Neuregelung des § 64 StGB aus psychiatrischer Sicht – Positionspapier einer Task-Force der DGPPN

Müller, Jürgen; Böcker, F; Eusterschulte, Beate; Köller, M.; Muysers, Jutta; Pollmächer, Thomas

doi:10.1007/s00115-021-01109-w

Cited by 16 publications

(7 citation statements)

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“…Although merely 33% of FCDD responded to our postal survey, 2,483 patients were included in the study, and thus more than 50% of all patients treated in FCDD in Germany in 2018 were represented in our sample ( 2 ). Of 823 patients that ended the therapy in 2018, 53% were relocated to prison, which aligns with the published data on unsuccessful treatments ( 2 , 17 ). As expected, variability in the clinical practice regarding OAT is high and availability relatively low in FCDD in Germany.…”

Section: Discussionmentioning

confidence: 99%

“…In Germany, specialized psychiatric-psychotherapeutic care is offered in FCDD to offenders that committed a crime in combination with a substance use disorder. These FCDD are typically separated from general forensic psychiatric care, and bed capacity in FCDD in Germany is continuously rising, with 1,230 patients in the year 1994 and 4,500 patients in treatment in the year 2021 ( 2 , 14 – 16 ). The rationale for these specific treatment institutions is that some committed crimes are supposedly connected to an individual substance use disorder and by offering an intensive treatment possibility for these patients, in theory, the risk for relapse and re-incarceration after release can be diminished.…”

Section: Introductionmentioning

confidence: 99%

“…Studies suggest that successful treatment participation is associated with higher rates of abstinence and fewer criminal relapses ( 3 ). But, it is important to note that studies repeatedly described a rate of about 50% when it comes to unsuccessful treatment termination in FCDD ( 2 , 17 ). Unsuccessful treatment termination leads to a transfer into general prison facilities, where OAT is (often) available, but specific psychotherapeutic interventions or group therapy is lacking.…”

Section: Introductionmentioning

confidence: 99%

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Availability of opioid agonist treatment and critical incidents in Forensic Clinics for Dependency Diseases in Germany

et al. 2022

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BackgroundPrevalence of substance use disorders, especially opioid use disorders, is high in patients admitted into forensic psychiatric settings. Opioid agonist treatment is a safe, well-established, and effective treatment option for patients that suffer from opioid dependence. Surprisingly, data on the availability and practice of opioid agonist treatment (OAT) options in German Forensic Clinics for Dependency Diseases is rare. Furthermore, essential data on the prevalence of critical incidents such as violent behavior, relapse, or escape from the clinic are missing for this particular treatment setting.Materials and methodsWe conducted an observational study on all forensic addiction treatment units in Germany (Sect. 64 of the German Criminal Code). A questionnaire on the availability and practice of OAT was sent to all Forensic Clinics for Dependency Diseases in Germany. Following items were assessed: availability and the total number of patients that received an OAT in 2018, available medication options, specific reasons for start and end of OAT, number of treatments terminated without success, number of successful treatments, and critical incidents such as violent behavior, relapse, escape and reoffending. We compared the forensic clinics that offered OAT with those that did not offer this treatment option. The data were analyzed descriptively. Mean and standard deviation was calculated for metric scaled variables. For categorical variables, absolute and relative frequencies were calculated. The two groups (OAT vs. Non-OAT institutions) were compared concerning the given variables by either using Fishers exact test (categorical variables), t-test (normally distributed metric variables), or Wilcoxon-test (metric variables not normally distributed).ResultsIn total, 15 of 46 Forensic Clinics for Dependency Diseases participated in the study (33%). In total, 2,483 patients were treated in the participating clinics, 18% were relocated into prison due to treatment termination, and 15% were discharged successfully in 2018. 275 critical incidents were reported: violence against a patient (4%), violence against staff (1.6%), escape (4.7%) and reoffending in (0.5%). In seven clinics treating 1,153 patients, an OAT was available. OAT options in forensic clinics were buprenorphine/naloxone, buprenorphine, methadone, and levomethadone. Regarding critical incidents and successful discharge, no differences were detected in the clinics with or without an OAT. In the clinics that offered an OAT, we found a significantly higher rate of treatment termination without success (p < 0.007) in comparison to clinics without an OAT program. Ninety-nine patients received an OAT, and this treatment was ended due to illegal drug abuse (57%), refusal to give a urine drug sample (71%), and cases where the OAT was given away to other patients (85%).ConclusionIn Forensic Clinics for Dependency Diseases in Germany, OAT is not available in every institution, and thus, access is limited. Critical incidents such as violent behavior against staff or patients and escape are not uncommon in these forensic treatment settings. Further studies are needed to enhance the understanding of OAT practice and the risks for patients and staff.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Availability of opioid agonist treatment and critical incidents in Forensic Clinics for Dependency Diseases in Germany

et al. 2022

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“…Bezogen auf das gesamte Behandlungsangebot der Klinik konnte anhand der vorliegenden Daten kein Nachteil für Patienten, die zu nächst das verkürzte Therapieprogramm nicht erfolgreich ab schließen können, belegt werden, sodass der weitere Einsatz des [17,18] lassen sich alleine anhand der bisherigen klinischen Erfahrung der Autoren im Hinblick auf das oben skizzi erte Therapieprogramm einige forschungsrelevante Problemfelder definieren, die der Beachtung bedürfen:…”

Section: Schlussfolgerungenunclassified

Verkürzte Therapiekonzepte im Maßregelvollzug gemäß §64 StGB: Ein maßgeschneiderter Behandlungspfad?

Praus

Biebinger²,

Bepler³

et al. 2022

Fortschr Neurol Psychiatr

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ZusammenfassungDie forensische Therapie gemäß §64 StGB zeichnet sich aktuell durch hohe Abbruch- bzw. Erledigungsquoten aus. Das hier vorgestellte verkürzte Therapiekonzept der Klinik für Forensische Psychiatrie des Pfalzklinikums für Patienten mit günstigen Prognosemerkmalen soll durch Förderung von Eigeninitiative, Verantwortung und Motivation sowie eine möglichst individualisierte, störungsorientierte, strafzeit- und tatangemessene Behandlung mit intensiver Erprobung unter Alltagsbedingungen zu einer Verkürzung der stationären Unterbringung führen. Empirische Belege hierfür fehlen jedoch bislang. Erstmals werden hier Pilotdaten aus dem Zeitraum April 2016 bis Mai 2021 vorgestellt. Zusammenfassend hat sich das o.g. Konzept als umsetzbar erwiesen. Die erhobenen Daten weisen darauf hin, dass die im verkürzten Therapieprogramm behandelten Patienten eine geringere Erledigungsquote als der Durchschnitt aller gemäß §64 StGB untergebrachter Patienten aufweist. Eine deutliche Verkürzung der durchschnittlichen Behandlungsdauer ließ sich demgegenüber jedoch nicht belegen. Die vorliegende Arbeit will einen ersten Beitrag zur Diskussion und Weiterentwicklung derartiger Behandlungsoptionen leisten. Mögliche Nachteile derartiger Therapieangebote bei für ungeeignet befundenen Patienten, z. B. eine Abnahme der Therapiemotivation, werden diskutiert.

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“…Vervielfältigung nur mit Zustimmung des Verlages. [26] ist in den letzten Jahren vielfach wiederholt kritisiert worden [11,17,18,28]. Die Kapazitätsgrenzen sind längst erreicht [18,28].…”

Section: Introductionunclassified

Neufassung des § 64 StGB und dessen Bedeutung für die Unterbringung von suchtkranken Rechtsbrechern im Maßregelvollzug

Soyka

2024

Nervenheilkunde

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ZUSAMMENFASSUNGZum 01.10.2023 ist die Neufassung des § 64 StGB, der die Maßregel (Unterbringung psychisch kranker Rechtsbrecher mit Suchterkrankungen) bedingt, in Kraft getreten. Die Neufassung zielt auf eine deutliche Beschränkung der Zahl der nach § 64 StGB untergebrachten Straftäter ab. Das Vorliegen und der Schweregrad einer Substanzkonsumstörung, ihre Bedeutung (Zusammenhang) mit der angeklagten Anlasstat und die Erfolgsaussichten einer Unterbringung nach § 64 StGB müssen genau begründet werden. Die Neufassung wird erhebliche Bedeutung für die Gutachtens- und Rechtspraxis haben.

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Neuregelung des § 64 StGB aus psychiatrischer Sicht – Positionspapier einer Task-Force der DGPPN

Cited by 16 publications

References 1 publication

Availability of opioid agonist treatment and critical incidents in Forensic Clinics for Dependency Diseases in Germany

Availability of opioid agonist treatment and critical incidents in Forensic Clinics for Dependency Diseases in Germany

Verkürzte Therapiekonzepte im Maßregelvollzug gemäß §64 StGB: Ein maßgeschneiderter Behandlungspfad?

Neufassung des § 64 StGB und dessen Bedeutung für die Unterbringung von suchtkranken Rechtsbrechern im Maßregelvollzug

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