[Experiences of dangerous situations in psychiatry and psychotherapy involving patients with extremist attitudes].

BACKGROUND AND OBJECTIVES

Dangerous situations in connection with the treatment of persons with suspected extremist attitudes have become increasingly relevant. A survey of physicians and psychotherapists is intended to provide information about concrete dangerous situations among these patients.

MATERIALS AND METHODS

By means of an anonymous online survey, which comprised 16 main questions and up to 95 additional questions, a total of 364 health professionals were asked about the general situation and about patients, as well as relatives with suspected extremist attitudes.

RESULTS

In all, 17.5% of the participants were physicians, 72.1% psychotherapists. 47.7% work exclusively in a hospital, 34.2% in a private practice. A total of 57.7% of the participants have already treated patients with suspected extremist attitudes (46.7% treated relatives); 27.6% were confronted with situations of self-endangerment (30.1% in the case of relatives), 49.5% with situations of danger to others (18.3% in the case of relatives), in which they often did not feel safe. Altogether, 20.3% of the professionals informed security authorities, and not quite half found this contact to be comparatively unhelpful/not at all helpful (45.5% among relatives). The majority of the participants had no contact to other agencies, such as specialized counselling centres for deradicalization. Physicians experienced the situations of endangerment more often than non-medical psychotherapists. A comparison between professionals from hospitals and private practices shows no significant differences.

DISCUSSION

The study was able to show that extremism and the associated dangerous situations are an important topic in the treatment of patients and that physicians and non-medical psychotherapists should be well prepared. Networking with extremism prevention agencies and good cooperation with security authorities would be important and desirable for the future.