We reviewed, prospectively, all patients who presented themselves at the reception of a large psychiatric hospital, which had no casualty department, to assess the extent and value of a long standing ‘unofficial emergency service’ that has been provided for decades. We found no evidence that the service was abused or that it led to unwarranted admissions. The service could provide a useful point of entry to mental health services for certain patients. The ‘ad hoc’ emergency service described here is hoping to become a recognised ‘Emergency Clinic’ in the reprovided service, after the closure of this 100 year old psychiatric institution in the very near future.
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