[Assisted suicide : Attitudes and experiences of members of the DGPPN]. / Der assistierte Suizid : Einstellungen und Erfahrungen der Mitglieder der DGPPN.

BACKGROUND AND OBJECTIVE: After the Federal Constitutional Court overturned the ban on business-like assisted suicide in 2020, politicians, society and the medical profession are discussing legal protective measures to prevent abuse. This survey among members of the DGPPN is the first to record the attitudes and experiences regarding assisted suicide of psychiatrists and other mental health workers in Germany, as suicidality and assisted suicide are highly relevant topics for medicine and especially for psychiatry and psychotherapy. MATERIAL AND METHODS: The survey was conducted as an online survey with a specially created questionnaire and a DSGVO-compliant data protection concept and sent to a total of 9356 members. In addition to the descriptive analysis of the questionnaire, the free-text responses were subjected to an additional qualitative analysis. Finally, correlations between sociodemographic variables and relevant items were examined. RESULTS: A total of 2048 members participated in the survey (22%). Most participants (88%) considered a (new) legal regulation of assisted suicide to be necessary; the separation of counselling, assessment and execution of assisted suicide was mentioned most frequently (76%). The majority considered assisted suicide to be legitimate under certain circumstances when the suicide wish is freely made (72%), especially in cases of high suffering and near the end of life (67%). Age, gender, and religious beliefs were found to be significant influencing factors in several responses. CONCLUSION: A large majority of the DGPPN members consider it necessary to find a legal regulation that prevents abuse of assisted suicide; however, while most participants did not consider assisted suicide to be legitimate or illegitimate in principle, but rather made this dependent on the specific circumstances of the suicide wish, more than half ruled out to assist with suicide. The results represent an important contribution to the political debates about legal protective measures.

[Person-centered care but living in a closed setting? The situation of closed residential facilities in Germany]. / Personenzentrierte Hilfen, aber geschlossen untergebracht? Zur Situation der geschlossenen Heime in Deutschland.

BACKGROUND: The United Nations Convention on the Rights of Persons with Disabilities and the Federal Participation Act state that all human beings have the right to choose where to live. This human right is compromised by the institutional limitations of the community psychiatric system, where persons with severe mental illnesses and with intensive support needs are often housed in closed (i.e. physically locked) living contexts. How can the concept of person-centered care help to solve this conflict? OBJECTIVE: Description of the nationwide situation of closed residential facilities and discussion of the person-centered approach as a solution to the problem of closed living contexts. METHODS: Summary of current knowledge on the structural and procedural data of closed residential facilities in Germany, which were collated within the framework of the "Coercive measures in the psychiatric care system-Collation and reduction" (ZIPHER) study. RESULTS: The empirical data indicate a great need for regionally based care of the target group and a lack of individual arrangements as alternatives to closed living contexts. The necessity for regional care obligations is highlighted by the example of Mecklenburg-Western Pomerania. CONCLUSION: The avoidance and reduction of closed accommodation can primarily be achieved by individual arrangements within the framework of person-centered and flexible proposal landscapes. For this the service providers of integration assistance, including the psychiatric hospitals, must be committed to the care of all people in their region. An appropriate accompaniment and refunding by the service provider are also necessary.

[Impact of the COVID-19 pandemic on the care situation in psychiatric hospitals in Germany]. / Auswirkungen der COVID-19-Pandemie auf die Versorgungssituation in psychiatrischen Kliniken in Deutschland.

AIM: To assess the structural performance of psychiatric hospitals in Germany during the COVID(coronavirus disease)-19 pandemic, a nationwide survey was launched in March 2020, in which the corona-related changes in care structures during the first wave of the pandemic were collated. METHODS: Data on the care situation were collected by means of a survey in 38 out of 388 contacted psychiatric and psychotherapy hospitals in Germany over the course of 1 month. The changes and adaptations of the care structures, the type of therapy measures applied and care options for people with mental disorders and a COVID-19 infection as well as the legal basis underlying the care for patients unable to consent were documented. RESULTS: On average, the inpatient treatment capacity of psychiatric hospitals in Germany decreased by approximately 40% compared with prepandemic periods. Day clinic and outpatient services were also only available in a limited form or were even discontinued completely. Specialized wards for patients with COVID-19 infections were available in most of the surveyed clinics (84%). CONCLUSION: Psychiatric hospitals were already able to respond quickly and adequately to the crisis situation in the first wave of the pandemic, e.g. by setting up COVID wards; however, the reduction in treatment capacity to 60% has significantly worsened the care situation for people with mental illnesses. Therefore, further efforts should urgently be made to adapt mental health care to the requirements of the pandemic in the long term.