summary
Over the past 25 years the system of centralised management of emergency psychiatry has disappeared and re-appeared. Since 2000 improvements have been made in the logistics, organisation and quality of emergency care. In the same period, however, there has been a horrendous increase in the number of compulsory admissions in the main Dutch cities. The authors hypothesise that this increase may be due partly to organisational changes in the psychiatric emergency services and partly to the introduction of a new mental health act and changes in society.