Zinkler Martin, Waibel Michael
Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Kliniken Landkreis Heidenheim gGmbH.
Psychiatr Prax. 2019 Mar;46(S 01):S6-S10. doi: 10.1055/a-0785-6435. Epub 2019 Feb 11.
Mechanical restraint is a common occurance in Germany's mental health care facilities; less common though not unusual are seclusion and compulsory medication. The authors describe a model to calculate additional resources required to provide mental health care without any of these forms of coercive measures. An analysis of actual clinical situations that led to mechanical restraint provides information of the 1:1, 2:1 or 3:1 intensive support necessary to cope with crises in inpatient mental health care. The additional resources required to provide inpatient mental health care without mechanical restraint, seclusion or compulsory medication would be at 4 % of the annual hospital budget. A national shortage of skilled nursing staff appears to be a limiting factor in moving towards a human-rights based mental health care.
在德国的精神卫生保健机构中,机械约束是一种常见现象;隔离和强制用药虽不那么常见但也并非罕见。作者描述了一种模型,用于计算在不采取任何这些强制手段的情况下提供精神卫生保健所需的额外资源。对导致机械约束的实际临床情况进行分析,可提供应对住院精神卫生保健危机所需的1:1、2:1或3:1强化支持的信息。在不进行机械约束、隔离或强制用药的情况下提供住院精神卫生保健所需的额外资源将占医院年度预算的4%。熟练护理人员的全国性短缺似乎是迈向基于人权的精神卫生保健的一个限制因素。