[Initial experiences in psychiatric emergency service. Comments on the prevention or indication of compulsory hospitalization in accordance with the Hamburg Law on Aid and Protective Measures in Mental Diseases (author's transl)].
On the basis of the rules of the Hamburg Law on Aid and Protective Measures in Mental Diseases, a psychiatric emergency service operates at night and on weekends. This emergency service is called upon to decide on the need for compulsory hospitalization and to prevent the same, if possible, via therapeutic alternatives. The article illustrates by documents an initial phase of the activities of this public service. Within the framework of a preliminary study, 63 recorded incidents of service by four physicians are presented who collected data on the situation encountered by them at the time of examination, on the social and anamnestic background of the patients, on their psychiatric evaluation and on the indication for compulsory hospitalization or alternative treatment methods. 22% of the patients were subjected to compulsory hospitalization. Provisional hypotheses on the conditions under which compulsory hospitalization becomes more probable, are developed from the recorded data. The concept of the risk situation is specially reflected upon. The therapeutic possibilities in connection with institutional factors are discussed with a view to promote further development of crisis intervention in the sense of preventing compulsory hospitalization.