Living in a forensic-psychiatric institution as a life perspective? – Quality of life and needs of long-term forensic psychiatric patients

Written by: Martin Feißt, Sabrina Wiecek, Bernd Dimmek and Inga Markiewicz

Across Europe an increase in the duration of the placement of patients in theforensic hospital can be observedas well as in GermanyThis development makes it imperative to deal with this topic and the related legalsocial and ethical issues. A cooperation between the LWL Academy of Forensic Psychiatrythe University of Witten/Herdecke and the Institute for Psychiatry and Neurology in Warschau, Poland,  an educational research project on quality of life of long-term patients in forensic hospital” has been taking place (up to and including the winter semester 2015/16).

The aim of this project is to attain a better understanding of the needs of patients on the basis of qualitative interviews with patients and staffwhich may be important for the design of the accommodation and for therapeutic purposes.

During the last 20 years the average duration of hospitalization of the mentally ill persons hospitalized under Section 63 of the StGB in Germany has risen dramatically. Accordingly, it is necessary to look more closely at the quality of life and needs of this clientele. This article provides an initial insight into a German-Polish cooperation project based on qualitative interviews with long-term patients in both countries.

In the light of system-theoretical considerations, it is proposed to operationalize the quality of life as a means of meaningful reference, in order not only to identify by dimensioning in factual, time and social dimensions where, depending on different subjects, meaning can be generated, but also how differently this can happen with regard to the same subjects.

This is concretized in two examples: First, it becomes clear how “work” is classified in very different ways by patients depending on the biography and the life situation.

Using the example of “intimate relationships and sexuality”, it becomes clear that dealing with this topic in practice can not be guided by formal rules and is therefore strongly influenced by the personal values of the staff.

First results and insights are presented here [in German].

Feißt, M., Wiecek, S., Dimmek, B. & Markiewicz, I. (2017): Der Maßregelvollzug als Lebensperspektive? – Lebensqualität und Bedürfnisse forensisch-psychiatrischer Langzeitpatienten. In: Saimeh, N. (Hrsg.): Abwege und Extreme. Herausforderungen der Forensischen Psychiatrie (Eickelborner Schriftenreihe zur Forensischen Psychiatrie). MWV Medizinisch Wissenschaftliche Verlagsgesellschaft, Berlin. S. 31-47