[Coercive measures in psychiatric clinics in Germany: current practice (2012)]
1Zentrum für Psychiatrie Südwürttemberg, Klinik für Psychiatrie und Psychotherapie I der Universität Ulm, Weingartshoferstr. 2, 88214, Ravensburg-Weissenau, Deutschland, tilman.steinert@zfp-zentrum.de.
Der Nervenarzt
|August 28, 2013
Summary
German psychiatric hospitals show high awareness of coercive measures, with most using guidelines and de-escalation training. A majority anticipate future practice changes regarding patient restraint and seclusion.
Area of Science:
- Psychiatry
- Clinical Psychology
- Healthcare Management
Background:
- German legal decisions spurred discussion on psychiatric coercive measures.
- Need for understanding current practices in German psychiatric hospitals.
Purpose of the Study:
- To survey the current use and management of coercive measures in German psychiatric hospitals.
- To assess awareness and preparedness for changes in practice.
Main Methods:
- Online questionnaire developed with expert groups and patient advocates.
- Anonymous survey distributed via psychiatric association email lists in Germany.
- Analysis of 88 responses from hospitals with catchment area responsibilities.
Main Results:
- 99% of hospitals utilize internal/external guidelines; 97.5% provide de-escalation training.
- Mechanical restraint (100%), seclusion (~50%), and physical restraint (7%) are employed.
- Continuous monitoring of mechanical restraint and seclusion was reported by most directors.
Conclusions:
- A high level of critical awareness regarding coercive measures exists in psychiatric facilities.
- There is a notable willingness among hospitals to adapt and improve practices related to coercive measures.
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