CRISIS INTERVENTION AND ACUTE PSYCHIATRY IN AMSTERDAM, 20 YEARS OF CHANGE: A HISTORICAL COMPARISON OF CONSULTATIONS IN 1983 AND 2004–2005

Aim: There has been a striking increase in the number of compulsory admission proceedings in the Netherlands since 1992, to such an extent that treatment in Amsterdam’s psychiatric clinics is in danger of being dominated by coercive treatment. Our aim was to establish a picture of the changes in emergency psychiatry that have contributed to the increase in the number of acute compulsory admissions. Methods: A cohort (N = 460) of psychiatric emergency consultations with the city crisis service in 1983 was compared with a similar cohort (N = 436) in 2004–2005. The study focused on the following variables: patient characteristics, crisis-service procedures and consultation outcomes. Results: Compared with 1983, there are now more services involved in crisis support in the public domain for psychiatric patients. The number of patients referred by the police has risen from 29 % to 63%. In 1983, all consultations took place where the patients were located; at present, 60 % take place at the crisis service premises