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Background: We wished to investigate how the flow of patients to the Psychiatric Casualty Clinic in Oslo was affected during the acute phase of the COVID-19 pandemic., Material and Method: All patient records from the Psychiatric Casualty Clinic in Oslo from and including 13 March 2020 up to and including 1 April 2020 were compared with the patient records from the same period in 2019. Patient visits were registered as COVID-19-related when the patient came to the clinic for an issue linked to the pandemic., Results: The Psychiatric Casualty Clinic in Oslo had 105 patient visits in the period 13 March 2019-1 April 2019 and 63 in the same period for 2020 (-40 %). The number of admissions amounted to 16 in 2019 and 7 in 2020 (-56 %). The number of COVID-19-related consultations was 14/63 (22 %). There was a reduction in the number of patient visits for crisis reactions, from 28 in 2019 to 8 in 2020., Interpretation: The background for the decline in the flow of patients in the acute phase of the COVID-19 pandemic is most likely a complex one. We believe that patients primarily chose not to visit the clinic due to the risk of infection and the wish to avoid burdening the health services. With the reservation that our data are limited, it does not appear that increased access to psychiatric health services requiring physical attendance is indicated in the acute phase of a pandemic.

Background: Most of those who commit suicide suffer from one or more mental disorders. We wished to identify the proportion that had been in contact with mental health care or interdisciplinary specialised addiction services during their lifetime and in the year prior to their death, and to describe characteristics of these patients., Material and Method: Information on suicides in the Agder counties in the years 2004–2013 was retrieved from the Cause of Death Registry. Patient records from Sørlandet Hospital were reviewed with the aid of a structured form., Results: Altogether 329 suicides were included in the study. Of these, 66.6 % had at some point in life been in contact with mental health care or interdisciplinary specialised addiction services, 46.2 % during the year preceding their suicide. Altogether 28.6 % were actively undergoing treatment. The proportion who had been in contact in the preceding year tended to be lower among patients younger than 20 when compared to other age groups. Among those who had completed their treatment, there were more patients with adaptation disorder than in the group that remained in treatment; among those who remained in treatment there were more patients with psychotic disorders than among those who had completed their treatment., Interpretation: A higher proportion of those who committed suicide in the Agder counties were in contact with mental health care and interdisciplinary specialised addiction services than what has been found in equivalent international studies. The findings underscore the need to develop effective measures to prevent suicides in these groups of patients.

Background: Patients who harm themselves are often considered difficult to treat. There are no evidence-based approaches available for the emergency setting. General practitioners should nevertheless be able to offer interventions directed towards emotional needs in self-harm patients. In this article we suggest how to intervene in such situations., Material and Method: Based on experience from Oslo psychiatric out-of-hours service and with elements from Dialectic Behavioural Therapy, we present a five-step model for treatment of these patients in an out-of-hours service within the primary health care services., Results: The aim of this model is to bring the patient out of the acute crisis and to arrange for further treatment. Assessment, validation or confirmation, problem-solving, avoiding unnecessary hospitalisation, and focus on continuing established treatment, are important elements in the proposed intervention. This can all be carried out in 60 - 90 min., Interpretation: The model may be suitable for training general practitioners to meet and care for patients with self-harm behaviour in the out-hours-services. We have positive experience with the intervention, but systematic research is necessary to assess the effect of the model.

The staff at the psychiatric emergency out-patient clinic in Oslo evaluated the services of the acute psychiatric wards when admitting patients to the hospital. Of 93 admittances during three months in 1998, the referring doctor was satisfied with the hospital's response in 84% of the cases. The mean time from contact was taken with the hospital till the admittance was accepted was 19 minutes. The admittance of patients in acute psychiatric hospitals in Oslo is straightforward, and reasonably well organized.