Order accommodation for mentally ill people

A court can order the placement of a mentally ill person in a psychiatric hospital against his or her will .

A medical examination must take place beforehand.

The mentally ill person must be accommodated, treated and cared for in such a way that the encroachment on his or her personal freedom is kept to a minimum. However, they must tolerate measures that ensure safety and order in the facility or protect themselves.

Children and adolescents shall be accommodated and cared for separately according to their illness and stage of development. Treatment shall take place in specialised departments of child and youth psychiatry.

During placement, the mentally ill person is entitled to the necessary curative treatment.The treatment also includes examination measures as well as measures that are necessary to enable the accommodated person to live independently in the community after release.

Insofar as the accommodated person is capable of giving consent, he or she must agree to the treatment. The person must have been adequately informed by a doctor beforehand and their consent must be based on their free will. However, the consent of the accommodated person is not required if, due to his or her illness, he or she has no capacity to understand the necessity of the treatment in order to avert further harm.

Prerequisite

  • The person is ill or disabled due to a mental disorder.
  • The mentally ill person, as a result of his or her mental disorder or disability, significantly endangers his or her life or health, or the mentally ill person, as a result of his or her mental disorder or disability, poses a significant present danger to the legal interests of others.
  • The endangerment or danger cannot be averted in any other way.

Responsible department

  • For the order of accommodation: The guardianship court (local court)
  • For the application for accommodation: The lower administrative authority (Ordnungsamt)

The lower administrative authority is,

  • if their place of residence is in a city district: The city administration
  • if your place of residence is in a rural district: The district administration office or, in large district towns and in associations, the district administration itself

Note: If the mentally ill person is already in a recognised institution, this institution is also entitled to apply.

Procedure

The authority must first apply for the accommodation in writing to the guardianship court. Only then can the court order it.

This also applies to

  • temporary accommodation,
  • accommodation for observation and preparation of an expert report.

If the court orders accommodation, the lower administrative authority is responsible for carrying out the accommodation. It selects, for example, the suitable facility. When making the selection, it should take into account the wishes of the mentally ill person as well as therapeutic aspects. In addition, the authority tries to place them as close to their place of residence as possible.

Notice: In urgent cases, a facility may admit or detain a person before placement has been requested or ordered. The reasons for this caring admission and restraint must be supported by a medical certificate. Only in very urgent cases, so-called "emergency presentations", can this be waived.

In the case of a caring admission and restraint:

The institution must send the accommodation application to the court no later than the end of the second day following the custodial admission or restraint. If the admission or restraint falls on a Friday, the application for accommodation must be submitted no later than noon on Monday. If it is not sent, the patient must be discharged.

However, the mentally ill person may also voluntarily remain in the facility.

The accommodated person must be discharged when

  • the period of placement has expired and no further placement has been ordered,
  • the placement order has been revoked,
  • the court has not ordered placement in the case of caring admission and restraint at the latest by the end of the day following receipt of the application,
  • the reason for the placement has ceased to exist.

Notice: If the continuation of the placement is necessary, the recognised institution shall file an application for continuation of the placement with the court in due time.

Deadlines

immediately

Required documents

  • Presentation of the facts by the lower administrative authority
  • Medical certificate from a health authority. It should state:
    • Current state of illness,
    • Need for accommodation,
    • expected duration of treatment,
    • Information as to whether the court can hear the person concerned orally without significant detriment to his or her state of health.

The certificate of a doctor from a recognised institution can replace the certificate of the health authority. However, it must be signed by a specialist in psychiatry and psychotherapy. In the case of children and adolescents, a specialist in child and adolescent psychiatry and psychotherapy must sign.

Note: If a certificate is not yet available at the time of application, it must be submitted as soon as possible.

Costs

No costs are incurred for the activities of the lower administrative authorities.

Note: The costs for the accommodation itself must be borne by the accommodated person, his or her payer (for example, the health insurance fund) or the breadwinners.

Miscellaneous

In addition to the administrative authority (or the recognised institution), the following institutions can also apply to the court for accommodation:

  • The guardian of a mentally ill person.
    Accommodation may be necessary because, for example, there is a risk that the person being cared for will kill him/herself. Is medical treatment necessary that the cared-for person cannot recognise as necessary because of his or her illness? Then the caregiver can also apply to the court for accommodation in this case ("civil" accommodation).
  • The court itself.
    The court can order accommodation if a mentally ill person or a person addicted to alcohol or drugs has committed an unlawful act ("criminal law" accommodation).

Appeal

Complaint

Release note

09.10.2023 Sozialministerium Baden-Württemberg