Objective

The present study aimed to characterize involuntary psychiatric admissions and coercive measures within psychiatric hospitals regarding their temporal development and processual aspects. Moreover, the influence of socio-economic factors on involuntary admissions and coercive measures was investigated.

Methods

Different data sets from the federal state of North-Rhine Westphalia (NRW) were used in this study. In addition to a survey in which n = 33 hospitals responded (40.7%), official data from the Federal Health Ministry were analysed over a decade regarding involuntary admissions and coercive measures. These data were available for all n = 54 districts, respectively, all n = 81 psychiatric hospitals in NRW. Datasets were mainly analysed comparing different socio-economic clusters.

Results

The hospital admission rate increased significantly over time (from 1.12 to 1.34 per 1000 inhabitants) within ten years. However, whereas the admission rates differed significantly between socio-economic clusters, the amount of coercive measures used in the hospitals did not. Compared to general psychiatry and addiction medicine, geriatric psychiatry had the highest amount of involuntary admissions (12.2% under public law, 14.1% under civil law). Furthermore, most coercive measures lasted at least an hour.

Conclusion

It seems that, despite intense discussions and enhanced efforts to reduce coercion, there are still some neglected aspects, such as the need for coercive measures and their duration, particularly in the geriatric psychiatric setting. In addition, the results show that further approaches to prevent involuntary admissions are needed to address other stakeholders beyond the hospitals and further aspects of the socio-economic environment.

中文翻译：

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德国精神病医院对非自愿入院和强制措施的社会经济影响。

目的

本研究旨在描述精神病医院内非自愿性精神病住院和强制措施的临时发展和过程方面。此外，还研究了社会经济因素对非自愿录取和强制措施的影响。

方法

这项研究使用了北莱茵-威斯特法伦州（NRW）联邦州的不同数据集。除了一项调查，其中n  = 33所医院做出了回应（40.7％），还分析了联邦卫生部10年来有关非自愿入院和强制措施的官方数据。这些数据分别适用 于北威州的所有n  = 54个地区，所有n = 81精神病医院。主要比较不同的社会经济集群来分析数据集。

结果

在十年内，住院率随时间显着增加（从每千名居民1.12增至1.34）。但是，尽管社会经济群体之间的入院率存在显着差异，但医院使用的强制性措施的数量却没有。与普通精神病学和成瘾医学相比，老年精神病学的非自愿入院率最高（根据公法为12.2％，根据民法为14.1％）。此外，大多数强制措施至少持续了一个小时。

结论

似乎，尽管进行了激烈的讨论并加大了减少胁迫的力度，但仍然存在一些被忽略的方面，例如需要采取强制措施及其持续时间，特别是在老年精神病学领域。此外，结果表明，需要采取进一步措施来防止非自愿住院，以应对医院以外的其他利益相关方以及社会经济环境的其他方面。