Reduction of coercive measures under routine conditions in psychiatric hospitals 2004-2019: Strong effects in old age psychiatry, much less in general psychiatry.

Background: Many interventions to reduce the use of seclusion and restraint have been suggested in the last decades. Evidence-based interventions in old age psychiatry are different from those in general psychiatry. A common database for psychiatric hospitals introduced in 2004 allowed to examine the use of seclusion and restraint over 16 years under routine conditions.

The use of mechanical restraint and seclusion in patients with schizophrenia: a comparison of the practice in Germany and Switzerland.

Background: The use of coercive measures is an indicator of the quality of psychiatric inpatient treatment. To date, there is no data available to European comparisons on the incidence of such measures.

Methods: The frequency and duration of mechanical restraint and seclusion on patients with a diagnosis of F2 ICD-10 was analysed in seven German and seven Swiss psychiatric hospitals in the year 2004 using three indicators.

Diagnosis-related frequency of compulsory measures in 10 German psychiatric hospitals and correlates with hospital characteristics.

Objective: To investigate the incidence of coercive measures in standard psychiatric care in different psychiatric hospitals.

Methods: We developed a common documentation of mechanical restraint, seclusion, and medication by coercion, and introduced it in 10 participating hospitals. We developed software able to process the data and to calculate four key indicators for routine clinical use.

A nurse-physician co-leadership model in psychiatric hospitals: results of a survey among leading staff members in three sites.

In three psychiatric hospitals in Baden-Wuerttemberg, Germany, a physician-nurse shared leadership model was implemented in 1997 by the hospital management. The whole hospital, departments, and single wards are led each by a leadership team consisting of a physician, psychologist or social worker and a nurse, being responsible for organization, staff, and budgets. The consequences for staff opinion in leadership positions were evaluated.