Steinert T, Schmid P
Zentrum für Psychiatrie Südwürttemberg, Klinik für Psychiatrie und Psychotherapie I der Universität Ulm, Weingartshoferstr. 2, 88214, Ravensburg-Weissenau, Deutschland,
Nervenarzt. 2014 May;85(5):621-9. doi: 10.1007/s00115-013-3867-8.
Due to the decisions of the German Constitutional Court on involuntary medication and the law on the prohibition of video surveillance in psychiatry in Nordrhine-Westfalia there has been an increasing discussion on coercive measures and how to conduct, supervise and prevent them. We conducted an online survey on the current practice of coercive measures in German psychiatric hospitals (2012).
An online questionnaire was developed together with the working group for the prevention of violence and coercion in psychiatry and the regional association of psychiatry-experienced people in Baden-Wuerttemberg. The survey was conducted anonymously using the e-mail distribution lists of the psychiatric associations in Germany.
A total of 88 questionnaires from hospitals with obligatory responsibility for a catchment area (19.7% of those addressed) could be analyzed. Of these 99% used internal or external guidelines, 97.5% conducted de-escalation training, 23% participated in external benchmarking on the use of coercive measures. All hospitals used mechanical restraint, approximately 50% seclusion and physical restraint was practiced in 7%. Most, but not all hospital directors reported that mechanical restraint and seclusion were continuously (24/7) monitored. Changes in practice in the years to come were expected by the majority.
The survey revealed a high critical awareness concerning the use of coercive measures and the willingness to further change the practice.
由于德国宪法法院关于非自愿用药的裁决以及北莱茵 - 威斯特法伦州精神科禁止视频监控的法律，关于强制措施以及如何实施、监督和预防这些措施的讨论日益增多。我们于2012年针对德国精神病医院强制措施的现行做法开展了一项在线调查。
与精神科暴力与强制预防工作组以及巴登 - 符腾堡州有精神科经验者地区协会共同编制了一份在线问卷。该调查通过德国精神科协会的电子邮件分发列表匿名进行。
共分析了来自对特定区域负有强制责任医院的88份问卷（占收件人的19.7%）。其中，99%的医院使用内部或外部指南，97.5%开展了降级培训，23%参与了关于强制措施使用的外部基准评估。所有医院都使用机械约束，约50%使用隔离，7%实施身体约束。大多数（但并非所有）医院院长报告称，机械约束和隔离受到持续（全天候）监控。大多数人预计未来几年会出现做法上的变化。
该调查显示出对强制措施使用的高度批判性认识以及进一步改变做法的意愿。
