[Open doors in psychiatric hospitals : An overview of empirical findings].
Offene Türen in psychiatrischen Kliniken : Eine Übersicht über empirische Befunde.
Coercion
Involuntary commitment
Locked doors
Open door policy
Psychiatry
Journal
Der Nervenarzt
ISSN: 1433-0407
Titre abrégé: Nervenarzt
Pays: Germany
ID NLM: 0400773
Informations de publication
Date de publication:
Jul 2019
Jul 2019
Historique:
pubmed:
6
6
2019
medline:
12
9
2019
entrez:
6
6
2019
Statut:
ppublish
Résumé
Currently, it is a topic of debate whether psychiatric hospitals can and should be managed with a full open door policy. The revised legislation of public law for involuntary commitment explicitly allows or even encourages such practice in several German federal states. In parts of Austria, open doors are required for legal reasons. A systematic literature search was conducted for articles providing empirical data related to this issue. Literature search in PubMed augmented by a manual search in references of retrieved papers and reviews with similar objectives. A total of 26 articles reporting empirical data could be identified. Most of these articles came from Germany or Switzerland. The majority were published within the past 5 years. The definition of "open doors" ranged from an only vaguely defined open door policy up to explicit set time periods with open doors. Some studies reported a decrease in coercive interventions. No study reported any associated adverse events resulting from open doors in psychiatric wards. Generally, all studies had methodological weaknesses. Prospective randomized controlled studies or quasi-experimental studies are missing in the context of European healthcare systems. The risk of bias was considerable in most studies. A final conclusion regarding the possible extent of psychiatry with open doors and the associated risks is currently not possible. There is an urgent need for future high-quality prospective studies.
Sections du résumé
BACKGROUND
BACKGROUND
Currently, it is a topic of debate whether psychiatric hospitals can and should be managed with a full open door policy. The revised legislation of public law for involuntary commitment explicitly allows or even encourages such practice in several German federal states. In parts of Austria, open doors are required for legal reasons. A systematic literature search was conducted for articles providing empirical data related to this issue.
METHOD
METHODS
Literature search in PubMed augmented by a manual search in references of retrieved papers and reviews with similar objectives.
RESULTS
RESULTS
A total of 26 articles reporting empirical data could be identified. Most of these articles came from Germany or Switzerland. The majority were published within the past 5 years. The definition of "open doors" ranged from an only vaguely defined open door policy up to explicit set time periods with open doors. Some studies reported a decrease in coercive interventions. No study reported any associated adverse events resulting from open doors in psychiatric wards.
DISCUSSION
CONCLUSIONS
Generally, all studies had methodological weaknesses. Prospective randomized controlled studies or quasi-experimental studies are missing in the context of European healthcare systems. The risk of bias was considerable in most studies. A final conclusion regarding the possible extent of psychiatry with open doors and the associated risks is currently not possible. There is an urgent need for future high-quality prospective studies.
Identifiants
pubmed: 31165212
doi: 10.1007/s00115-019-0738-y
pii: 10.1007/s00115-019-0738-y
doi:
Types de publication
Journal Article
Systematic Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
680-689Références
Can Med Assoc J. 1976 Apr 17;114(8):689-91, 694
pubmed: 1260616
Eur Psychiatry. 2004 Dec;19(8):483-8
pubmed: 15589707
Cochrane Database Syst Rev. 2006 Jul 19;(3):CD002084
pubmed: 16855984
J Psychiatr Ment Health Nurs. 2007 Feb;14(1):49-54
pubmed: 17244005
J Psychiatr Ment Health Nurs. 2009 Apr;16(3):293-9
pubmed: 19291159
Issues Ment Health Nurs. 2009 Apr;30(4):260-71
pubmed: 19363731
J Psychiatr Ment Health Nurs. 2010 Dec;17(10):873-80
pubmed: 21078002
Int J Ment Health Nurs. 2012 Feb;21(1):41-9
pubmed: 21740492
J Psychiatr Ment Health Nurs. 2011 Sep;18(7):614-21
pubmed: 21848596
Nervenarzt. 2014 Mar;85(3):312-8
pubmed: 23538944
Psychiatr Prax. 2015 Mar;42(2):76-81
pubmed: 24254421
J Psychiatr Res. 2014 Jul;54:94-9
pubmed: 24726637
Assist Inferm Ric. 2014 Jul-Sep;33(3):134-41
pubmed: 25343415
HERD. 2015 Spring;8(3):116-21
pubmed: 25929476
Psychiatr Prax. 2016 Mar;43(2):69-70
pubmed: 26953802
Psychiatr Prax. 2017 Apr;44(3):141-147
pubmed: 27399589
Lancet Psychiatry. 2016 Sep;3(9):842-9
pubmed: 27477886
Psychiatr Prax. 2016 Nov;43(8):441-443
pubmed: 27618169
Lancet Psychiatry. 2016 Dec;3(12):1103-1104
pubmed: 27889005
Lancet Psychiatry. 2016 Dec;3(12):1103
pubmed: 27889006
Eur Addict Res. 2017;23(2):87-96
pubmed: 28351023
Psychiatr Prax. 2018 Apr;45(3):133-139
pubmed: 28371949
BJPsych Bull. 2017 Apr;41(2):92-96
pubmed: 28400967
J Psychiatr Res. 2017 Dec;95:189-195
pubmed: 28866330
Eur Psychiatry. 2018 Feb;48:51-57
pubmed: 29331599
Front Psychiatry. 2018 Feb 26;9:57
pubmed: 29535651
Psychiatr Prax. 2018 Sep;45(6):321-326
pubmed: 29801183
Nervenarzt. 2019 Jan;90(1):45-57
pubmed: 30191253
BMC Psychiatry. 2018 Sep 19;18(1):304
pubmed: 30231893
BMJ. 2018 Dec 13;363:k5094
pubmed: 30545967
BMC Psychiatry. 2019 May 14;19(1):149
pubmed: 31088418
Psychiatr Prax. 1987 Mar;14(2):40-5
pubmed: 3575547
Br J Psychiatry Suppl. 1994 Aug;(24):45-51
pubmed: 7946231
Br J Psychiatry Suppl. 1994 Aug;(24):52-7
pubmed: 7946232
Psychiatr Prax. 1996 Nov;23(6):285-9
pubmed: 9036399