[The legal basis for the work of the sociopsychiatric services in Germany]

Abstract

Introduction: The legal basic principles of community mental health services or sociopsychiatric services (SpDi) in the Federal Republic of Germany are state, not federal laws, namely laws on help and protective measures for mentally disordered people (PsychKG) and laws on Public Health Services (ÖGDG) as SpDi are all integral parts of Community Public Health Authorities in most places. State laws of the 16 German states differ considerably. Earlier research on PsychKG focussed exclusively on involuntary hospitalisation, this work is the first to address PsychKG as related to the work of SpDi and to consider ÖGDG as well.

Methods: Based on an internet-based literature review the expedient laws of the 16 German states were systematically reviewed and compared.

Results: There is an ÖGDG in 15/16 states, a PsychKG in 12/16 and some laws concerning SpDi in 13/16. Where ÖGDG has health support to socially disadvantaged people, there is also a law on SpDi. SpDi are mainly part of the municipal or county health authorities except for 3 states without PsychKG. Where there is a legal basis, SpDi fulfills the 5 core tasks of counselling and support, crisis intervention, psychiatric expertise, coordination of mental health services and controlling of mental health institutions.

Conclusion: In every day practice, the "Recommendations of the Board of Experts" of 1988 are more relevant than the actual state laws. However, where no such law has been passed, the impact of the "Recommendations" was much weaker. As PsychKG and ÖGDG do not warrant individual claims, but give only general indications of action, precise standards of practice are needed, as they were recently formulated in the state of Schleswig-Holstein. The UN Convention on the rights of disabled persons with its claim to more assistance may be facilitating the process of further development of state laws and to the work of the community mental health services based on them.