[Compulsory admission in Germany--epidemiological data 1992-2003].
OBJECTIVE
An overview of compulsory admission and civil commitment in Germany is presented. Legal, administrative, and methodological aspects are described, to allow interpretation of long-term trends.


METHODS
The official court proceedings in all German federal states from 1992 to 2003 were statistically investigated. Admission data from psychiatric hospitals are reported.


RESULTS
Total civil commitment rates, excluding those allowing physical restraint, increased from 24 to 55 per 100 000 inhabitants, being rarely applied in East Germany. Public commitment rates increased from 64 to 75. They remained stable in the old West German states with 80 (range 76 to 89), and increased in the new states (15 to 26). The total of all commitments increased by 38 %. Independent of compulsory admission, court decision rates with regard to physical restraint, which have been obligatory since 1992, increased markedly from 12 to 90.


CONCLUSIONS
Taking into account the limitations of assessing court proceedings, there is no evidence for a strong rise of compulsory admissions in Germany. The actual number of compulsory admissions shows a tendency to stabilize on a high level, reflecting an increasing legal orientation and changing clinical practice with shorter treatments and more placements in hostels.
Spengler
Andreas
A
Niedersächsisches Landeskrankenhaus Wunstorf, Südstrasse 25, 31515 Wunstorf. andreas.spengler@nlkhwunstorf.niedersachen.de
D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data* / Q000639:trends; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D005858:Germany; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology; D012149:Restraint, Physical / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data