management”. Commission 4 observed that elderly patients in Vienna remain hospitalised for a lengthy period of time even though this may not be medically necessary, as they could not be discharged without subsequent care being ensured. The organisation of adequate care at home or placement in short- or long-term care facilities requires time and – above all – the support of third parties. It is not a rare occurrence for legal guardians to be appointed during this phase and this extends hospital stays even further. Hospitalisation Health complications can occur in such situations. Hospitalisation can namely promote the occurrence of delirium, especially in the case of elderly patients. In a hospital setting, their psychosocial needs cannot be met and non-pharmacological, therapeutic occupational offerings cannot be adequately provided. The Municipality of Vienna has reacted to this problem area insofar as a simplified application and approval process for subsidies for short- and long-term care is being tested within the scope of a pilot project. In psychiatry, there is an underlying conflict between coercive measures and therapeutic objectives, as they also have a role in preserving order. This regulatory obligation is frequently used as a reason for restricting the freedom of patients if they are a danger to themselves or others. Coercive measures are necessary under the standardised conditions set out in the Hospitalisation of Mentally Ill Persons Act (Unterbringungsgesetz), which are a prerequisite for admissibility. International studies show, however, that the use of measures that restrict freedom in psychiatric wards varies a great deal and cannot be explained using objective criteria. It can be assumed that a targeted preventive strategy can reduce the frequency of measures that restrict freedom. It is and remains a core responsibility of the NPM to initiate and promote such strategy. Psychiatry As far as the question is concerned how best to avoid restrictions of freedom, one must begin with the risk factors. It is scientifically substantiated that there is a strong correlation between measures that restrict freedom and aggressive behaviour. An effective prevention strategy must therefore include measures that are suitable for the prevention of violence and aggression and that can have a deescalating effect in already existing violent situations. As violence and aggression are also always consequences of social interaction, the propensity for violence on the part of patients is significantly influenced by how relationships are managed and by the attitude of the clinic management in this regard. The institutional conditions are also relevant to the prevention of violence. These include spatial circumstances (appropriate occupancy, distribution of patients with a higher potential for violence), as well as organisational processes. Clear and transparent structures result in a lower occurrence of aggressive incidents; when Scientifically substantiated risk factors 45