Soft cell
Under padded cell (colloquially padded cell , formerly: Tobzelle ), isolation , separation or crisis intervention room is understood in psychiatry an enclosed small room where patients during severe psychopathology can be induced seizures in which they endanger himself or others yourself kept. They are designed with padded walls, floors, and other safety precautions.
background
Padded cells have a long tradition in classical psychiatry . Because the term has less negative connotations, these spaces are now referred to as soft cells. They represented a response from psychiatry to the risk of self-harm of the patients to be treated. In addition to straitjackets , padded cells were fixed terms that were associated with psychiatric clinics (formerly known as madhouses) and the often inhuman or inhuman treatment. Since patients can now be sedated by drug treatment with special drugs , straitjackets and padded cells have only rarely been used in most industrialized countries since the 1980s.
prehistory
In 1784, Emperor Joseph II had a “building for the reception and healing of the mentally ill ” built in Vienna , which was later also referred to as the “madhouse” or the “ fool's tower ”. The first primary physician started his work there after 30 years. The first occupants of the building were admitted on April 16, 1784. Up until then, the mentally ill were housed in prisons together with criminals. With this new facility, they could for the first time receive medical care from their own doctor or be treated in a general hospital. The staff and caregivers were forbidden to abuse the patients, which was also an innovation. Medicines that were used (albeit sparingly) for therapy included Epsom salts , emetic tartar, and cinchona bark . Ice water was also poured over the skin for treatment. In 1839, the physician Michael Viszanik (1792–1872) stipulated that the chains with which “the raging lunatics” were fixed for their own protection and that of their fellow patients were finally banned from treatment. It was 3000 kg of iron that was removed.
In the 19th century, it was common in psychiatry to put a patient who was experiencing a fit of madness in a straitjacket, an invention of Benjamin Rush . Since, despite this jacket, there was still the risk that the patient might hit his head against the wall, for example, he could also be accommodated in a padded cell. With the introduction of neuroleptics in the 1950s, patient restraint or accommodation in soft cells became almost superfluous.
Structure and equipment
A rubber or soft cell contains only a small number of items. The furniture consists of rubber-like soft materials, and all accessible walls, floors and ceilings are lined with foam . Such soft cells or crisis intervention rooms are sometimes also found in modern hospitals. The equipment includes a daybed and a seat, both made of rubber-like soft material. Often, smaller, foam-filled bodies, on which the patient can react, are enclosed. The floor and walls are sometimes lined with foam and covered with a durable, very strong plastic film. Windows, if present, are attached at the top or can only be pushed open a small gap. The soft cell must also have a viewing window in the door that allows every corner of the cell to be seen; cameras are often installed instead in more modern systems. The ceiling light can only be switched on and off from outside by the staff.
Security measures in the penal system
In the Federal Republic of Germany's Law on the Execution of Measures , “isolation” is set down as one of several permissible security measures . If a doctor orders a patient to be segregated, they will be accommodated for a limited period in a specially secured room (crisis intervention room, KIR) without any hazardous objects. This should in particular serve to protect the patient from self-harm. Endangering third parties (fellow patients or employees) should also be excluded in this way.
The coercive measures in the penal system are primarily intended to protect the patient. The psychiatrist and doctor Nahlah Saimeh from Lippstadt says: “The psychiatric crisis interventions are of course situations in which doctors and nursing staff become active together. A medical coercive measure, also a restraint, also a secretion with a certain observation status can only be ordered by a doctor and medication can only be given by a doctor. But if, for example, it is a question of participating in restraint, then when a patient is at great risk himself, for example in the context of suicidal behavior that cannot be otherwise averted , then the nursing staff is also involved. "
Web links
- Sharon Osbourne locked Kelly in the rubber cell on focus.de.
- Separation experience in the crisis intervention room on forensik.de
Individual evidence
- ↑ Soft cell / rubber cell on pons.com, accessed on May 24, 2014.
- ↑ a b Straitjacket and padded cell ( memento from April 17, 2017 in the Internet Archive ) on springermedizin.at, accessed on May 24, 2014.
- ↑ a b Irrenhaus on ntz.de, accessed on May 24, 2014.
- ↑ Borwin Bandelow: Kurzlehrbuch Psychiatrie Steinkopff, Heidelberg 2008, ISBN 978-3-798-51836-0 , p. 204.
- ↑ § 36 on forensik.de, accessed on May 24, 2014.
- ↑ Separation experience in the crisis intervention room on forensik.de, accessed on May 24, 2014.
- ^ Annette Wilmes : Criminal offenders in psychiatry - Federal Constitutional Courts decide on the privatization of the penal system on deutschlandfunk.de