[People with mental disorders in East and West Germany: indicators of institutionalized care since reunification].

Abstract

OBJECTIVES: The aim of this study is to compare the historic development of indicators of institutionalized care for the mentally ill in East and West Germany since the political change of 1989. METHODS: Data on numbers of psychiatric beds, prison populations, the occupancy in forensic psychiatric institutions, in rehabilitation services, in supported housing units and involuntary admission rates are presented in historic time lines. Changes were calculated as a percentage. RESULTS: After 1989 general psychiatric bed numbers decreased by 61% and the prison population by 77% in East Germany both from initially higher to then lower rates than in West Germany. Since 1993 there has been an approximation of the numbers in East and West Germany. In both parts of Germany the forensic psychiatric bed numbers, supported housing and rehabilitation capacities have increased. Involuntary admission rates into general psychiatry are on the increase in both parts of Germany. They continue to be 3.3 times higher in West Germany than in East Germany. CONCLUSION: The harmonization of capacities in mental health care institutions between both parts of Germany was realized within a few years after reunification. Continuous differences remain regarding the involuntary admission rates.