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Simulation and reduction of coercive measures in psychiatry (SRZP)

Head of research group: PD Dr. Stephan Debus

English version

Background

The professional use of coercion in psychiatry (such as forced medication, forced restraint, isolation) is one of the measures that deprive people of their liberty and place a great deal of strain on all those involved (patients, relatives and professional teams), albeit to varying degrees. Coercive measures on acute psychiatric wards involve patients and all clinical professional groups, but sometimes also external staff from the police, courts, fire department or ambulance service. The social relevance of the topic (around 200,000 - 300,000 restraints per year in Germany in adult psychiatry alone) is undisputed in the scientific literature.

The extensive research on dangerous situations in acute psychiatric wards suggests that violence and coercion only occur more frequently in certain situations, at certain times and in certain places, e.g. in front of duty rooms or closed ward doors, often on Monday mornings when therapy programs begin, or at lunchtime when the teams are less available for discussions. In such situations, patients and teams seem to challenge each other and push each other to their limits. A coercive measure is ultimately a testimony to the fact that Communications fails - "a psychiatric accident": the attempt to resolve conflicts in dangerous situations without coercion fails.

The LRCP project investigates the emergence and course of violence and coercion in psychiatric dangerous situations. The central question is: what happens between the actors in psychiatric dangerous situations in which coercion and violence either escalate or de-escalate? Which dangerous situations can be compared or distinguished by which communication characteristics? What distinguishes dangerous situations in which de-escalation is possible from those that escalate? What rules govern the interactions?

Overarching goals

Based on a linguistic and situation-theoretical approach, the overarching aims of our research group are to...

  • Reconstruction of psychiatric risk situations
  • Identification of linguistic patterns in the course of interactions with the help of locutionary and illocutionary aspects of speech acts
  • Identification of regulative and constitutive rules that control interaction patterns
  • Identification of the communicative conditions for success (conditions of success, seriousness and truthfulness) of utterance acts in psychiatric endangerment situations
  • Systematization of the process dynamics of dangerous situations with the help of decision trees;
  • Classification and typology of dangerous situations
  • Development of scientifically supported alternative scenarios for the use of psychiatric coercion

Scientific collaborations

External (Germany-wide):

  • Klinikum Region Hannover, Psychiatry Langenhagen
  • Hannover Region Clinic, Forensic Psychiatry, Wunstorf
  • Hanover Social Psychiatric Contact Center
  • Psychodrama Forum, Berlin
  • Technical University of Berlin, Center for Semiotics
  • Helmut Schmidt University, Hamburg, Department of Mathematics, Statistics
  • Hanover University of Applied Sciences and Arts, Faculty V, Department of Social Work
  • University of Hagen, Faculty of Cultural and Social Sciences

External (international):

  • Alpen-Adria-Universität Klagenfurt, Faculty of Cultural Studies, Austria

Equipment

The SRZP project cooperates with the Institute for Cultural Semiotics. The Institute provides a seminar hall that functions as a "social lab" and is specially equipped for video recordings. The "social lab" is networked with a video production studio. The videos are made available via an inter-university internet platform for analysis by students from colleges and universities as part of their doctoral, Master's and Bachelor's theses:

Participatory Internet Portal Psychiatry (PIPP): https://www.pipp.pro.

Research group members

Head of research group

PD Dr. Stephan Debus

University lecturer, SRZP project leader

Phone: +49 05103 7067743

Fax: -49 5103 7045892

Debus.Stephan@mh-hannover.de

Publications [PMID]: 9816602, 30743302, 30743305, 30743306, 30743307

Other positions:

  • Member of FA Research, Deutsch. Gesell. Soc. Psychiatry (DGSP)

  • Spokesperson of the FA "Network: Psychiatry without Violence" (DGSP)

  • Member of the advisory board of the German Society for Semiotics (DGS)

  • Head of the Institute for Cultural Semiotics, Wennigsen;

  • Editor of the Journal for Semiotics for many years.