National Preventive Mechanism XX Psychiatric care services must be aligned to the respective needs with as few restrictions for the individual as possible. Sufficient services meeting these criteria must be made available and further developed. XX Transfers of patients requiring hospital placement must be avoided where possible and must be accompanied by psychiatrically trained personnel. 5.2.7 Involuntary placement without doctor‘s certificate as the norm? The law on involuntary placement distinguishes two types of forced hospitalisation: the regular case with doctor’s certificate and the emergency case, i.e. in the event of imminent danger and without a doctor’s certificate. Public safety officers are thus authorised and obliged in general to bring a person, who they consider requires involuntary placement for certain reasons, to a doctor, or to call a doctor. If the doctor certifies that the conditions for involuntary placement are given, the police must bring the person affected to a psychiatric ward or organise the same. Only in the event of imminent danger can the police bring the person affected to a psychiatric ward without a medical examination and doctor’s certificate. In reality however, the exception is becoming the rule. In rural areas in particular it can be observed that the relevant qualified doctor for examinations and certificates pursuant to the Hospitalisation of Mentally Ill Persons Act is often not available. In some regions, it is becoming increasingly difficult to fill permanent positions or to find municipal, county, parish and district doctors. Outside cities the exception is becoming the rule Police officers have made it clear in interviews with commissions that it is extremely stressful for them to have to decide autonomously whether a person displaying behavioural disorders is suffering from an illness which, due to acute and considerable harm to themselves or others, justifies the involuntary placement in a psychiatric hospital. It also happens that the originally perceived escalation eases during the forced hospitalisation and that doctors in the psychiatric ward then do not see a reason for admitting the person. This repeatedly causes conflict between all of those involved and questions the legitimacy of state actions. It is thus worth considering, for example, that emergency doctors and registered medical specialists for psychiatry be legally empowered to issue certificates pursuant to the Hospitalisation Act. XX The group of doctors authorised to issue the necessary certificate for involuntary placement should be increased in order to limit the autonomous assessment made by public safety officers to exceptions. 133