Internal structure of inpatient psychiatric hospital care 22 years after the psychiatry inquest

Abstract

Starting with the recommendations of the "Psychiatrie-Enquête", a current empirical stock-taking was undertaken about the structure of care in psychiatric hospital units. 319 treatment units (289 in Germany, 11 in Austria, and 19 in Switzerland) were investigated concerning size of the treatment unit, number of wards, centrality of admission, existence of large observation rooms ("Wachsäle"), specialized wards, single sex wards, regionalization/sectorialization, open-door wards, coercive measures, and intended structural changes. The return rate of questionnaires amounted 59%. The results show that the recommendations of the "Psychiatrie-Enquête" are mostly realized today, but not everywhere. Across countries differences resulted in size of ward, centrality of admission, open-door wards, and coercive measures. Treatment units in the western and eastern parts of germany differed in size of ward and centrality of admission. Differences between psychiatric hospitals, psychiatric departments at general hospitals and psychiatric university hospitals were, though significant, smaller than expected in the light of past controversies. Intended structural changes mainly concerned open-door wards, internal sectorialization, decentralization of admission, and mixing the sexes in single sex wards.