The wandering psychiatric emergency room--design, location and transformations.
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.
Gutkowski
S
S
Talbieh Mental Health Center, POB 4487, Jerusalem 91044, Israel. silvio@mdz.huji.ag.il
Davis
H
H
Ghinea
C
C
D004637:Emergency Services, Psychiatric; D006272:Health Facility Environment; D006274:Health Facility Moving; D006801:Humans; D007557:Israel