Die Haltung der Öffentlichkeit zu Zwangsmassnahmen bei psychiatrischen PatientInnen

Zusammenfassung

Studienziel Die Haltung der Allgemeinbevölkerung in Basel gegenüber dem Einsatz von Zwangsmaßnahmen zu evaluieren. Dies vor dem Hintergrund, dass Zwangsmaßnahmen indirekt u. a. von der allgemeinen Stigmatisierung von Menschen mit psychischen Erkrankungen, der Haltung der Öffentlichkeit und dem jeweiligen sozialen Netzwerk gesteuert werden.

Methodik Antworten von 1,112 Personen aus einer repräsentativen Bevölkerungsbefragung im Kanton Basel-Stadt wurden ausgewertet. Die Teilnehmenden erhielten schriftliche Fallvignetten und Fragebögen, in denen die Akzeptanz der Zwangsmaßnahmen «Zwangseinweisung», «Zwangsmedikation» und «Zwangsisolation» erfragt wurde.

Ergebnisse Beim Vorliegen der Symptome einer psychotischen Störung befürworteten 31,5% mindestens eine Zwangsmassnahme, bei Symptomen einer Borderline-Persönlichkeitsstörung (22,0%) und einer Alkoholabhängigkeit (20,7%) war die Akzeptanz geringer. Insgesamt war die Ablehnung von Zwangseinweisungen und Zwangsmaßnahmen in der Basler Bevölkerung ausserordentlich hoch. Die differenzierte Einschätzung des Einsatzes von Zwangsmaßnahmen durch die Basler Bevölkerung entsprach den medizinethischen Leitlinien im Umgang mit diesen Störungsbildern.

Schlussfolgerung Die Haltung der Öffentlichkeit dürfte indirekten Einfluss auf die lokale Anwendung von Zwangsmaßnahmen haben und sollten in den psychiatrischen Fachdiskurs einbezogen werden.

Abstract

Objective To examine the attitude of the general public in Basel concerning the use of coercive measures while dealing with psychiatric patients. The common population indirectly governs the use of coercive measures in psychiatry by its stigmatization of people with psychiatric illnesses, and its attitude towards treatment in psychiatry and by local opinion leaders and reactions of social networks.

Methods The answers of 1,112 persons from a representative population survey were evaluated. Participants were mailed case vignettes and questionnaires, and asked if they considered involuntary admission, coercive medication, and/or seclusion as acceptable measures in dealing with psychiatric patients.

Results When symptoms of a psychotic disorder were present, 31.5% approved of at least one coercive measure, with 22% approval in the case of a borderline personality disorder, and 20.7% in the case of alcohol dependency. However, the overall rejection of coercive measures by the general public in Basel was high. The differential approval of the examined coercive measures depending on psychiatric symptoms was in line with professional medical and ethical guidelines.

Conclusion Public attitudes have an indirect influence on the local use of coercive measures and should be included in the specialist psychiatric discourse.

Schlüsselwörter

Akutpsychiatrie - geschlossene Stationsführung - Türöffnung - Zwangsmaßnahmen

Key words

acute psychiatry - locked doors - open doors policy - coercive measures

Publication History

Received: 02 March 2022

Accepted: 10 January 2023

Article published online:
12 April 2023

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