Joined in 2023 
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63 About this deal
IO, JV, GJ, and JG made substantial contributions to the conception and design of the qualitative subproject and GJ and JG to the conception and design of the quantitative subproject.JB, IO, and JG recruited and interviewed the participants in the qualitative subproject. The qualitative data were analyzed and interpreted by SE, JB, JK, IO, and JG. JK, BU, H-JA, SZ, PN, GJ, and JG managed the collection and preparation of the quantitative data, which were mainly analyzed and interpreted by SE and JG. SE, JB, and JG wrote the first draft of the manuscript. All authors read the manuscript and were involved in revising and finalizing it. Funding
Some of the writing on the drawings is, as Adamson put it, esoteric. One drawing, done in the art studio on a large sheet of paper (and with a pencil), includes the following set of words, which I couldn’t help thinking may have been partly inspired by Stevenson. For how long had that book been his only companion? But I knew I had to do it, because my journey around the coast of Ireland with the donkey was tremendous. And it would be a failing of mine if I could never put that on paper. Regarding the relationship between ward atmosphere and patient satisfaction, the only correlation we found was with the subscale of “Therapeutic Hold.” As this statistical correlation was only small to moderate, there seems to be no strong relationship between the two scales. This is in line with previous studies ( 48, 49) and supports the assumption that ward atmosphere and patient satisfaction are rather independent from each other. On the other hand, the interviewees in the qualitative subproject saw a relationship between satisfaction with treatment and the amount and quality of therapeutic offers. Other studies also assume a link between patient satisfaction and therapy, among others showing satisfied patients are more adherent to the treatments offered ( 36). However, the direction of the relationship between patient satisfaction and “Therapeutic Hold” in our study remains unclear. On the one hand, more satisfied patients might have experienced greater therapeutic hold. On the other hand, a greater therapeutic hold might have improved patient satisfaction. It would be interesting to investigate this relationship further in the specific context of involuntarily committed patients in the future. Strengths and Limitations He would never on any account be rough with a patient. Restraint and coercion were sometimes unavoidable, but must always be exerted with the utmost tenderness. After all it was a mercyseat. If singlehanded he could not handle a patient without hurting him, let him call the other nurses to his assistance …
Results
Instrumental to that future was a change in the nature of consent to the system. In the total institutions described by Goffman, the patients’ consent to their condition as patients differed little from acquiescence. And a kind of silent acquiescence was also required from people who lived on the outside, people who knew the institutions existed (and perhaps had family members inside) but preferred not to know too much about what went on in them. This was a model in which the institutions were wholly imbricated in the workings of the community, but at the same time wholly cut off – invisible to ordinary sight. A friend of mine from Dublin likes to play a kind of parlour game in which he asks locals to tell him the location of Grangegorman, the huge Dublin psychiatric hospital that was decommissioned in 2013. It’s on the north side, centrally located between Phoenix Park and O’Connell Street, and is now part of Technological University Dublin. But everyone puts it out in the country somewhere, or they guess at suburbs such as Artane or Santry or Ballymun. The hospital was and is an almost mythical building, both there and not there, looming large but impossible to locate. I was sorry I did not have a chance to look at a book of paintings done by patients. Many of them have never painted before, and to a psychiatrist I’m sure these paintings would tell volumes about the mental condition of a patient in different stages of his illness. None of them receives instruction. They just paint what they have in their minds and want to put on paper. The most important benefit of open doors regarding “Therapeutic Hold” was seen by all groups in the greater mutual respect between patients and mental health professionals, resulting in further positive effects for all groups. Zydalis Bauer: Much like the story that you just told, you take a humorous approach to a lot of these stories. I mean, when you hear psychiatric nurse or psych unit, psych ward, your mind tends to go to kind of a serious place, but you take a little bit of that seriousness out of it.
He would never on any account allow himself to be affected by the abuse, no matter how foul and unmerited, that would be poured out upon him. The patients seeing so much of the nurses and so little of the doctor, it was natural that they should regard the former as their persecutors and the latter as their saviour. I got this because I thought it would be the British equivalent of Behind the Gates of Gomorrah: A Year with the Criminally Insane by Stephen Seager which is a Good Read. But it wasn’t because Stephen Seager can write plain English and Dennis O’Donnell can’t. If he's not doing his infodumps, Dennis thinks he has to be performing in every sentence, he can’t say a single thing without it has to be in this blokey, slangy, self-regardingly comical voice which grated so badly I thought I would rather be watching a boxed set of Everybody Loves Raymond and at that point I pressed the EJECT button. I hate Everybody Loves Raymond.
Methods
All institutions participating were acute psychiatric hospitals located in the Ruhr Area in North-Rhine Westphalia, a federal state in Western Germany. They all had the obligation to admit involuntarily committed patient resident in a hospital’s defined catchment area. As the sizes of these catchment areas were different, the hospitals participating differed in the total number of beds (hospital 1: 464, hospital 2: 137, hospital 3: 159). The three hospitals pursued different strategies to manage involuntary commitments including different door policies. No hospital participating made major conceptual changes during the period assessed. of Psychiatry, Psychotherapy and Preventive Medicine, LWL University Hospital, Ruhr University Bochum, Bochum, Germany The quantitative subproject included a standardized documentation and assessment of all involuntary commitments over a period of 6 months, between September 2016 and March 2017, in psychiatric hospitals with different ward settings and door policies. The documentation and assessment started with the first and ended with the last day of the involuntary commitment. Five hospitals were initially recruited for the study, but only four hospitals finally participated in the study. The additional assessment of ward atmosphere and patient satisfaction using standardized questionnaires was conducted only in three hospitals, so only results from the latter will be presented in this paper. Hospital Description One thing that took some getting used to for me was the dialect that a lot of the dialogues are written in. Think Scotland, wee lassies and words being spelled exactly as they are said. Although it did have its charm, as well. Especially when you after a while are getting into it and can almost hear the Scottish dialect in your head. I had lost count of the amount of times I rang that day. I kept reiterating about how lost he was the day before; blank and expressionless. A mother's instinct, I knew something was not right and I was petrified he was going to try and kill himself," she emotionally told jurors. Support worker who found Niall did not have formal training on completing observations
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