Open doors, open mind. Plea for an open treatment psychiatry

Patients who are committed against their natural will are regularly accommodated in closed wards in Germany. Only afew clinics treat patients who have been involuntarily committed on open wards. On the basis of own clinical experience and relevant study results, closed and open wards are compared with respect to the extent of aggression and coercive measures, the risks of absconding and suicide. Compared to open wards, closed wards are unlikely to reduce the risk of absconding, do not result in adecreased suicide rate and do not result in areduction of aggressive behavior. In contrast, coercive measures seem to be practiced more frequently in closed wards. Therefore, the regular practice of accommodation in closed wards should be revised.