Citation

Cibis ML, Wackerhagen C, Müller S, Lang UE, Schmidt Y, Heinz A. Psychiatr. Prax. 2016; 44(3): 141-147.

Vernacular Title

Vergleichende Betrachtung von Aggressivität, Zwangsmedikation und Entweichungsraten zwischen offener und geschlossener Türpolitik auf einer Akutstation.

Affiliation

Klinik für Psychiatrie und Psychotherapie, Campus Mitte, Charité - Universitätsmedizin Berlin.

Copyright

(Copyright © 2016, Georg Thieme Verlag)

DOI

10.1055/s-0042-105181

PMID

27399589

Abstract

OBJECTIVE: According to legal requirements coercive treatment must be limited to acts necessary for the protection of patients and cannot be used for institutional interests. Here, we aimed to test the hypothesis that opening psychiatric wards can reduce the number of aggressive assaults and of coercive treatment without increasing absconding rates.

METHODS: Numbers of absconding, coercive medication, fixation and special security actions were collected retrospectively and compared between phases of closed (N total = 409; N legally committed = 64) and 90 % of daytime opened (N total = 571; N legally committed = 99) doors in an acute psychiatric ward.

RESULTS: During the phase of opened doors we observed significantly reduced aggressive assaults (p < 0,001) and coercive medication (p = 0,006) compared to the closed setting, while the absconding rate did not change (p = 0,20). Limitation: Given the retrospective non-experimental design, no causal interpretations can be drawn.

CONCLUSION: The results suggest that open door is associated with reduction of aggressive assaults and coercive medication without increasing absconding rates. This speaks for a stronger implementation of open door policies in acute wards in order to preserve human rights in psychiatry. To collect more robust evidence for this thesis, longer phases should be monitored and moderating variables such as atmosphere and social cohesion should be assessed.

© Georg Thieme Verlag KG Stuttgart · New York.

Language: de