STRUCTURE OF CARE IN PSYCHIATRIC-HOSPITAL UNITS 22 YEARS AFTER THE PSYCHIATRIE-ENQUETE

Starring with the recommendations of the ''Psychiatrie-Enquete'', a cu rrent empirical stock-taking was undertaken about the structure of car e in psychiatric hospital units. 319 treatment units (289 in Germany, 11 in Austria, and 19 in Switzerland) were investigated concerning siz e of the treatment unit, number of wards, centrality of admission, exi stence of large observation rooms (''Wachsale''), spezialized wards, s ingle sex wards, regionalization/sectorization, open-door wards, coerc ive measures, and intended structural changes. The return rate of ques tionnaires amounted 59%. The results show that the recommendations of the ''Psychiatrie-Enquete'' are mostly realized today, but not everywh ere. Across countries differences resulted in size of ward, centrality of admission, open-door wards, and coercive measures. Treatment units in the western and eastern parts of germany differed in size of ward and centrality of admission. Differences between psychiatric hospitals , psychiatric departments at general hospitals and psychiatric univers ity hospitals were, though significant, smaller than expected in the l ight of past controversies. Intended structural changes mainly concern ed open-door wards, internal sectorization,decentralization of admissi on, and mixing the sexes in single sex wards.