Psychiatr Prax 2017 Mar 14;44(2):85-92. Epub 2015 Dec 14.
Arbeitsbereich Klinische Psychologie und Psychotherapie, Fachbereich Psychologie, Universität Hamburg.
In recent years the legal basis in Germany for the use of coercive measures in psychiatry has changed. Now, coercive measures are permitted only as last resort after milder measures failed. However, there is no regulation of the type or amount of milder measures. In this study, we investigated which and how many milder measures were experienced by service users before coercion was used and which measures they value as potentially helpful to avoid it. A sample of 83 service users was recruited. In an online survey the experience with 21 milder measures and their evaluation as helpful were assessed by self-report. On average, participants reported 5.4 experienced milder measures. The most frequent reason provided for why measures failed were structural factors, followed by staff behavior, and reasons caused by the participants themselves. The only milder measure rated by less than 50 % as potentially helpful in avoiding coercive measures was Although many milder measures are perceived as potentially helpful, only few seem to be made use of in routine clinical practice. In order to prevent coercion staff members should apply a wider range of milder measures.