When may one be committed in case of psychosis?
In technical jargon, forced admission is called accommodation under the Mental Health Act, often also referred to as PsychKG. In Germany, a person cannot usually be taken to an institution against his or her will or held there, as this is considered to be deprivation of liberty. Therefore there must be weighty reasons for the accommodation of a person according to the PsychKG, which are listed in the legal text: In the psychiatric field, the term “self-endangerment” or “endangerment of others” is usually used for the sake of simplicity.
Patients with an acute psychotic disorder may, under certain circumstances, be able to show the reasons mentioned for admission according to PsychKG. On the one hand, there is a mental illness, on the other hand, within the scope of the psychosis, there may be a danger to oneself or others. Examples of this would be the following: The ill person hears voices telling him to jump out of the window.
This is acute suicidal behaviour and thus self-endangerment. Another scenario is that the affected person hears voices that give orders that the affected person will do serious violence to other people. These are only exemplary examples to explain in which situations a placement (forced placement) can become necessary and justified.
In order to carry out such a placement, the public order office or the fire department must be called in, depending on the federal state and time of day. Furthermore, a medical certificate must be issued that explains the reasons for the planned accommodation. This must be delivered to the local court.
Within 24 hours a judicial hearing must take place. Until then, the sick person may be accommodated in a psychiatric institution against his or her will. Within this time – if absolutely necessary – forced medication is also possible, as well as the application of fixation measures. After these 24 hours, a judge must decide whether further accommodation of the patient is legal or whether the accommodation measures must be terminated.
- The person concerned must be mentally ill.
- There must be a significant danger to the person from himself or herself or
- There must be a substantial endangerment of legal interests of others by the person.
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