Hospitals and psychiatric institutions of the medical and therapeutic staff, psychologists as well as social workers had completed the training (less than 10% respectively). All staff with patient contact should have adequate competence in the field of de-escalation in the interest of violence prevention. The NPM is thus of the view that an incentive system should be created in the medical facilities to ensure that as many employees as possible from all professions take part in de-escalation management training programmes. In addition to corresponding basic training, regular detailed courses should be offered. XX  All staff of the medical facility with patient contact should take part in de-escalation training programmes in the interest of comprehensive violence protection. 2.2.8 Structural deficits Protection of privacy and personal space In the year under review, the NPM once again observed that, due to the confined space in psychiatric hospitals, the personal space of the patients is often not adequately safeguarded. Patients are still often cared for in shared rooms, which are only provisionally divided by folding screens. The legal entities behind the medical facilities regularly promise to refurbish existing buildings and construct new facilities. The implementation of such measures, however, can usually only be expected in several years’ time. From the NPM’s point of view, interim solutions are thus necessary in order to improve the care situation of the patients. It can be stressful for patients who are not suffering from a cognitive disorder if they are taken care of in a ward together with patients who have considerable care needs or are seriously cognitively impaired. This can cause sleep problems which can in turn require more of the prescribed sleeping pills. It would therefore be expedient to take care of patients with predominantly neurological complaints in combination with pain symptoms or depression in “quiet” wards. This applies to persons suffering from dementia in particular, for whom the unfamiliar surroundings, strangers, unfamiliar rooms, unfamiliar routines and requirements are frightening. If multi-morbidity or the severity of the psychiatric disease so require, a specialised geriatric psychiatric service is necessary for these patients. Therapy conversations in shared rooms 58 A massive infringement of the privacy and personal space of patients also occurs when they are informed about their diagnoses and treatment in meetings with the staff held in front of other patients or visitors in the room or in the hallway. Observations made on a visit to Zwettl Regional Clinic indicated that doctors