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Psychiatr Prax 2009; 36(1): 7-15
DOI: 10.1055/s-2008-1067498
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Behandlungsvereinbarungen in der Psychiatrie

Joint Crisis Plans in PsychiatryRaoul  Borbé1 , Susanne  Jaeger1 , Tilman  Steinert1
  • 1ZfP Die Weissenau, Ravensburg
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Publication History

Publication Date:
05 September 2008 (online)

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Zusammenfassung

Anliegen Erstellung einer Übersicht über Definitionen, praktische Aspekte und Effekte von Behandlungsvereinbarungen in der Psychiatrie. Methode Systematische Literaturübersicht. Ergebnisse Verschiedene Arten von Behandlungsvereinbarungen wurden im letzten Jahrzehnt vor allem in Nordamerika und Großbritannien etabliert. Daher kommt ein Großteil der wissenschaftlichen Literatur zu dem Thema aus diesen Ländern. Es gibt Hinweise aus einer randomisierten kontrollierten Studie, dass Behandlungsvereinbarungen Zwangseinweisungen und -behandlungen verringern können. In Deutschland werden Behandlungsvereinbarungen ebenfalls zunehmend verwendet, rechtliche Regelungen fehlen dazu ebenso wie eine wissenschaftliche Evaluation. Schlussfolgerungen Behandlungsvereinbarungen werden seitens der Betroffenen, aber auch von einem Teil der professionell Tätigen als nützliches Instrument in der Patientenversorgung angesehen. Untersuchungen zu möglichen Zielgruppen, der Akzeptanz, der Implementierung und den Effekten sollten in Deutschland vermehrt durchgeführt werden.

Abstract

Objective To give an overview about definitions, practice and effects of joint crisis plans in psychiatry. Method Systematic literature review. Results Different types of joint crisis plans have been emerging within the last decade mostly in North America and Great Britain. So far, scientific literature stems nearly exclusively from those countries. There is evidence from one RCT that joint crisis plans can reduce involuntary hospitalisation and involuntary treatment. In Germany, joint crisis plans are increasingly in use, but legal regulations do not exist and research is missing. Conclusions Joint crisis plans are considered as a useful instrument by service users and some professionals. Research is needed on target groups, acceptance, implementation strategies, and outcomes in Germany.

Schlüsselwörter

Behandlungsvereinbarungen - Patientenverfügung - Patientenautonomie - Patientenwille

Key words

joint crisis plans - advance directives - patient autonomy - patient will

Literatur

  • 1 Hamann J, Loh A, Kasper J. et al . Partizipative Entscheidungsfindung. Implikationen des Modells des „Shared Decision Making” für Psychiatrie und Neurologie.  Nervenarzt. 2006;  77 1071-1078
    CrossrefPubMedGoogle Scholar
  • 2 Swartz M S, Swanson J W, Hannon M J. Does fear of coercion keep people away from mental health treatment? Evidence from a survey of persons with schizophrenia and mental health professionals.  Behav Sci Law. 2003;  21 459-472
    CrossrefPubMedGoogle Scholar
  • 3 Dietz A, Pörksen N, Voelzke W. Behandlungsvereinbarungen. Vertrauensbildende Maßnahmen in der Akutpsychiatrie. Bonn; Psychiatrie Verlag 1998
    Google Scholar
  • 4 Noack T. Eingriffe in das Selbstbestimmungsrecht des Patienten. Juristische Entscheidungen, Politik und ärztliche Positionen 1890–1960. Frankfurt / M; Mabuse-Verlag 2004
    Google Scholar
  • 5 Waltzer H. Brief or crisis-oriented therapy in a city hospital setting.  Am J Psychother. 1975;  29 550-557
    PubMedGoogle Scholar
  • 6 Rosen B. Written treatment contracts: their use in planning treatment programmes for in-patients.  Br J Psychiatry. 1978;  133 410-415
    CrossrefPubMedGoogle Scholar
  • 7 Szasz T S. The psychiatric will. A new mechanism for protecting persons against „psychosis” and psychiatry.  Am Psychol. 1982;  37 762-770
    CrossrefPubMedGoogle Scholar
  • 8 Seibt M. Behandlungsvereinbarungen. In: Dietz A, Pörksen N, Voelzke W, Hrsg Vertrauensbildende Maßnahmen in der Akutpsychiatrie. Bonn; Psychiatrie Verlag 1998
    Google Scholar
  • 9 Seltzer M A, Koenigsberg H W, Kernberg O F. The initial contract in the treatment of borderline patients.  Am J Psychiatry. 1987;  144 927-930
    PubMedGoogle Scholar
  • 10 Henderson C, Swanson J W, Szmukler G. et al . A typology of advance statements in mental health care.  Psychiatr Serv. 2008;  59 63-71
    CrossrefPubMedGoogle Scholar
  • 11 Srebnik D S, La Fond J Q. Advance directives for mental health treatment.  Psychiatr Serv. 1999;  50 919 -925
    PubMedGoogle Scholar
  • 12 Lifton I, Kettl P A. Suicidal ideation and the choice of advanvce directives by elderly persons with affective disorders.  Psychiatr Serv. 2000;  51 1447-1449
    CrossrefPubMedGoogle Scholar
  • 13 Widdershoven G, Berghmans R. Advance directives in psychiatric care: a narrative approach.  J Med Ethics. 2001;  27 92-97
    CrossrefPubMedGoogle Scholar
  • 14 Barta H, Kalchschmid G. Die „Patientenverfügung in Europa”.  Wien Klin Wochenschr. 2004;  116 442-457
    PubMedGoogle Scholar
  • 15 Ritchie J, Sklar R, Steiner W. Advance directives in psychiatry. Resolving issues of autonomy and competence.  Int J Law Psychiatry. 1998;  21 245-260
    CrossrefPubMedGoogle Scholar
  • 16 Sass H-M. Advance directives for psychiatric patients? Balancing paternalism and autonomy.  Wien Med Wschr. 2003;  153 380 -384
    PubMedGoogle Scholar
  • 17 Rittmannsberger H, Lindner H. Erste Erfahrungen mit dem Angebot einer Behandlungsvereinbarung.  Psychiat Prax. 2006;  33 95-98
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Poerksen N, Dietz A. Experiences with the Bielefeld therapeutic accord.  Int J Ment Health. 1998;  26 61-66
    PubMedGoogle Scholar
  • 19 Fazel S, Hope T, Jacoby R. Assessment of competence to complete advance directives: validation of a patient centred approach.  BMJ. 1999;  318 493-497
    PubMedGoogle Scholar
  • 20 Srebnik D S, Appelbaum P S, Russo J. Assessing competence to complete psychiatric advance directives with the competence assessment tool for psychiatric advance directives.  Compr Psychiatry. 2004;  45 239-245
    CrossrefPubMedGoogle Scholar
  • 21 Srebnik D S, Kim S Y. Competency for creation, use and revocation of psychiatric advance directives.  J Am Acad Psychiatry Law. 2006;  34 501-510
    PubMedGoogle Scholar
  • 22 Bielefelder Behandlungsvereinbarung:. http://www.psychiatrie-bielefeld.de/behandlungsvereinbarung/behandlungsvereinbarung.pdf
    Google Scholar
  • 23 Srebnik D S, Russo J, Sage J. et al . Interest in psychiatric advance directives among high users of crisis services and hospitalization.  Psychiatr Serv. 2003;  56 592-598
    PubMedGoogle Scholar
  • 24 Papageorgiou A, King M, Janmohamed A. et al . Advance directives for patients compulsorily admitted to hospital with serious mental illness.  Br J Psychiatry. 2002;  181 513-519
    CrossrefPubMedGoogle Scholar
  • 25 Swartz M S, Swanson J W, Van Dorn R A. et al . Patient preferences for psychiatric advance directives.  Int J Forensic Ment Health. 2006;  5 67-81
    PubMedGoogle Scholar
  • 26 Srebnik D S, Rutherford L T, Peto T. et al . The content and clinical utility of psychiatric advance directives.  Psychiatr Serv. 2005;  56 592-598
    CrossrefPubMedGoogle Scholar
  • 27 Swanson J, Swartz M, Ferron J. et al . Psychiatric advance directives among puplic mental health consumers in five U. S. cities: prevalence, demand and correlates.  J Am Acad Psychiatry Law. 2006 a;  34 43-57
    PubMedGoogle Scholar
  • 28 Peto T, Srebnik D, Zick E, Russo J. Support needed to create psychiatric advance directives.  Admin & Policy Ment Health. 2004;  31 409-419
    PubMedGoogle Scholar
  • 29 Atkinson J M, Garner H C, Gilmour W. Models of advance directives in mental health care: stakeholder views.  Soc Psychiatry Psychiatr Epidemiol. 2004;  39 667-672
    PubMedGoogle Scholar
  • 30 O'Conell M J, Stein C H. Psychiatric advance directives: perspectives of community stakeholders.  Adm Policy Ment Health. 2005;  32 241-265
    CrossrefPubMedGoogle Scholar
  • 31 Swanson J W, Van McCrary S, Swartz M S. et al . Overriding psychiatric advance directives: factors associated with psychiatrists' decisions to preempt patients' advance refusal of hospitalization and medication.  Law Hum Behav. 2007;  31 77-90
    CrossrefPubMedGoogle Scholar
  • 32 Van Citters A D, Naidoo U, Foti M E. Using a hypothetical scenario to inform psychiatric advance directives.  Psychiatr Serv. 2007;  58 1467-1471
    CrossrefPubMedGoogle Scholar
  • 33 Srebnik D S, Russo J. Consistency of psychiatric crisis care with advance directive instructions.  Psychiatr Serv. 2007;  58 1157-1163
    CrossrefPubMedGoogle Scholar
  • 34 Swartz M S, Swanson J W, Ferron J. et al . Psychiatrists' views and attitudes about psychiatric advance directives.  Int J Forensic Ment Health. 2005;  4 107-117
    PubMedGoogle Scholar
  • 35 Wilder C M, Elbogen E B, Swartz M S. et al . Effect of patients' reasons for refusing treatment on implementing psychiatric advance directives.  Psychiatr Serv. 2007;  58 1348-1350
    CrossrefPubMedGoogle Scholar
  • 36 Geller J L. The use of advance directives by persons with serious mental illness for psychiatric treatment.  Psychiatric Quart. 2000;  71 1-13
    PubMedGoogle Scholar
  • 37 Backlar P, McFarland B H, Swanson J W, Mahler J. Consumer, provider, and informal caregiver opinions on psychiatric advance directives.  Admin Policy Ment Health. 2001;  28 427-441
    PubMedGoogle Scholar
  • 38 Valletto N M, Kamahele R, Menon A S, Ruskin P. Completion of advance directives for general health care among inpatients with schizophrenia.  J Nerv Ment Dis. 2002;  190 264-265
    CrossrefPubMedGoogle Scholar
  • 39 Papageorgiou A, Janmohamed A, King M. et al . Advance directives for patients compulsorily admitted to hospital with serious mental disorders: directive content and feedback from patients and professionals.  J Ment Health. 2004;  13 379-388
    CrossrefPubMedGoogle Scholar
  • 40 Amering M, Denk E, Griengl H. et al . Psychiatric wills of mental health professionals: a survey of opinions regarding advance directives in psychiatry.  Soc Psych Psychiatr Epidemiol. 1999;  34 30-34
    CrossrefPubMedGoogle Scholar
  • 41 Elbogen E B, Swartz M S, Van Dorn R. et al . Clinical decision making and views about psychiatric advance directives.  Psychiatr Serv. 2006;  57 350-355
    CrossrefPubMedGoogle Scholar
  • 42 Kim M M, Van Dorn R A, Scheyett A M. et al . Understanding the personal and clinical utility of psychiatric advance directives: a qualitative perspective.  Psychiatry. 2007;  70 19-29
    PubMedGoogle Scholar
  • 43 Sherman P S. Administrative update. Computer-assisted creation of psychiatric advance directives.  Comm Ment Health J. 1998;  34 351-362
    PubMedGoogle Scholar
  • 44 Amering M, Stastny P, Hopper K. Psychiatric advance directives: qualitative study of informed deliberations by mental health service.  Br J Psychiatry. 2005;  186 247-252
    CrossrefPubMedGoogle Scholar
  • 45 Henderson C, Flood C, Leese M. et al . Effect of joint crisis plans on use of compulsory treatment in psychiatry: single blind randomised controlled trial.  BMJ. 2004;  329 136-140
    CrossrefPubMedGoogle Scholar
  • 46 Flood C, Byford S, Henderson C. et al . Joint crisis plans for people with psychosis: economic evaluation of a randomised controlled trial.  BMJ. 2006;  333 729
    CrossrefPubMedGoogle Scholar
  • 47 Campbell L A, Kisely S R. Advance treatment directives for people with severe mental illness.  Cochrane Database of Systematic Reviews. 2007;  (3)
    PubMedGoogle Scholar
  • 48 Thomas P, Cahill A B. Compulsion and psychiatry – the role of advance statements.  BMJ. 2004;  329 122-123
    CrossrefPubMedGoogle Scholar
  • 49 Swanson J W, Swartz M S, Elbogen E B. et al . Facilitated psychiatric advance directives: a randomized trial of an intervention to foster advance treatment planning among persons with severe mental illness.  Am J Psychiatry. 2006 b;  163 1943-1951
    CrossrefPubMedGoogle Scholar
  • 50 Elbogen E B, Swanson J W, Appelbaum P S. et al . Competence to complete psychiatric advance directives: effects of facilitated decision making.  Law Hum Behav. 2007;  31 275-289
    CrossrefPubMedGoogle Scholar
  • 51 Sutherby K, Szmukler G I, Halpern A. et al . A study of „crisis cards” in a community psychiatric service.  Acta Psychiatr Scand. 1999;  100 56-61
    PubMedGoogle Scholar
  • 52 Evans J, Evans M, Morgan H G. et al . Crisis card following self-harm: 12-month follow-up of a randomised controlled trial.  Br J Psychiatry. 2005;  187 186-187
    CrossrefPubMedGoogle Scholar
  • 53 Della Picca E, Fischer R. Psychoedukation während stationärer Behandlung.  Psychiat Prax. 2000;  27 351-353
    PubMedGoogle Scholar
  • 54 Kapp M B. Implications of the Patient Self-Determination Act for psychiatric practice.  Hosp Comm Psychiatry. 1994;  45 355-358
    PubMedGoogle Scholar
  • 55 Monahan J, Swartz M, Bonnie R J. Mandated treatment in the community for people with mental disorders.  Health Aff. 2003;  22 28-38
    CrossrefPubMedGoogle Scholar
  • 56 National Resource Center on Psychiatric Advance Directives:. http://www.nrc-pad.org/
    Google Scholar
  • 57 Ambrosini D L, Crocker A G. Psychiatric advance directives and the right to refuse treatment.  Can J Psychiatry. 2007;  52 397-402
    PubMedGoogle Scholar
  • 58 Scottish Parliament .Mental Health Care an Treatment (Scotland) Act 2003. Edinburgh; Stationery Office 2003
    Google Scholar
  • 59 NICE .http://www.nice.org.uk/guidance/CG1/niceguidance/pdf/english
  • 60 Bernat E. Patientenverfügungen – die Rechtslage in Österreich.  Wien Med Wschr. 2003;  153 376-379
    PubMedGoogle Scholar
  • 61 Körtner U HJ, Kopetzki C, Kletecka-Pulker M. Das österreichische Patientenverfügungsgesetz. Wien; Springer 2007
    Google Scholar
  • 62 Pro Mente Sana .http://www.promentesana.ch/selbsthilfe/selbsthilfe_werkzeug.php
  • 63 Bundestagsdebatte über Patientenverfügungen am 29.03.2007:. http://www.bundestag.de/bic/plenarprotokolle/pp/2007/16091a.zip
    Google Scholar
  • 64 Atkinson J M. Advance directives in mental health. London; Jessica Kingsley Publishers 2007
    Google Scholar
  • 65 Swanson J W, Tepper M C, Backlar P, Swartz M S. Psychiatric advance directives: an alternative to coercive treatment?.  Psychiatry. 2000;  63 160-172
    PubMedGoogle Scholar
  • 66 La Fond J Q, Srebnik D S. The impact of mental health advance directives on patient perceptions of coercion in civil commitment and treatment decisions.  Int J Law Psychiatr. 2002;  25 537-555
    PubMedGoogle Scholar
  • 67 Scheyett A M, Kim M M, Swanson J W, Swartz M S. Psychiatric advance directives: a tool for consumer empowerment and recovery.  Psychiatr Rehabil J. 2007;  31 70-75
    CrossrefPubMedGoogle Scholar

Dr. med. Raoul Borbé

AG Versorgungsforschung, Zentrum für Psychiatrie Die Weissenau, Abt. Psychiatrie I der Universität Ulm

Weingartshoferstraße 2

88214 Ravensburg

Email: raoul.borbe@zfp-weissenau.de

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