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
Further Information

Publication History

Publication Date:
05 September 2008 (online)

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.

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
  • 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
  • 3 Dietz A, Pörksen N, Voelzke W. Behandlungsvereinbarungen. Vertrauensbildende Maßnahmen in der Akutpsychiatrie. Bonn; Psychiatrie Verlag 1998
  • 4 Noack T. Eingriffe in das Selbstbestimmungsrecht des Patienten. Juristische Entscheidungen, Politik und ärztliche Positionen 1890–1960. Frankfurt / M; Mabuse-Verlag 2004
  • 5 Waltzer H. Brief or crisis-oriented therapy in a city hospital setting.  Am J Psychother. 1975;  29 550-557
  • 6 Rosen B. Written treatment contracts: their use in planning treatment programmes for in-patients.  Br J Psychiatry. 1978;  133 410-415
  • 7 Szasz T S. The psychiatric will. A new mechanism for protecting persons against „psychosis” and psychiatry.  Am Psychol. 1982;  37 762-770
  • 8 Seibt M. Behandlungsvereinbarungen. In: Dietz A, Pörksen N, Voelzke W, Hrsg Vertrauensbildende Maßnahmen in der Akutpsychiatrie. Bonn; Psychiatrie Verlag 1998
  • 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
  • 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
  • 11 Srebnik D S, La Fond J Q. Advance directives for mental health treatment.  Psychiatr Serv. 1999;  50 919 -925
  • 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
  • 13 Widdershoven G, Berghmans R. Advance directives in psychiatric care: a narrative approach.  J Med Ethics. 2001;  27 92-97
  • 14 Barta H, Kalchschmid G. Die „Patientenverfügung in Europa”.  Wien Klin Wochenschr. 2004;  116 442-457
  • 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
  • 16 Sass H-M. Advance directives for psychiatric patients? Balancing paternalism and autonomy.  Wien Med Wschr. 2003;  153 380 -384
  • 17 Rittmannsberger H, Lindner H. Erste Erfahrungen mit dem Angebot einer Behandlungsvereinbarung.  Psychiat Prax. 2006;  33 95-98
  • 18 Poerksen N, Dietz A. Experiences with the Bielefeld therapeutic accord.  Int J Ment Health. 1998;  26 61-66
  • 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
  • 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
  • 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
  • 22 Bielefelder Behandlungsvereinbarung:. http://www.psychiatrie-bielefeld.de/behandlungsvereinbarung/behandlungsvereinbarung.pdf
  • 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
  • 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
  • 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
  • 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
  • 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
  • 28 Peto T, Srebnik D, Zick E, Russo J. Support needed to create psychiatric advance directives.  Admin & Policy Ment Health. 2004;  31 409-419
  • 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
  • 30 O'Conell M J, Stein C H. Psychiatric advance directives: perspectives of community stakeholders.  Adm Policy Ment Health. 2005;  32 241-265
  • 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
  • 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
  • 33 Srebnik D S, Russo J. Consistency of psychiatric crisis care with advance directive instructions.  Psychiatr Serv. 2007;  58 1157-1163
  • 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
  • 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
  • 36 Geller J L. The use of advance directives by persons with serious mental illness for psychiatric treatment.  Psychiatric Quart. 2000;  71 1-13
  • 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
  • 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
  • 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
  • 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
  • 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
  • 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
  • 43 Sherman P S. Administrative update. Computer-assisted creation of psychiatric advance directives.  Comm Ment Health J. 1998;  34 351-362
  • 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
  • 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
  • 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
  • 47 Campbell L A, Kisely S R. Advance treatment directives for people with severe mental illness.  Cochrane Database of Systematic Reviews. 2007;  (3)
  • 48 Thomas P, Cahill A B. Compulsion and psychiatry – the role of advance statements.  BMJ. 2004;  329 122-123
  • 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
  • 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
  • 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
  • 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
  • 53 Della Picca E, Fischer R. Psychoedukation während stationärer Behandlung.  Psychiat Prax. 2000;  27 351-353
  • 54 Kapp M B. Implications of the Patient Self-Determination Act for psychiatric practice.  Hosp Comm Psychiatry. 1994;  45 355-358
  • 55 Monahan J, Swartz M, Bonnie R J. Mandated treatment in the community for people with mental disorders.  Health Aff. 2003;  22 28-38
  • 56 National Resource Center on Psychiatric Advance Directives:. http://www.nrc-pad.org/
  • 57 Ambrosini D L, Crocker A G. Psychiatric advance directives and the right to refuse treatment.  Can J Psychiatry. 2007;  52 397-402
  • 58 Scottish Parliament .Mental Health Care an Treatment (Scotland) Act 2003. Edinburgh; Stationery Office 2003
  • 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
  • 61 Körtner U HJ, Kopetzki C, Kletecka-Pulker M. Das österreichische Patientenverfügungsgesetz. Wien; Springer 2007
  • 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
  • 64 Atkinson J M. Advance directives in mental health. London; Jessica Kingsley Publishers 2007
  • 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
  • 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
  • 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

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