Hospitals and psychiatric institutions 2.2 Hospitals and psychiatric institutions 2.2.1 Introduction In 2020 the NPM commissions visited 28 medical facilities, including 19 psychiatric and 9 somatic clinics or departments. As early as 1999, the CPT recommended the Austrian Federal Government to stop the use of net beds in psychiatric clinics. The NPM has taken up this demand several times (see Annual Report 2013, p. 37 et seq.). Per decree of 22 July 2014, the Minister of Health forbid the use of psychiatric intensive beds (net neds) as well as other “cage-like” beds and granted a transition period until 1 July 2015. This gave rise to controversial discussions because without additional personnel it was feared there would be an increase in belt restraints. Surveys of patients indicated that they would not prefer any of the body-restricting measures in question to the net beds. Abolition of net beds The patient advocacy (Network for Patient Advocacy – VertretungsNetz) made it clear in 2020 that the negative fears did not materialise (Rappert/Gschaider, Auswirkungen der Abschaffung der Netzbetten in der Wiener Psychiatrie, ÖZPR 2020/64, issue 4, p. 114 et seq.). A total of 2,357 random sample placements from February 2014 to September 2017 in three Vienna hospitals were analysed in detail. The frequency and duration of net bed restrictions as well as restraints before and after the ban were recorded. The proportion of the placements in which there was a belt restraint remained unchanged after a brief rise, although in 14.3% of all placements the net beds were not used at all. Less severe restrictions such as bed side rails were used for around 3.7% of the patients. What is also positive is that the total duration of restrictions to freedom fell by 55.3% so that the freedom of every affected person was restricted for 17 hours less than before 1 July 2015. Survey by the patient advocacy in Vienna shows positive effects The NPM focussed on the monitoring priority of psychiatry in several workshops in 2020. From January to July 2021, a questionnaire will be used to examine the causes and ways of dealing with agitated and aggressive behaviour, deescalation measures as well as the documenting and evaluation of aggressive events. All of the governors were notified of this monitoring priority in December 2020 and requested to inform all psychiatric hospitals. Information was published on the AOB website and made available to the media. Psychiatry as monitoring priority for 2021 In psychiatric institutions, in particular in acute psychiatry, the greatest occupational risk for the staff is attacks by patients. Inversely, the use of coercive measures (or other “non-professional” violence when working in the wards) poses a great risk of complications in the healing process. Severe traumatisation with (lifelong) emotional scars fosters the refusal to undergo subsequent treatments. Examination in the first half of 2021 44