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Background: A clinical admission is a frightening event, especially in a crisis situation, and above all when it comes with legal measures. The effectiveness of an acute crisis admission has been demonstrated in a Cochrane review, but cohort studies of a clinic setting are not yet available., Aim: To assess and determine the treatment effects after a crisis admission in a metropolitan acute psychiatric clinic of patients with severe mental illness (SMI patients)., Method: In the context of routine outcome monitoring, the 12 HoNOS scores at admission and discharge (pre- and post-measurements) were rated by clinicians. The data of 1423 patients were analyzed by a statistician., Results: The crisis admissions have a substantial positive clinical effect: 76 percent of the patients improved, 16 percent was stable and 10 percent worsened (effect size ES = 1.2). The patients improved most in regard to psychotic problems, aggressiveness and social problems. This applies equally to patients who have been admitted voluntarily, as well as to patients with a legal measure. The admission duration of patients is two months, except for patients with compulsory treatment (seclusion, sedation, forced medication). In this case the treatment duration prolongs to three months., Conclusion: Acute short-term clinical admission is an effective part of the clinical and outpatient treatment chain for patients with severe mental illness (SMI). A substantial treatment effect is achieved by the crisis admission. These findings are an important addition to the Cochrane review.

Background: The Temporary Holding Department (toa) is a link between the 7/24 service and the admissions departments. We examined the make-up of the admission cohorts and the use of isolation between 2001 and 2017 in the context of demographic developments and changes in the mental healthcare sector.
METHOD: Comparison of patient data in four cohorts who came in during four consecutive periods.
RESULTS: The number of admissions rose from 408 a year in the period 2001-2003 to 728 in the period 2013-2016. The proportion of voluntary admissions increased from 4 to 33%, while emergency compulsory admissions (ibs) fell from 83 to 54%. The proportion of admissions of Dutch people from outside Amsterdam and of people from other countries rose from 11 to 23%. The percentage of patients with schizophrenic disorder rose from 25 to 32%, the percentage with mood disorder from 14 to 20% and the percentage with drug-related disorders from 3 to 7%. Assessment at a police station and the classification psychotic disorder were predictors of compulsory admissions (under the terms of the Dutch bopz act). Men under the age of 45 who were admitted compulsorily were more likely to be isolated. The percentage of patients isolated during admission fell from 37% to 20%, and the length of the periods of isolation also declined. CONCLUSIONS The increase in the annual number of admissions to the toa indicates, in the context of population growth and the rise in tourism, that there is a shortage of available beds in regular admissions departments in Amsterdam. Over the course of fifteen years, the number of Dutch nationals from outside Amsterdam and foreigners doubled. Due to policy and/or as a result of the increased proportion of patients admitted voluntarily, the use of isolation decreased.