[Should an adolescent psychiatric clinic be managed as an open setting? Initial evaluation of 7 years experiences]

After a controversial discussion, the adolescent department of the child and adolescent psychiatry clinic of the university of Basle (KJUP) opened seven years ago as an open ward for the treatment of acute psychiatric breakdowns in adolescents. Meanwhile more than 22.000 days of care have been provided. The patients suffered from the whole range of psychiatric illnesses. The lack of possibilities to engage in an examination of security measures lead to an increased involvement in relationships between patients and his/her parents and the staff. Yet there are limits in treating psychiatric patients in an open ward. A conditio sine qua non is the possibility to hospitalize patients in peaks of crisis in the locked ward of the adult department of the university clinic. In the first seven years, 13 patients had to be transferred to the locked ward for a total of 0.05@1000 of the days of care, 6 of whom returned to the adolescent department after a short while (2.6 days in average). In the rest of the time, the advantages of an open setting could be used to the full extent.