The wandering psychiatric emergency room--design, location and transformations
Gutkowski, S.; Davis, H.; Ghinea, C.
Israel Journal of Psychiatry and Related Sciences 37(4): 297-301
2000
ISSN/ISBN: 0333-7308 PMID: 11201935 Document Number: 517551
We describe the changes in location and philosophy of a psychiatric emergency room over a period of 20 years. Four phases are described in which location, size, modes of access as well as internal and external boundaries reflect philosophies of treatment and the evolving identity of a psychiatric emergency room. The four phases include an early embryonic stage, a second stage involving rapid development of services, a third stage involving regression and consolidation and a fourth stage representing a fully developed independent service. The authors stress both external and rational considerations, such as mental health policies and budget, as well as unconscious irrational processes, which reflect the dynamic forces within the organization.