T Rohe1, T Dresler2,3, M Stuhlinger2, M Weber2, T Strittmatter4, A J Fallgatter2,3,5. 1. Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland. tim.rohe@med.uni-tuebingen.de. 2. Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland. 3. Graduiertenschule LEAD, Universität Tübingen, Tübingen, Deutschland. 4. Amt Tübingen, Vermögen und Bau Baden-Württemberg, Tübingen, Deutschland. 5. Werner Reichardt Centrum für Integrative Neurowissenschaften (CIN), Tübingen, Deutschland.
Abstract
BACKGROUND: Coercive measures are widely applied in psychiatric hospitals as a last resort to prevent patients seriously harming themselves or others, with negative psychological and somatic consequences for those affected. OBJECTIVE: In a naturalistic observational study it was investigated whether relocation of the structural milieu of a psychiatric hospital to an architectonically improved new building influenced the application of coercive measures. MATERIAL AND METHODS: The frequency and duration of coercive measures (e.g. fixation, coercive medication and preventive restraints) were routinely documented and compared in the periods before and after the relocation. RESULTS: After the relocation the utilization of coercive measures was significantly reduced by 48-84 %. CONCLUSION: Despite the limitations of the study design the results suggest that the architectural improvements reduced the application of coercive measures. It is speculated that the positive structural milieu enhanced the well-being of patients and staff and their social relations, which in turn prevented coercive measures.
BACKGROUND: Coercive measures are widely applied in psychiatric hospitals as a last resort to prevent patients seriously harming themselves or others, with negative psychological and somatic consequences for those affected. OBJECTIVE: In a naturalistic observational study it was investigated whether relocation of the structural milieu of a psychiatric hospital to an architectonically improved new building influenced the application of coercive measures. MATERIAL AND METHODS: The frequency and duration of coercive measures (e.g. fixation, coercive medication and preventive restraints) were routinely documented and compared in the periods before and after the relocation. RESULTS: After the relocation the utilization of coercive measures was significantly reduced by 48-84 %. CONCLUSION: Despite the limitations of the study design the results suggest that the architectural improvements reduced the application of coercive measures. It is speculated that the positive structural milieu enhanced the well-being of patients and staff and their social relations, which in turn prevented coercive measures.
Entities:
Keywords:
Architecture; Coercion; Observational study; Psychiatry; Structural milieu
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