title: [Architectural modernization of psychiatric hospitals influences the use of coercive measures].
abstract: BACKGROUND
  Coercive measures are widely applied in psychiatric hospitals as a last resort to prevent patients seriously harming themselves or others, with negative psychological and somatic consequences for those affected.
  
  
  OBJECTIVE
  In a naturalistic observational study it was investigated whether relocation of the structural milieu of a psychiatric hospital to an architectonically improved new building influenced the application of coercive measures.
  
  
  METHODS
  The frequency and duration of coercive measures (e.g. fixation, coercive medication and preventive restraints) were routinely documented and compared in the periods before and after the relocation.
  
  
  RESULTS
  After the relocation the utilization of coercive measures was significantly reduced by 48-84 %.
  
  
  CONCLUSIONS
  Despite the limitations of the study design the results suggest that the architectural improvements reduced the application of coercive measures. It is speculated that the positive structural milieu enhanced the well-being of patients and staff and their social relations, which in turn prevented coercive measures.
authors.affiliation: Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland. tim.rohe@med.uni-tuebingen.de.
authors.forename: T
authors.initials: T
authors.lastname: Rohe
authors.affiliation: Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.|Graduiertenschule LEAD, Universität Tübingen, Tübingen, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Dresler
authors.affiliation: Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Stuhlinger
authors.affiliation: Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.affiliation: Amt Tübingen, Vermögen und Bau Baden-Württemberg, Tübingen, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Strittmatter
authors.affiliation: Psychophysiologie und Optische Bildgebung, Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.|Graduiertenschule LEAD, Universität Tübingen, Tübingen, Deutschland.|Werner Reichardt Centrum für Integrative Neurowissenschaften (CIN), Tübingen, Deutschland.
authors.forename: A J
authors.initials: AJ
authors.lastname: Fallgatter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003068:Coercion; D003134:Commitment of Persons with Psychiatric Disorders / Q000706:statistics & numerical data; D003617:Dangerous Behavior; D005160:Facility Design and Construction / Q000706:statistics & numerical data*; D005858:Germany; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D010356:Patient Isolation / Q000706:statistics & numerical data; D010360:Patient Transfer / Q000706:statistics & numerical data*; D012149:Restraint, Physical / Q000706:statistics & numerical data*; D014600:Utilization Review; D055815:Young Adult
keywords: Architecture; Coercion; Observational study; Psychiatry; Structural milieu
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