[Benchmarking of freedom-restricting coercive measures in psychiatric hospitals]

Coercive measures that restrict personal freedom have been in the focus of critical public interest since the beginning of modern psychiatry. Psychiatric hospitals have the two-fold mission to prevent danger to self or danger to others on the one side and on the other to keep optional coercive measures as little restrictive and as short as possible. Critical and regardful handling of coercive measures has both qualitative and quantitative aspects. For quantitative comparisons, we introduced benchmarking in psychiatric hospitals in Baden-Wuerttemberg, which in the meantime have been joined by hospitals in other German federal states, Switzerland, and Luxemburg. The most important quality indicators include the percentage of admissions exposed to coercive measures and the mean duration of a coercive measure. For the purpose of benchmarking, the results of four quality indicators are presented, separated for each ICD-10 principal diagnostic group, both cross-sectionally and longitudinally. The project has been continuously pursued since 2004. Participating hospitals were allowed to develop their own projects to reduce coercive measures according to the benchmarking results.