Abstract
The Future of German Psychiatry. An (un)realistic reform proposal for psychiatry From the existing deficits and undesirable developments in German psychiatry, more or less realistic recommendations for the future are derived here and their chances are assessed. The current psychiatric paradigm has not yet fulfilled many of its promises; extensive institution-centredness still allows for profit extraction on a considerable scale. In order to develop a psychiatric help system that meets the legitimate expectations of those affected, a paradigmatic shift is needed so that contexts can be created in which recovery is systematically possible, coercion is avoided and human rights are no longer violated, as well as the promise of social and work inclusion is seriously fulfilled. For this, concepts such as recovery and trauma-informed treatment as well as outpatient team-based treatment models such as Open Dialogue and Supported Employment are available, which are quite demanding for professionals. Effective psychiatry, especially for people with so-called severe mental illnesses, must be offered in the living environment, competently, relationship-oriented and long-term.
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