[Client-orientation versus institutional-orientation. What helps towards client-orientation in psychiatric settings?]

Client- or Patient-Orientation is seen as an indicator for quality of psychiatric work. How to observe and record this orientation? Three different concepts are presented: the German A11, a staff- and client-oriented documentation, Soteria Bern, and Shepherd's 25 homes-investigation around London. Four areas of typical conflicts of interest between client- and institutional orientation are presented with examples: duty times, strategies to fill up beds, "creaming off", and application-talks for clients to enter a residential setting. On the basis of the quality of Life and Care research and the 3 concepts above questions for visiting and evaluating homes and living groups and for personal check-ups are presented.