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Background: At the start of the COVID-19 pandemic, there were fears that a higher proportion of patients with a psychiatric disorder would find themselves in crisis due to the threat of COVID-19 and the impact of the restrictions. If the emergency mental health department would become blocked this could work through to emergency rooms (ER). Acute psychiatry is also assessed at the ER due to lack of space in the emergency mental health department, this is called ‘overflow’. There already was the fear that the virus would flood the hospitals with SARS-CoV-2 infected patients. The emergency mental health department and hospitals agreed that the psychiatric assessments and admissions would take place at the mental health departments as much as possible., Aim: To describe and evaluate the use of measures taken and set up facilities in Amsterdam-Amstelland to minimize psychiatric assessments in the emergency room during the COVID-19 pandemic. Secondly, to present how psychiatric assessments and admissions were conducted safely if there was suspicion or infection with SARS-CoV-2., Method: Use of acute psychiatric crisis monitor, the minutes of regional acute care counsel and literature., Results: People with a psychiatric crisis were rarely suspected to be infected with SARS-CoV-2. There was always , sufficient capacity in COVID-19 wards in the mental health department. During the lockdown, we managed to , minimize overflow from the mental health emergency department to emergency rooms. Conclusion During the COVID-19 pandemic effective collaboration between healthcare partners was achieved in Amsterdam-Amstelland, so that psychiatric assessments and admissions with (suspected) COVID-19 could be conducted safely. Interventions to relieve the emergency room from overflow during lockdown were effective.

OBJECTIVE Many healthcare professionals are confronted in their practice with migrants who don't have a valid residence permit. With this study, we want to provide more insight in the health problems and healthcare consumption of this group. DESIGN Retrospective file study. METHOD Data were taken from files created by municipal health-service physicians when medically screening people who present to the municipality to apply for 24-hour shelter on the basis of their health condition. Symptoms and disorders were coded according to the International Classification of Primary Care (ICPC), and use of medication according to the Anatomical Therapeutic Chemical Classification (ATC). RESULTS The study population consisted of 356 people, mainly men, 39 years of age on average (range: 18-80 years). Compared with the total population of people without a valid residence permit who presented to the municipality (n = 1010), in the study population both women (25.6%) and people in age categories above 45 years of age (32.0%) were overrepresented. At the time of screening, 45.2% had a regular, stable place of residence. Most people without a valid residence permit (98.6%) reported one or more health problems. Psychological symptoms, such as stress (78.5%), insomnia (69.7%) and feelings of depression, were the most common ones. At the same time, many people without a valid residence permit were receiving medical care (86.8%). CONCLUSION A majority of people without a valid residence permit who present to apply for 24-hour shelter have health problems. Stress and other psychological symptoms are the most common ones. At the same time, a large part is receiving adequate care. This means that barriers to care, at least in Amsterdam, do not seem too high.