Non-coercive techniques for the management of crises in mental health settings in Germany—a narrative review

Abstract

Coercion is common in mental health care settings in Germany. At the same time, considerable efforts are undertaken to reduce and ultimately abolish coercive interventions. Need adapted treatment, open door policies, and moving away from the biomedical model of mental illness can contribute to non-coercive care. WHO’s QualityRights Training can be used to advance knowledge about and adherence to human rights standards in institutions, and to transform institutions to a non-coercive approach. Advance care decisions can make sure that will and preferences prevail in situations when capacity is questioned. However, a radical overhaul of legislation would be required to abolish coercive mental health care in Germany.

Keywords:

• Coercion
• open-door policy
• human rights
• advance care decisions
• mental health care
• Germany

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1 Most German regions don’t provide data on coercion in mental healthcare, however Baden Württemberg, a large region with 11 Mio inhabitants does and regularly publishes data (e.g. Flammer & Steinert, 2019). Taking into account the paucity of data covering all of Germany, the data from Baden-Württemberg may be taken as more or less representative for Germany. Heidenheim is situated in Baden-Württemberg.