Mental Illness Act

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The Psycho-sick-laws designate the German state laws , the custodial placement of mentally ill people in acute self or danger to others in a psychiatric hospital rules. In many federal states they are abbreviated as PsychKG . Only in Saarland is the regulation still called the Accommodation Act ( UBG ).

The first reform to overcome so-called custody psychiatry was brought about in West Germany by the Psychiatry Enquête of 1975, and in the GDR by the Rodewian theses from 1963.

With the adoption of the UN Disability Rights Convention in German law in 2009, patient autonomy came to the fore. According to the report of the former UN Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan E. Méndez , any coercive treatment that does not serve to avert an acute life-threatening condition is, according to the UN CRPD , which is used in the states, which they have ratified has legal status, regardless of whether the person concerned is capable of giving consent or not.

The case law of the Federal Constitutional Court on the self-determination of mentally ill people, on compulsory treatment , the legal structure of which must be based on the level of protection for persons placed under civil law and in the penal system, and on the transfer of sovereign powers ( lending ) in the context of public-law accommodation have recently led to new regulations in almost all federal states.

In the GDR, the law on admission to inpatient facilities for the mentally ill was valid from June 11, 1968. According to Art. 9 Para. 1 of the Unification Treaty in conjunction with Art. 1 of the Unification Treaty Act, it was applicable until the new provincial law was amended Federal states as state law.

Overview of state laws

state title Short title abbreviation Original version / new version Last change comes into effect
Baden-Württemberg Law on Help and Protection in Mental Illnesses Mentally Ill Aid Act PsychKHG November 25, 2014 / June 25, 2019 January 1, 2015
Bavaria Bavarian Mental Health Aid Act Mental Health Assistance Act Bavaria BayPsychKHG July 24, 2018 August 1, 2018
Berlin Law on Help and Protection in Mental Illnesses PsychKG 17th June 2016 June 29, 2016
Brandenburg Law on assistance and protective measures as well as on the execution of court-ordered accommodation for mentally ill and mentally disabled people in the state of Brandenburg Brandenburg Mental Illness Act BbgPsychKG May 5, 2009 January 27, 2016
Bremen Law on Help and Protection in Mental Illnesses PsychKG December 22, 2000 2nd August 2016
Hamburg Hamburg Law on Help and Protective Measures for Mental Illnesses HmbPsychKG September 27, 1995 May 25, 2018
Hesse Hessian law on help with mental illness Hessian Mental Health Assistance Act PsychKHG 4th May 2017 August 1, 2017
Mecklenburg-Western Pomerania Law on Help and Protection for People with Mental Illnesses Mental Illness Act PsychKG M – V July 14, 2016 15th July 2016
Lower Saxony Lower Saxony law on assistance and protective measures for the mentally ill NPsychKG June 16, 1997 May 25, 2018
North Rhine-Westphalia Law on Help and Protection in Mental Illnesses PsychKG December 17, 1999 January 1, 2017
Rhineland-Palatinate State law for mentally ill people PsychKG November 17, 1995 May 27, 2014
Saarland Law No. 1301 on the Accommodation of the Mentally Ill Accommodation Act UBG November 11, 1992 May 29, 2014
Saxony Saxon law on assistance and accommodation in the event of mental illness SächsPsychKG October 10, 2007 August 31, 2014
Saxony-Anhalt Law on help for the mentally ill and protective measures of the state of Saxony-Anhalt PsychKG LSA January 30, 1992 April 13, 2010
Schleswig-Holstein Law on Help and Accommodation for Mentally Ill People Mental Illness Act PsychKG January 14, 2000 May 25, 2018
Thuringia Thuringian Law on Help and Accommodation for Mentally Ill People ThürPsychKG February 5, 2009 August 8, 2014

Legal content

requirements

The mentally ill laws also make it possible to stay if “significant legal interests of others are at considerable risk”. They regulate the powers of the police , public order offices , social psychiatric services and legal counselors. In addition, it regulates when compulsory examinations, compulsory measures and treatments are allowed. In the more recent laws it is also described that outpatient preventive and aftercare help should be offered and advice should be made. The inmate has the right to be treated, but he does not have the choice of whether to be treated with medication or psychotherapy. However, he can refuse medication.

Jurisdiction

In almost all countries, the social psychiatric services are responsible for providing help in accordance with the laws for the mentally ill. In most countries they belong to the health authorities. In some state laws, they are also authorized in certain cases to carry out home visits and medical examinations against the will of those affected.

The judicial procedure for custodial placement is regulated in the law on the procedure in family matters and in matters of voluntary jurisdiction (abbreviated: FamFG) , there §§ 312 ff. Anyone can suggest measures according to PsychKG. In almost all federal states, however, a formal application from the responsible district office is required so that legal proceedings can begin.

Forced treatment

A forced treatment against the will of the person concerned is in most countries even in the absence of capacity to consent of the person concerned only in cases of danger to life allowed of considerable danger to their own and the health of other people. Forced medication and restraint for more than half an hour require judicial approval.

According to the report of the UN Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment, Juan E. Méndez, any coercive treatment that does not serve to avert an acute life-threatening condition is under the Convention on the Rights of Persons with Disabilities , which has legal status in the states that have ratified it, regardless of whether the person concerned is capable of giving consent or not.

Most of the federal states have currently (autumn 2018) regulated inpatient compulsory treatment in the mental health laws themselves. As a rule, the requirements that apply to compulsory childcare measures are followed ( Section 1906a BGB).

These are:

state Regulation
Baden-Württemberg Section 20 PsychHKG
Bavaria Art. 20 BayPsychKHG
Berlin Section 28 PsychKG
Brandenburg Section 18 PsychKG
Bremen Section 22 PsychKG Bremen
Hamburg Section 16 HmbPsychKG
Hesse Section 20 PsychHKG
Mecklenburg-Western Pomerania Section 26 PsychKG
Lower Saxony Section 21a NPsychKG
North Rhine-Westphalia Section 18 (5) PsychKG
Rhineland-Palatinate Section 20 PsychKG
Saarland Section 13 Accommodation Act
Saxony Section 22 SächsPsychKG
Saxony-Anhalt Section 17 PsychKG LSA
Schleswig-Holstein Section 14 PsychKG
Thuringia Section 12 ThürPsychKG

In the other federal states (until a change in the law), only compulsory treatment is permitted with the consent of the supervisor (Section 1906a BGB) and with the relevant approval from the supervisory court. The supervisor needs the judge's appointment for the health care task area.

According to plans for a Mental Health Assistance Act (BayPsychKHG), the police should register who was forcibly housed or who can be proven to be a danger to others. A law that doctors misuse in the sense of danger prevention to catch and hold on to alleged threats is an abuse of psychiatry. Critics also speak of the stigmatization of the mentally ill. According to the original draft, more generally everyone who receives psychiatric inpatient treatment should be registered with the police.

Daily stay outdoors

In North Rhine-Westphalia, § 16 PsychKG NRW stipulates: “The hospital operator must allow the daily stay outdoors, usually for at least one hour.” According to § 16 PsychKG Rhineland-Palatinate, the following applies: “The accommodation is therapeutic, taking into account Adapt aspects to the general living conditions as far as possible. This also includes regular occupation, suggestions for the organization of leisure time and the daily stay outdoors. ”According to § 24 PsychKG Bremen:“ The patient is to be allowed to stay outdoors regularly. ”

According to § 25 PsychKHG in Baden-Württemberg: "Special security measures are only permitted if and as long as there is a significant current risk to the security of the recognized facility, in particular in the case of significant self-endangerment, the endangerment of significant legal interests of third parties or if the person accommodated the facility wants to leave without permission, and this danger cannot be countered with less intrusive means. (...) Special security measures are: 1. the restriction and the withdrawal of the stay in the open air, ... "In Lower Saxony according to § 21c NPsychKG" the withdrawal or the restriction of the stay in the open air "applies as a" special security measure ". In Hesse as a "special security measure" according to § 21 PsychKHG.

Visits and telecommunications

According to § 22 PsychKG North Rhine-Westphalia: “Those affected have the right to receive regular visits. (...) Further details can be regulated by house rules. (...) For the use of telecommunication means ... accordingly. "

According to § 25 Abs. NPsychKG applies in Lower Saxony: "The accommodated person has the right to send and receive letters, telegrams or parcels freely and to make telephone calls freely, as far as this right is not restricted according to paragraph 2."

Care of the patient by an authorized representative

Includes one having a power of attorney related living will , the patient psychiatric treatment fails, this is according to a decision of the OLG Hamm an accommodation on the basis of § 11 PsychKG North Rhine-Westphalia not answer when accommodation to avert imminent danger of suicide is needed and precaution Agents cannot guarantee the protection of the person concerned. Due to the current risk of suicide, in the opinion of the court, those limits have obviously been exceeded within which a mentally ill person is to be given the "freedom to be ill". The state is empowered to protect sick people from themselves.

renewal

If the placement is based on an interim order for provisional security, it may only be provided for a period of six weeks and not exceed a total of three months.

literature

  • Cornelia Bohnert: Right of placement. Beck-Verlag, Munich 2000, ISBN 3-406-47174-9 .
  • Horst Deinert : Caregiver activity and deprivation of liberty according to the laws for the mentally ill. In: BtPrax . Volume 9, No. 5, 2000, pp. 191-194.
  • Horst Deinert, Wolfgang Jegust: The right of the mentally ill. Text collection. 2nd Edition. Bundesanzeiger Verlag, Cologne 2006, ISBN 3-89817-477-8 .
  • Christian Kopetzki: Outline of the right of accommodation. Springer, Vienna / New York 1997, ISBN 3-211-82890-7 . (f. Austria)
  • Rolf Marschner, Bernd Volckart , Wolfgang Lesting: Deprivation of liberty and placement. 5th edition. Verlag CH Beck, Munich 2010, ISBN 978-3-406-60554-3 .
Scientific investigations
  • Aart Jan Verijlandt: Compulsory measures in a European comparison. (PDF file; 1.34 MB). In: Johann Kebbel, Niels Pörksen (ed.): Violence and coercion in inpatient psychiatry. Cologne 1998, ISBN 3-7927-1737-9 , p. 49.
  • Wolf Crefeld: Help out of compulsion - or compulsion out of helplessness. Introduction to the topic. In: Karl-Ernst Brill (Ed.): Ten Years of Care Law: Qualification of Implementation or New Legal Reform? Recklinghausen 2002, ISBN 3-936644-00-4 , p. 219 f.
  • H. Steinberg: 25 years after "reunification": attempt to provide an overview of psychiatry in the GDR. Part 1: Postwar Period, Pavlovization, Psychopharmacological Era and Social Psychiatric Movement . In: Advances in Neurology and Psychiatry. 2016, pp. 196-210.
  • H. Steinberg: 25 years after "reunification": The attempt to provide an overview of psychiatry in the GDR. Part 2: From pluralistic perspectives and the collapse in the 1980s . In: Advances in Neurology and Psychiatry. 2016, pp. 289–297.

Web links

Individual evidence

  1. ↑ Norbert Jachertz: social psychiatry in the GDR: The unfinished reform. In: Ärzteblatt . 110 (38), 2013, pp. A-1732 / B-1528 / C-1504.
  2. ↑ Lena Hennings: The history of the origins of the Rodewian theses in the context of psychiatry, social hygiene and rehabilitation medicine of the GDR University dissertation. Lübeck 2015.
  3. ↑ aekno.de
  4. ↑ a b United Nations Human Rights Council: Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez; A / HRC / 22/53, paragraph 35 and 65.f.
  5. ↑ BVerfG, decision of March 23, 2011 - 2 BvR 882/09
  6. ↑ BVerfG, decision of October 12, 2011 - 2 BvR 633/11
  7. ↑ BVerfG, decision of February 20, 2013 - 2 BvR 228/12
  8. ^ Journal of the GDR I 1968, p. 273.
  9. ↑ Federal Law Gazette 1990 II p. 885
  10. ↑ A law that brings fear and terror. In: www.sueddeutsche.de. April 22, 2018. Retrieved April 29, 2018 .
  11. ↑ Florian Bruns: Psychiatry Act in Bavaria: The dangerous lunatic in our heads. In: time online. April 28, 2018. Retrieved April 29, 2018 .
  12. ^ Higher Regional Court Hamm, order of December 19, 2006 - Az .: 15 W 126/06
  13. ↑ Lübeck Regional Court, decision of February 4, 2015, Az. 7 T 29/15