Palatinate Clinic for Psychiatry and Neurology

from Wikipedia, the free encyclopedia
Central building of the former insane asylum near Klingenmünster

The Palatinate Clinic for Psychiatry and Neurology AdöR , or Palatinate Clinic for short , is the provider of mental health offers in the Palatinate . The head office is in Klingenmünster .

The focus in the field of inpatient and semi-inpatient hospital care is on psychiatric , neurological , psychotherapeutic , psychosomatic and social therapeutic offers. The Pfalzklinikum is responsible for the execution of measures according to § 63 and § 64 of the Criminal Code. The community psychiatric services include both inpatient and outpatient forms of living as well as other outpatient aids to ensure participation in social life.

The health and social enterprise is run in the legal form of an institution under public law . The Pfalzklinikum is sponsored by the District Association of the Palatinate , a higher municipal association . The Pfalzklinikum maintains 15 facilities at 12 locations in the Palatinate. It is the sole shareholder of the Community Psychiatric Center Vorderpfalz GmbH in Speyer and the Medical Care Center Pfalzklinikum GmbH based in Kaiserslautern .

Headquarters and locations

The headquarters of the Pfalzklinikum is in Klingenmünster ( Südliche Weinstrasse district ) on the western edge of the Rhine plain . In addition, offers and facilities are maintained in Rockenhausen , Landau , Wörth-Maximiliansau , Kaiserslautern , Kusel , Maikammer , Pirmasens , Speyer , Dahn , Rodalben and Bad Bergzabern .

meaning

The Pfalzklinikum has a total of around 1000 beds and places. Every year around 30,000 patients are treated and cared for as inpatients, daypatients or outpatients. Inpatient and outpatient housing options are available for around 160 residents. The outpatient psychiatric nursing service looks after around 200 clients per year (as of January 2012). Mentally impaired people (Speyer) and people with dementia (Bad Bergzabern) are cared for in two day care centers. The Pfalzklinikum has around 1500 employees, including around 1300 full-time positions.

Performance profile

The Pfalzklinikum is a provider of inpatient, outpatient and rehabilitation services in the field of mental health. Offers are made available in the child and adolescent psychiatric (as well as psychosomatic), psychiatric, geriatric psychiatric , psychosomatic, psychotherapeutic, neurological, social therapeutic and community psychiatric area.

Facilities

Locations

Adult Psychiatry Sites

  • Kusel: day clinic and psychiatric outpatient clinic
  • Rockenhausen: Clinic, day clinic and psychiatric outpatient clinic
  • Kaiserslautern: Clinic, day clinic and psychiatric outpatient department
  • Speyer: day clinic and psychiatric outpatient department
  • Landau: day clinic and psychiatric outpatient clinic
  • Wörth: Day clinic and psychiatric outpatient department
  • Klingenmünster: Offers in general and geriatric psychiatry, residential offers, outpatient care, sleep medicine , treatment of addictive disorders, neurology

Child and adolescent psychiatry locations

  • Speyer: day clinic and psychiatric outpatient department
  • Kaiserslautern: day clinic and psychiatric outpatient clinic
  • Pirmasens: day clinic and psychiatric outpatient clinic
  • Klingenmünster: Differentiated offer

Community psychiatry locations

  • Rockenhausen: Outpatient psychiatric care and support
  • Kaiserslautern: Outpatient psychiatric care and support
  • Rodalben: Care - Support - Live
  • Speyer: Outpatient psychiatric care and support, Community Psychiatric Center Vorderpfalz GmbH, day care centers
  • Bad Bergzabern: care - support - living, day care center for dementia
  • Dahn: Outpatient psychiatric care and support, mentoring - promoting - living, participation center
  • Maikammer: care - support - living, curative educational home
  • Klingenmünster: Housing offers, outpatient psychiatric care and support

Locations of integrative care

  • Rockenhausen
  • Kaiserslautern: Medical supply center
  • Klingenmünster

Training and further education offers

The Pfalzklinikum is an academic teaching hospital of the Johannes Gutenberg University Mainz . The Pfalzklinikum also offers the following training courses:

There are also further training opportunities:

  • to a doctor for psychiatry and psychotherapy and
  • to the doctor for child and adolescent psychiatry and psychotherapy,
  • to a doctor for neurology,
  • for Fachkrankenschwester / to Fachkrankenpfleger Psychiatry,
  • as a specialist in child and adolescent psychiatry (focus on forensic psychiatry),
  • to the psychological psychotherapist ,
  • to child and adolescent psychotherapist.

The Palatinate Clinic has its own nursing school available to carry out nursing training, which is operated in cooperation with the Landau-Südliche Weinstrasse Clinic. In-house training courses and employee seminars are coordinated by a training center established specifically for this purpose. In cooperation with the Catholic University of Applied Sciences in Mainz , academic training for psychiatric nurses at Bachelor / Master level will be offered from the 2013 winter semester. For this purpose, the endowed professorship "Extended nursing skills for long-term care needs (focus on psychiatry)" was established. Scholarships can be issued to promote young academics in the medical field.

history

The Klingenmünster district insane asylum in the 19th century

Planning and construction of the insane asylum district

As early as 1809, a begging and poor house was opened in Frankenthal in the Palatinate . Although it was expanded in the meantime, it was overcrowded with over 100 patients in 1831. After the decision was made against a new building in Frankenthal (an extension was also not possible), a new institution was planned in the Palatinate. The lack of funds led to long negotiations with the Ministry of the Interior, which resulted in the rejection of the new building. Alternatively, a merger of the Palatinate with other Bavarian districts ( Lower Franconia and Aschaffenburg) and the construction of a joint facility in Würzburg was proposed. However, the Palatinate Doctors Association was able to continue negotiations in 1839 with reference to the grievances in the Frankenthal facility, so that in 1852 a building site was found and bought in the Palatinate. In order to decide in favor of the (rural) location in Klingenmünster, in addition to the favorable purchase price of the building site and the prevailing unemployment, the prevailing theories within psychiatry at that time were also decisive. Accordingly, a sick person should be removed from their original environment as much as possible for the duration of the treatment.

Although the building decision was already in place in 1851, the establishment of the institution was delayed due to problems with the condition of the soil. As a result, the construction costs also increased considerably, so that an economic building, a church, central heating and gas lighting had to be dispensed with. The lighting was later provided by kerosene lamps, and heating by gas stoves. Dick himself helped to construct the institution and designed it in the corridor system. The facility was planned as a closed facility and was intended to accommodate 300 patients.

Construction of the institute began in 1852 and opened on December 31, 1857. Hermann Dick was the first director of the institute. About 40 patients from Frankenthal were admitted at the opening.

Developments up to 1900

In the following years the institution had to struggle with overcrowding again and again. In the first few years after the opening, many families took the opportunity to have their mentally ill relatives cared for in Klingenmünster. However, comparatively low contributions to care costs resulted in patients staying in the institution longer than necessary. In 1861 another 120 patients from Frankenthal came to the institution, so that capacity was exceeded by 1864. Anticipating this problem, after the completion of the hospital cemetery in 1859, renovations to gain space were started, which were completed in 1862. In the course of the population growth associated with the beginning of industrialization, the number of patients rose to 350 in 1866 and to 400 in 1870, despite the structural expansion. In order to reduce the risk of fires, a hospital fire brigade was founded in 1866, which is still in existence today.

In 1870 the institution was used as a hospital during the Franco-German war. At the beginning of the 1870s there were also outbreaks of typhoid and smallpox, which resulted in deaths. After a new building for 80 patients was built in 1874, the construction of two epidemic houses for the isolation of infected patients began in 1879. In addition, the asylum's abortion system was modernized by the introduction of collectable bins, which were emptied daily from the asylum's bags. A bowling alley, greenhouse, stables and magazines were also built at this time. The institution finally had a capacity of 500 patients, which was no longer sufficient at this point in time.

In 1879 the previous director of the institution, Hermann Dick, died. He was followed by Rudolf Loechner, who in turn was replaced after three years by Ferdinand Karrer.

In 1887 the occupancy number reached its previous maximum. Therefore, 150 of 591 patients were relocated to Frankenthal, where space was created after renovation work. A year later, several patients and two employees died as a result of a tuberculosis infection. In 1888 the patients built an outdoor pool. The clinic was occupied with 470 people this year.

In 1890 the first free, not closed station was opened. An estate was also acquired, in which around 20 chronically ill patients found employment in agriculture and forestry. As a result, the agricultural area on the premises of the institution could be given up one year later.

In 1893 the institution was occupied with 591 patients. As patients continued to be admitted, the occupancy rose to 600 patients in 1895 and finally reached a maximum of 617 patients in 1897. This meant that the institution was too busy with over 100 people. Therefore, in 1897, 30 patients were referred to Frankenthal. In 1898 further stations were built so that full occupancy could be achieved at short notice.

Life and everyday life in the county insane asylum

According to its statutes, the institution initially provided for the admission of curable and incurable patients, whereby curable patients were given preference.

Regular meals and help with household chores characterized the patients' everyday lives. Great importance was also attached to personal hygiene: the patients were given the opportunity to practice personal hygiene and had to take part in a weekly cleaning bath. Individual recovery hours tailored to the performance of the respective patient alternated with various therapeutic activities. These included primarily occupational therapy: manual activities as well as field and gardening work were intended for male patients, while women were mostly entrusted with manual and household work. Medicines were only available in small quantities, alcohol and opium tinctures were used as sedatives. All treatments took place under the principles of non-restraint (no physical compulsory treatment) and traitement moral. By 1900, however, bed rest moved into the center of the treatment of the mentally ill.

Situation of the nursing staff

At the time of its opening, the staff of the insane asylum included 29 ambulances, 15 housekeeping workers, two singing teachers and an organist. Shopping was done by a messenger on foot in Landau, a good 10 km away. In 1861 a carpenter was hired.

The guards were obliged to live inside the institution. Certain behaviors towards the sick were also prescribed: a mild disposition towards the patient and obedience towards the doctors were compulsory. Maltreatment and disciplinary punishments against the patients were strictly forbidden, coercive measures were only used in justified individual cases and required precise records.

Development into a sanatorium and nursing home: The years 1900–1933

Overcrowding and remodeling

At the beginning of the 20th century, the overcrowding of the district insane asylum reached critical proportions: Due to a strong increase in population in the region, the asylum was already occupied with 765 patients in 1903. Although a good 100 patients could be moved to a new facility in Homburg, the occupancy rose to 875 in 1909. In 1909 the occupancy reached 1,200 patients. In addition to population growth, the cause was that more people were admitted than discharged over a long period of time. Numerous renovations were carried out in the years to come. Baths, heating, electric light and terraces were installed.

In 1910 the institution was renamed "Heil- und Pflegeanstalt Klingenmünster".

According to the Versailles Treaty , Homburg was separated from the Palatinate and assigned to the Saar area, which resulted in the hospital in Homburg being vacated in 1921 and the 150 patients relocated back to Klingenmünster. Klingenmünster was now occupied with 700 patients. Since the facility in Frankenthal was also fully booked, Klingenmünster had to accept all new additions from the region in the following years. The occupancy rose to 717 in 1923, to 777 in 1925 and finally to 850 in 1926. In order to prevent the institution from being overcrowded again, 100 patients were transferred to non-Palatinate institutions in 1923.

In 1922 Josef Klüber took over the management of the institution. He realized that the institution had to replace the patient's home in the meantime and immediately initiated a modernization: old cells were replaced by bright single rooms with windows. A sewage treatment plant and sewer system were installed. Further extensions consisted of the construction of lounges and wax rooms, permanent baths, five residential buildings for the staff, a greenhouse and a fish pond. The epidemic houses and workshops were also expanded.

Thanks to these extensions, the institution had a well-developed infrastructure in 1929, in particular the following facilities:

  • a waggon
  • a joinery
  • a bricklayer
  • a plumber
  • a locksmith's shop
  • an outdoor swimming pool
  • a nursery to look after the cemetery and manage the cultivation of food (land 3 hectares)
  • a sewing shop
  • a backery
  • a slaughterhouse
  • a whitewash
  • a basket maker
  • a tailor shop
  • a saddlery
  • a bookbindery
  • a shoemaker
  • a church
  • a fire department
  • an estate with 4 horses, 120 pigs and 500 chickens (recycling of waste, covering milk needs, 56 hectares of land)

In contrast to the past, the products were now mainly used to meet the needs within the institution.

In 1929 the Pfalzklinik cared for over 1000 patients.

The institute during the First World War

With the beginning of the First World War in 1914, all modernization measures in the sanatorium were stopped. The number of personnel was reduced considerably through recruitment, the use of the building as a hospital was examined by the Palatinate government and approved in the same year. The hospital had 60 beds. During the war it took in at least 700 members of the army, who were mostly treated there for physical injuries. Since the fastest possible deployment at the front was a top priority, there was a tendency, especially in the case of mental illness, to accuse the respective patient of simulating the illness and to force them back to the front with sometimes violent methods. Due to the geographical proximity to the front and the associated price increases in the region, the food supply in the institution deteriorated more and more: As early as 1915, staple foods such as bread, flour and potatoes were becoming significantly scarce. When all food distribution was organized by the state in 1916, mortality in the institution rose to a maximum. However, this so-called patient death did not affect the hospital department.

Life and everyday life in the sanatorium and nursing home

Analogous to the conditions in the institution in the 19th century, everyday life was still determined by a strictly prescribed daily routine, which was intended to give the patient security and routine. In addition, numerous new treatment methods were introduced. In the non-drug area, these included bed treatment (immobilization, if necessary also supported with medication), physical therapy (long baths) and occupational / work therapy (facilitated reintegration into society), talk therapy, hypnosis and suggestion.

Medical innovations were usually adopted quite quickly. For example, treatment with sleeping pills and sedatives as well as insulin (insulin shock therapy) was introduced in the pharmaceutical sector. From 1922, cardiazole convulsive therapy was used to treat schizophrenia as well as sleep and fever therapy. In addition to medical innovations, new forms of catering were also introduced. This included, for example, the institute's own farm. It provided jobs for 28 patients and supplied the entire facility with food. The stables previously housed in the institution could now be relocated to this, which enabled the construction of new workshops and service apartments. Another new form of catering was the so-called family care. This was understood to mean the temporary care of mentally ill patients in the sanatorium within other families. It was introduced around 1900 and initially remained unsuccessful, as hardly any families agreed to accept a sick person. The relatives of the patients also had concerns about this new form of catering, so it was temporarily abolished in 1911. In 1926, family care was reintroduced under the new name of "external care". It was intended for patients on leave and discharged and was intended to facilitate their reintegration into society. In order to better support the families involved, a counseling center was opened, which also organized home visits. This should also record the success of the treatment and, under certain circumstances, initiate a re-admission. By 1928, the welfare office looked after 637 patients, advised 836 people and made 1,932 house calls.

Situation of the nursing staff

With the new forms of treatment, the working conditions of the nursing staff also changed. The nurses, who were previously called “guards”, worked under poor working conditions during the 19th century: They were obliged to be permanently present in the institution and saw themselves strongly integrated into a patriarchal structure with the institution director at the top. The guards were not trained. They were moderately paid and had a low reputation among the population. These working conditions led to a frequent change in the workforce, so that the Bavarian Ministry of the Interior reformed the instructions for the guards in 1901: Among other things, it provided for the change of the job title to "Pfleger", as well as better pay and social security. Attempts have also been made to reduce the workload through a more favorable ratio of caregivers and patients. Since the abuse of internal resources was rampant, the Ministry of the Klingenmünster Sanatorium in 1902 also issued a ban on any private use of goods or patient work for private purposes. The requirements of the ministry were largely implemented in 1903. As before, however, the nurses were largely bound by the instructions of the doctors and the director. The reform was also unable to ensure a separation of work and private life.

The sanatorium and nursing home under National Socialism: The years 1933–1945

The beginnings of Nazi psychiatry in Klingenmünster

As early as the second half of the 19th century, teachings of degeneracy and degeneration began to manifest themselves socially. These theories, which also made use of elements of social Darwinism and evolutionary theory , gained particular importance under National Socialist leadership. Immediately after the seizure of power , propaganda began against the mentally ill and handicapped, who from then on were portrayed as ballast existences .

As early as 1927, a well-organized NSDAP cell was established in the institution . Despite various efforts by the head of the institution, Klüber, who was hostile to the National Socialists, he was unable to prevent the National Socialist movement from gaining power among the staff of the institution. His efforts ended in an attack against him in 1935, which he survived seriously injured. Due to the injuries, Klüber was unable to return to work. The perpetrators were arrested, but released again after a short time.

Everyday life and treatment methods at the time of National Socialism

In 1936 Gottfried Edenhofer took over the management of the institution. Under him, the everyday life and treatment of patients changed significantly. Little by little, all leisure events and parties for the patients were abolished, and a large number of the books in the patient library were confiscated. Guided tours of the institution, which meanwhile served as a demonstration site for hereditary and mental illnesses, were carried out more and more frequently. The guided tours were intended to illustrate the perceived dangers of reproducing the mentally ill.

The treatment methods also changed under Edenhofer's leadership: occupational therapy no longer served to heal the patients, but to exploit their labor. Drug treatments increased, with able-bodied patients being preferred for treatment. After the outbreak of the Second World War, sick people who were fit for work were no longer deported to sanatoriums or imperial institutions because their labor was needed during the war.

Forced sterilizations

In 1933 the law for the prevention of genetically ill offspring was passed, which legalized the forced sterility of mentally ill people. Corresponding patients were recorded both within the institution and outside as part of external care. People who had previously had no contact with the institution, such as relatives, were also reported. The sterilization applications were subsequently approved by so-called hereditary health courts and carried out by hospitals in the region. Since patients classified as inherited diseases were not allowed to leave the institution, some patients voluntarily allowed themselves to be sterilized in order to have the opportunity to go out or even to be discharged. By the end of the war, 425 patients from the sanatorium had been sterilized.

The evacuation of the sanatorium and its involvement in the organized murder of the sick

In 1939, the Klingenmünster sanatorium was evacuated within one day, regardless of the concerns of its patients, so that the buildings could be used for military purposes. The patients, some of whom were severely traumatized by being torn out of their familiar surroundings, were deported to 13 different Bavarian institutions under chaotic circumstances. The cattle wagons in which the transport took place sometimes took months to reach their destination. The responsible station staff was also transferred to the appropriate institutions, a small part remained in Klingenmünster for organizational tasks.

In the same year, the organized murder of the sick was decided and implemented under the code name of the so-called Action T4 . Of the 1251 deported patients, at least 223 were taken to killing centers and murdered there. In addition to the illness, criteria for the selection were also external motives, such as the amount of care required for a patient or ethnic origin. No Jewish patient survived the evacuation phase. From 1943 onwards, all forced laborers and those in preventive detention were also deported to killing centers and concentration camps in order to make room for the (physically) sick from other hospitals. Sick people who were fit for work were mostly spared deportation to killing centers. As early as 1940, 114 patients were transferred back to Klingenmünster so that they could begin cleaning up. In the same year, the restart of the institution was discussed. Edenhofer, the director of the institution, then made the proposal to convert the institution into an observation institution. The meaning of the term observation institute could not be clearly clarified until today. Edenhofer's application was rejected, so that the institution went back into operation as a sanatorium and nursing home in September 1940 with around 800 patients. According to the current state of research, no organized murders as part of Action T4 were carried out in Klingenmünster. However, the management of the institution was fully informed about the organized killing of patients. Attempts to rescue patients, for example by refusing extradition, were not made. The clinic took part in all measures (registration forms) to record the patients to be killed.

Wild euthanasia: the Bavarian hunger decree and the Brandt campaign

The murders of the sick from 1941 onwards are called wild euthanasia . In contrast to Action T4, these were not organized centrally and took place in the individual sanatoriums and nursing homes. The victims were murdered by overdosing on drugs, deprivation of food, or a combination of both. The killings were for base motives.

Detecting the murders during this period is difficult because the wild euthanasia was carried out undercover. With regard to the Klingenmünster sanatorium and nursing home, the investigation is made more difficult by the destruction of all economic and budgetary files in 1947/48 by the management of the institution at the time. In the corresponding patient files, fictitious causes of death and blackening can be found.

In addition to the incomplete and manipulated record keeping, an above-average death rate (which, however, partly coincides with a famine), a reduction in the average age at death by 10 years (by 35 years for inpatients), the sudden death of physically healthy patients speak in favor of carrying out euthanasia measures in Klingenmünster Patients, the absence of long-term patients and the operation of two hunger stations.

The murders of the wild euthanasia took place against the background of the so-called hunger decree and the Brandt campaign . The Bavarian hunger decree was passed in 1942 and stipulated that sick people who were no longer able to work should only be given subordinate food. This had important consequences for the sanatorium and nursing home. When the withdrawal diet was introduced, it had the highest death rate of all Bavarian institutions. By 1945, an estimated 1,880 patients died in Klingenmünster, who were buried in the clinic cemetery and in mass graves.

In addition to the hunger waiver, the massive capacity problems caused by the immense patient transfers within the Brandt campaign also favored the killing of patients.

In connection with the hunger waiver, its manipulation by the staff is discussed as well as an enrichment of the staff with the food supplies of the institution. Although the implementation of the hunger waiver was largely dependent on the cooperation of the doctors and nursing staff, there has been no conviction to date. Participation in the implementation or in the manipulation of the hunger waiver has not yet been proven.

End of war

When Klingenmünster was captured by the US Army in 1945, the Second World War ended in the region. In the meantime Heinrich Schmidt had taken over the management of the institution. He organized hamster rides and asked aid organizations for food. Schmidt managed to continue to be employed as the head of the institution even after the denazification. He used his position to destroy and manipulate household, economic and patient files during the Nazi era. Due to staff shortages, many of the workers laid off during denazification had to be reinstated.

Coming to terms with the time of National Socialism

In 1953 the sanatorium and nursing home was renamed "Palatine Mental Hospital Landeck". Gerhard Mall became the new head. The latter, who led his own brother into Nazi euthanasia, expressed the opinion to the public that the sanatorium had not been affected by the killing actions of the Nazi psychiatry. He also claimed that the staff systematically circumvented the starvation waiver. Inquiries from relatives of the victims of National Socialism were answered against their better judgment with the statement that they did not know what had happened to the patients.

From 1986 onwards, the faction of the Greens asked several times about the past of what was then the “Pfalzklinik Landeck”. In 1988, the Palatinate District Association initially announced that there had been no surgical interventions for forced sterilization in Klingenmünster. In 1989 the Institute for Palatinate History and Folklore was finally commissioned to investigate the clinic's Nazi past. Due to the disordered archives, the research was initially difficult. The researchers themselves were also confronted with massive resistance, including death threats, property damage and theft. In 1990 the institute announced that no employee of the clinic had been convicted of crimes from the Nazi era since 1945. However, it can be assumed that 150 patients were killed during the evacuation of the institution. In 1992 it was also announced that there was no suspicion of culpable behavior on the part of the staff. This finding was sharply criticized by the press at the time, so that in 1993 the district government of the Palatinate announced a profound scientific analysis, since sources had now been encountered that raised the suspicion that the sanatorium was on a larger scale in the former Practices of euthanasia have been involved. The press also expressed suspicion of serious physical abuse of patients and murder through the administration of overdosed sleeping pills. In June 1993, the responsible public prosecutor began investigations into genocide against unknown persons.

Palatinate Mental Hospital Landeck: The years 1945–1970

After the death of Heinrich Schmidt, Gerhard Mall took over the management of the institution. Under him began the transformation of the sanatorium and nursing home into a clinical-therapeutic facility. In 1953 the facility was renamed the "Palatinate Mental Hospital Landeck".

Situation and training of the nursing staff

The nursing staff was very old in the 1950s. As more and more staff left the service, a shortage of nurses developed. At the same time, a debate began about the workload and the number of carers. Since the staff was also poorly qualified, a three-year internal course was introduced as early as 1949, which was intended to enable them to work as "auxiliary nurses". The first courses were viewed critically, especially by the older nursing staff, and were largely rejected. Due to the high demands on the resilience of the applicants, the job description of the caregiver also met with little interest from external applicants. To counter this development, the clinic has taken various measures, such as a takeover guarantee and higher vacation entitlements. The nursing school was opened in 1954 and officially recognized by the district government in the same year. Up until the 1960s, the general conditions for carers were continuously improved. Women were no longer allowed to be dismissed because of a marriage. Married women were hired, applicants could now be employed up to the age of 40.

Treatment modernization

The redesign of the Landeck Mental Hospital also included modernization in the medical field. Under Mall, the neurological department was upgraded through various technical innovations, such as X-ray machines. Several metabolic laboratories and an electroencephalographic laboratory were also set up. Mall also brought his own methods into the diagnosis. In 1963 an endocrinology laboratory was opened. The further development of hormone research took place at great expense. The endocrinologist Ursula Laschet, who was an employee of the clinic at the time, played a key role in researching the drug Androcur , which aroused great media coverage nationwide and made the clinic an important center for forensic psychiatry . With the start of work at Mall, work therapy was also expanded. The goods resulting from it no longer served to meet the needs of the institution, but were intended for external sales. However, with the introduction of psychotropic drugs , occupational therapy quickly got into a conflict situation, as effective drug treatment meant that the patients only remained in the institution for a short time and were therefore no longer eligible as workers. In addition to the expansion of drug therapy and the reorganization of occupational therapy, the establishment of child and adolescent psychiatry was another important innovation.

Overcrowding of the institution

In 1958 the mental hospital was too busy with over 300 patients. The overcrowding was countered with the construction of new workshops and a new nursing home. The number of doctors and the use of medication were increased in order to keep the length of stay of the patients as short as possible. In addition, it was planned to set up outpatient clinics in order to avoid unnecessary inpatient stays. In 1960 a central admission and ambulance station as well as an epilepsy ambulance were opened. External welfare, which was reactivated in 1948, also gained in importance again. She now focused on caring for former patients who were now being transferred to old people's homes. The aim was to prevent (re) admission to the mental hospital.

Developments in the context of the psychiatric reform: The 1970s

First innovations

In the course of the psychiatric reform, the focus was initially on the acute treatment of patients. Pure care cases were transferred to specialized facilities. The staff was relieved of non-care activities by outsourcing. Efforts were also made to create a more appropriate environment for treatment. Clinic director Kurt Heinrich (clinic director from 1969) had all bars removed from the windows. Many stations could now be occupied by mixed sexes. Art exhibitions were shown several times in the following years. Work therapy now served the patients' own earnings.

Orientation towards the needs of the patient

Even Hans-Joachim Haase , who in 1972 took over the hospital management, the needs of the patients presented at the center. So he arranged for the purchase of cupboards for each patient in order to guarantee more privacy, although other infrastructural innovations were urgently needed. In order to give patients more opportunities to spend their free time, various games were purchased, the tennis court and the clinic's own outdoor pool were released for use by patients. In 1973 a cafeteria and a supermarket were opened on the clinic premises.

As part of the so-called “ therapeutic community ”, patients should from now on be given the opportunity to participate as actors and active creators of everyday hospital life. In weekly ward group discussions, the patients were allowed to suggest improvements and give feedback. These attempts to break the strict hierarchical conditions of the clinic were supplemented in 1973 by the introduction of a sponsorship program. Voluntary sponsors were allowed to choose patients with whom they would spend some of their free time together. The aim of the sponsorships was to break down prejudices on the part of the population and to facilitate the reintegration of patients into society. However, it was criticized that the patients were completely at the mercy of the godparents when they were selected. The godparents criticized the fact that they did not learn enough about the illness of the respective patient and that contacts were sometimes lost due to unannounced transfers. In 1975 the sponsorships were supplemented by so-called lay aid. Lay assistance was understood to mean the involvement of laypeople in the operation of acute treatment. Patients who were about to be discharged and had no relatives were particularly taken into account. The patient and lay helper were now assigned anonymously. With the help of questionnaires, patients and helpers with the same interests and gender were selected and assigned to one another. As with sponsorships, the focus should be on spending your free time together. In order to support the lay helpers, training events were offered in which the helpers were informed about the illnesses of the patients, for example. To care for the patients after discharge, patient clubs were established in which citizens and former patients could join together to spend their free time together. In order to coordinate further rehabilitative measures, the Landecker Aid Association for the Mentally Ill was founded in 1973. The clinic promoted these new measures by enabling its patients to attend patient club meetings and other recreational events by purchasing buses. From 1974 onwards, there were regular summer festivals that the population could attend.

In 1978, the construction of the treatment, supply and communication center that still exists on the clinic premises began.

Changes in treatment

The passing of the hospital reform law in 1973 posed new challenges for the "Pfalzklinik Landeck", which has since been renamed again. The clinic was expanded in terms of staff by hiring various new professional groups, such as psychologists, educators, etc., which was initially accompanied by differences of opinion between the groups. A department for addiction disorders and an geriatric psychiatric ward were also opened. The further differentiation in wards and the expansion of the clinic through various facilities characterize the development up to the turn of the millennium.

Current developments

Commemoration

In 1993 a memorial stone for the victims of Nazi psychiatry was inaugurated. Since 1996, the Pfalzklinikum has participated annually in a memorial event on the national day of remembrance for the victims of National Socialism. In 2003 the exhibition "Euthanasia in Hadamar and Klingenmünster" was shown, which was visited by more than 25,000 people. Since 2004, part of the clinic cemetery has been redesigned into a memorial. In 2012, the touring exhibition "NS Psychiatry in the Palatinate" at the Palatinate Clinic in Klingenmünster stopped. From January to April 2014 the Pfalzklinikum showed the exhibition In Memory of Children. The pediatricians and the crimes against children during the Nazi era .

Outpatient care

Following the trend towards outpatient treatment, the Pfalzklinikum has expanded the following facilities: eight psychiatric institute outpatient clinics at the locations of the clinics and day clinics for adults, three psychiatric institute outpatient clinics in child and adolescent psychiatry (IAP) in Klingenmünster, Kaiserslautern, Pirmasens and Speyer, one forensic psychiatric outpatient clinic of the Clinic for Forensic Psychiatry, the outpatient psychiatric nursing and care service (appb), and a day care center for people with dementia.

Interdisciplinary sleep center

The Palatinate Clinic's sleep center has been a specialized unit that has existed since 1988 and in which sleep disorders can be recognized and treated. In 2001 it was expanded to 10 treatment units.

Department of Neurology

The Neurology Clinic has been located in a newly constructed building since 2006. The ward now has 54 beds. The technical equipment includes a spiral computer tomograph, a magnetic resonance tomograph as well as X-ray and ultrasound diagnostics and electrophysiological techniques.

Trivia

In the Palatinate, mainly in the South and Front Palatinate , and also in North Baden on the other side of the Rhine , people who are thought to have psychological problems are sometimes disparagingly said: "He belongs to Klingenmünster!"

literature

  • Christof Beyer: From the county insane asylum to the Pfalzklinikum . A history of psychiatry in Klingenmünster. Institute for Palatinate History and Folklore, Kaiserslautern 2009, ISBN 978-3-927754-68-3 .
  • Gabriele Carpano-Diehl: Suspected euthanasia in the Klingenmünster sanatorium, 1944–1946. Tectum, Marburg 2012.
  • The Rhine Palatinate : Public prosecutor's office is investigating suspected euthanasia. 1993.
  • Bernhard Kukatzki: Did Nazi doctors kill in Klingenmünster too? A documentation about how the Pfalzklinik Landeck deals with the past. Schifferstadt 1993.
  • Otfried K. Linde: Eugenics and “euthanasia” in the Nazi state - their roots and what was left of them . In: Albert H. Keil, Dirmstein Municipality (ed.): "Dirmstein remembers" . Days of Remembrance for the Victims of National Socialism. Dirmstein 2009 ( home.arcor.de [PDF]).
  • Karl Scherer, Otfried K. Linde and Roland Paul (eds.): The Klingenmünster sanatorium and nursing home 1933–1945 . Psychiatry under National Socialism . Institute for Palatinate History and Folklore, Kaiserslautern 1998, ISBN 3-927754-34-X (2 additional editions).
  • Otfried Linde u. a .: The Klingenmünster sanatorium and nursing home 1933–1945 (= contributions to the history of the Palatinate. Volume 14). Institute for Palatinate History and Folklore, Kaiserslautern 2003.
  • M. Müller: Did Nazi doctors kill in Klingenmünster too? In: Rheinpfalz. No. 138, 1993.
  • Monika Pritzel, Reinhard Steinberg (ed.): 150 years of the Pfalzklinikum . Psychiatry, psychotherapy and neurology in Klingenmünster . Franz Steiner Verlag, Stuttgart 2012, ISBN 978-3-515-10091-5 .
  • H. Reinhard: Shadow of a Dark Time. In: Speyerer Tagespost . 1993.
  • Heinrich von Schmidt: The Palatine district sanatorium and nursing home Klingenmünster. GH Fix, Landau (Palatinate) 1926.
  • Heinrich von Schmidt: The Palatine district sanatorium and nursing home Klingenmünster. Lindner, Düsseldorf 1929.
  • Economic factor Pfalzklinikum. In: Ludwigshafener Rundschau . Ludwigshafen 2012.
  • District Association of the Palatinate, Palatinate Clinic for Psychiatry and Neurology (Ed.): Nazi Psychiatry in the Palatinate. Klingenmünster 2012 (catalog for the traveling exhibition of the same name).

Web links

Individual evidence

  1. ↑ a b Pfalzklinikum for Psychiatry and Neurology: Numbers and facts . Retrieved April 9, 2015.
  2. ^ Ludwigshafener Rundschau regional: Economic factor Pfalzklinikum. 2012.
  3. ^ Palatinate Clinic for Psychiatry and Neurology: Locations . Retrieved April 9, 2015.
  4. ↑ a b Palatinate Clinic for Psychiatry and Neurology: Further and advanced training ( memento of the original from April 2, 2015 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / www.pfalzklinikum.de archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved March 29, 2015.
  5. ↑ Palatinate Clinic for Psychiatry and Neurology: Health and Nursing ( Memento of the original from April 4, 2015 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / www.pfalzklinikum.de archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved April 9, 2015.
  6. ↑ Monika Pritzel, Reinhard Steinberg (ed.): 150 years of the Pfalzklinikum . Psychiatry, psychotherapy and neurology in Klingenmünster. Franz Steiner Verlag, Stuttgart 2012, ISBN 978-3-515-10091-5 , p. 31.
  7. ↑ Palatinate Clinic for Psychiatry and Neurology: Degree in Health and Nursing ( Memento of the original from April 2, 2015 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / www.pfalzklinikum.de archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved March 29, 2015.
  8. ↑ Palatinate Clinic for Psychiatry and Neurology: Scholarships for Medical Students ( Memento of the original from April 2, 2015 in the Internet Archive ) Info: The @1@ 2Template: Webachiv / IABot / www.pfalzklinikum.de archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved March 29, 2015.
  9. ^ Christof Beyer: From the district insane asylum to the Pfalzklinikum. A history of psychiatry in Klingenmünster . Institute for Palatinate History and Folklore, Kaiserslautern 2009, ISBN 978-3-927754-68-3 , pp. 33–35.
  10. ↑ Steinberg (2012), pp. 11-14.
  11. ^ Heinrich von Schmidt: The Palatinate district sanatorium and nursing home in Klingenmünster . GH Fix, Landau (Pfalz) 1926, pp. 4-7.
  12. ^ Heinrich von Schmidt: The Palatinate district sanatorium and nursing home in Klingenmünster . Lindner, Düsseldorf 1929, p. 5.
  13. ↑ a b c Palatinate Clinic for Psychiatry and Neurology: Our story . Retrieved April 7, 2015.
  14. ↑ Steinberg (2012), pp. 14-17.
  15. ↑ Beyer (2009), pp. 35-48.
  16. ↑ Von Schmidt (1926), p. 8.
  17. ↑ Von Schmidt (1929), pp. 3-11.
  18. ↑ District Association of the Palatinate, Palatinate Clinic for Psychiatry and Neurology (ed.): Nazi Psychiatry in the Palatinate . Klingenmünster 2012, p. 16 (catalog for the traveling exhibition of the same name).
  19. ↑ Beyer (2009), pp. 36-38.
  20. ↑ Steinberg (2012), pp. 15-16, 44, 46, 54, 213.
  21. ↑ Von Schmidt (1926), pp. 9-14.
  22. ↑ Von Schmidt (1929), pp. 11-20.
  23. ↑ Beyer (2009), pp. 49-57.
  24. ↑ Steinberg (2012), pp. 18-20.
  25. ↑ Beyer (2009), pp. 91-94.
  26. ↑ Steinberg (2012), p. 20.
  27. ↑ Steinberg (2012), pp. 214–232.
  28. ↑ Beyer (2009), p. 63.
  29. ↑ Beyer (2009), pp. 63-65.
  30. ↑ Von Schmidt (1929), pp. 20-21.
  31. ↑ Beyer (2009), pp. 70-79.
  32. ↑ Steinberg (2012), pp. 18-19, 320-322.
  33. ↑ Beyer (2009), pp. 128-129.
  34. ↑ Bezirksverband Pfalz (Ed.) (2012), pp. 32–33.
  35. ↑ Steinberg (2012), p. 21.
  36. ^ Otfried Linde et al.: The Klingenmünster sanatorium and nursing home 1933–1945 (= contributions to the history of the Palatinate , Volume 14). Kaiserslautern 2003, pp. 28–37 (Ed. Of the volume: Institute for Palatinate History and Folklore).
  37. ↑ District Association of the Palatinate (2012), p. 42.
  38. ↑ Linde (2003), pp. 37-46.
  39. ↑ Steinberg (2012), pp. 232-233, 238.
  40. ↑ Bezirksverband Pfalz (2012), pp. 40–41.
  41. ↑ Beyer (2009), pp. 129-140.
  42. ↑ Beyer (2009), pp. 141-157, 166-168.
  43. ↑ Linde (2003), pp. 47-81.
  44. ↑ Bezirksverband Pfalz (2012): pp. 62–69, 88, 94–96.
  45. ↑ Gabriele Carpano-Diehl: Suspected euthanasia in the Klingenmünster sanatorium from 1944 to 1946 . Tectum, Marburg 2012, pp. 21-24.
  46. ↑ Linde (2003), p. 82.
  47. ↑ Steinberg (2012), p. 343.
  48. ↑ Linde (2003), p. 103.
  49. ↑ Steinberg (2012), pp. 235, 347.
  50. ↑ Steinberg (2012), p. 355.
  51. ↑ Steinberg (2012), pp. 234-235.
  52. ↑ Linde (2003), p. 96.
  53. ↑ a b Bezirksverband Pfalz (2012), p. 102.
  54. ^ Carpano-Diehl (2012), p. 37.
  55. ↑ Linde (2003), pp. 158–159.
  56. ↑ Carpano-Diehl (2012), pp. 25-26.
  57. ^ Carpano-Diehl (2012), p. 35.
  58. ↑ Beyer (2009), p. 159.
  59. ↑ Steinberg (2012), p. 356.
  60. ↑ a b Bezirksverband Pfalz (2012), pp. 110–117.
  61. ↑ Linde (2003), pp. 120-125.
  62. ↑ M. Müller: Did Nazi doctors kill in Klingenmünster too? In: Rheinpfalz, No. 138, 1993.
  63. ↑ Bernhard Kukatzki: Killed Nazi doctors in Klingenmünster? A documentation about how the Pfalzklinik Landeck deals with the past . Schifferstadt 1993.
  64. ↑ Bezirksverband Pfalz (2012), pp. 118–121.
  65. ↑ H. Reinhard: Shadows of a Dark Time. In: Speyerer Tagespost. 1993.
  66. ↑ Die Rheinpfalz: Public prosecutor's office investigates suspected euthanasia. 1993.
  67. ↑ Beyer (2009), pp. 177-182.
  68. ^ Palatinate Clinic for Psychiatry and Neurology: Our story . Retrieved April 8, 2015.
  69. ↑ Beyer (2009), pp. 183-189.
  70. ↑ Beyer (2009), pp. 200-209.
  71. ↑ Beyer (2009), pp. 215-238.
  72. ↑ Palatinate Clinic for Psychiatry and Neurology: Memorial work . Retrieved April 8, 2015.
  73. ^ Palatinate Clinic for Psychiatry and Neurology: News . Retrieved April 8, 2015.
  74. ↑ Palatinate Clinic for Psychiatry and Neurology: Memorial work . Retrieved April 9, 2015.