis, lower rate of psychiatric admissions, and higher rate of visits resulting in a medical admission than the infrequent-user group.