Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005

L.F.M. van der Post, J.J.M. Dekker, J.F.J. Jonkers, A.T.F. Beekman, C.L. Mulder, L. de Haan, W.G. Mulder, R.A. Schoevers

Research output: Contribution to journalArticleProfessional

Abstract

BACKGROUND: Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics. AIM: To build up a picture of the changes in emergency psychiatry which have contributed to the increase in the number of acute compulsory admissions. METHOD: A cohort (n = 460) of consultations conducted by the city crisis service in 1983 was compared with a similar cohort (n = 436) of consultations conducted in 2004-2005 based on the following variables: crisis-service procedures, patient characteristics, diagnosis and consultation outcomes. RESULTS: In 2003-2004 more services were involved with psychiatric patients in acute situations in the public domain than were involved in 1983. The number of patients referred by the police almost doubled, rising from 29.3 to 62.7%. In 1983 all consultations took place where the patients were located; in 2004-2005 60% took place at the premises of the crisis service. The number of psychotic patients in the cohort rose from 52 to 63.3%. There was a rise in the number of compulsory admissions (from 16.7 to 20%) and a sharp decline in voluntary admissions (from 25.7 to 7.6%). The total number of admissions following a consultation decreased from 42 to 28%. CONCLUSIONS: The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry
Original languageUndefined/Unknown
Pages (from-to)139-150
JournalTijdschrift voor Psychiatrie
Volume51
Issue number3
Publication statusPublished - 2009

Cite this

van der Post, L. F. M., Dekker, J. J. M., Jonkers, J. F. J., Beekman, A. T. F., Mulder, C. L., de Haan, L., ... Schoevers, R. A. (2009). Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005. Tijdschrift voor Psychiatrie, 51(3), 139-150.
van der Post, L.F.M. ; Dekker, J.J.M. ; Jonkers, J.F.J. ; Beekman, A.T.F. ; Mulder, C.L. ; de Haan, L. ; Mulder, W.G. ; Schoevers, R.A. / Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005. In: Tijdschrift voor Psychiatrie. 2009 ; Vol. 51, No. 3. pp. 139-150.
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title = "Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005",
abstract = "BACKGROUND: Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics. AIM: To build up a picture of the changes in emergency psychiatry which have contributed to the increase in the number of acute compulsory admissions. METHOD: A cohort (n = 460) of consultations conducted by the city crisis service in 1983 was compared with a similar cohort (n = 436) of consultations conducted in 2004-2005 based on the following variables: crisis-service procedures, patient characteristics, diagnosis and consultation outcomes. RESULTS: In 2003-2004 more services were involved with psychiatric patients in acute situations in the public domain than were involved in 1983. The number of patients referred by the police almost doubled, rising from 29.3 to 62.7{\%}. In 1983 all consultations took place where the patients were located; in 2004-2005 60{\%} took place at the premises of the crisis service. The number of psychotic patients in the cohort rose from 52 to 63.3{\%}. There was a rise in the number of compulsory admissions (from 16.7 to 20{\%}) and a sharp decline in voluntary admissions (from 25.7 to 7.6{\%}). The total number of admissions following a consultation decreased from 42 to 28{\%}. CONCLUSIONS: The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry",
author = "{van der Post}, L.F.M. and J.J.M. Dekker and J.F.J. Jonkers and A.T.F. Beekman and C.L. Mulder and {de Haan}, L. and W.G. Mulder and R.A. Schoevers",
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pages = "139--150",
journal = "Tijdschrift voor Psychiatrie",
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van der Post, LFM, Dekker, JJM, Jonkers, JFJ, Beekman, ATF, Mulder, CL, de Haan, L, Mulder, WG & Schoevers, RA 2009, 'Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005' Tijdschrift voor Psychiatrie, vol. 51, no. 3, pp. 139-150.

Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005. / van der Post, L.F.M.; Dekker, J.J.M.; Jonkers, J.F.J.; Beekman, A.T.F.; Mulder, C.L.; de Haan, L.; Mulder, W.G.; Schoevers, R.A.

In: Tijdschrift voor Psychiatrie, Vol. 51, No. 3, 2009, p. 139-150.

Research output: Contribution to journalArticleProfessional

TY - JOUR

T1 - Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005

AU - van der Post, L.F.M.

AU - Dekker, J.J.M.

AU - Jonkers, J.F.J.

AU - Beekman, A.T.F.

AU - Mulder, C.L.

AU - de Haan, L.

AU - Mulder, W.G.

AU - Schoevers, R.A.

PY - 2009

Y1 - 2009

N2 - BACKGROUND: Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics. AIM: To build up a picture of the changes in emergency psychiatry which have contributed to the increase in the number of acute compulsory admissions. METHOD: A cohort (n = 460) of consultations conducted by the city crisis service in 1983 was compared with a similar cohort (n = 436) of consultations conducted in 2004-2005 based on the following variables: crisis-service procedures, patient characteristics, diagnosis and consultation outcomes. RESULTS: In 2003-2004 more services were involved with psychiatric patients in acute situations in the public domain than were involved in 1983. The number of patients referred by the police almost doubled, rising from 29.3 to 62.7%. In 1983 all consultations took place where the patients were located; in 2004-2005 60% took place at the premises of the crisis service. The number of psychotic patients in the cohort rose from 52 to 63.3%. There was a rise in the number of compulsory admissions (from 16.7 to 20%) and a sharp decline in voluntary admissions (from 25.7 to 7.6%). The total number of admissions following a consultation decreased from 42 to 28%. CONCLUSIONS: The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry

AB - BACKGROUND: Since 1992 The Netherlands has seen a striking increase in the number of compulsory admissions. There is a danger that coercion will become the dominant form of treatment in the Amsterdam clinics. AIM: To build up a picture of the changes in emergency psychiatry which have contributed to the increase in the number of acute compulsory admissions. METHOD: A cohort (n = 460) of consultations conducted by the city crisis service in 1983 was compared with a similar cohort (n = 436) of consultations conducted in 2004-2005 based on the following variables: crisis-service procedures, patient characteristics, diagnosis and consultation outcomes. RESULTS: In 2003-2004 more services were involved with psychiatric patients in acute situations in the public domain than were involved in 1983. The number of patients referred by the police almost doubled, rising from 29.3 to 62.7%. In 1983 all consultations took place where the patients were located; in 2004-2005 60% took place at the premises of the crisis service. The number of psychotic patients in the cohort rose from 52 to 63.3%. There was a rise in the number of compulsory admissions (from 16.7 to 20%) and a sharp decline in voluntary admissions (from 25.7 to 7.6%). The total number of admissions following a consultation decreased from 42 to 28%. CONCLUSIONS: The front-line outreach service of 1983 has been transformed into a specialist psychiatric emergency department with only a modest outreach component. Voluntary admissions via the consultation service have almost ceased. Further research is needed into the characteristics of the consultations and into the variables that play a role in the use of compulsion in emergency psychiatry

M3 - Article

VL - 51

SP - 139

EP - 150

JO - Tijdschrift voor Psychiatrie

JF - Tijdschrift voor Psychiatrie

SN - 0303-7339

IS - 3

ER -

van der Post LFM, Dekker JJM, Jonkers JFJ, Beekman ATF, Mulder CL, de Haan L et al. Veranderingen in crisisinterventie en acute psychiatrie; Amsterdamse consulten in 1983 en 2005. Tijdschrift voor Psychiatrie. 2009;51(3):139-150.