Einfuhrung einer Offenen TurPolitik - Was bedeutet diese konkret und wie wirkt sie sich auf ZwangsmaBnahmen aus?

The incidence of coercive measures varies considerably between different countries, from hospital to hospital and even within hospitals between different teams. In the absence of any controlled trials no clear recommendations can be made on the benefits or harmful effects of coercive measures and containment strategies. In a current observational study in 350.000 cases, suicides and absconding behaviour seemed not to differ between psychiatric hospitals with and without locked units in Germany. Several smaller studies indicate that the implementation of an open door policy leads to less coercive measures. In this paper, we discuss possible mechanisms how an open door policy might influence the use of coercive measures. Determining factors are discussed: overcrowding, concentration of severely ill patients on locked units, length of stay, therapeutic setting, milieu, staff rotation, staff attitudes, treatment atmosphere and emotional responsiveness in nursing staff.