Hospitals and psychiatric institutions protected area have a considerable negative impact on the care situation of the patients. These inadequate overall conditions mean in particular that patients in acute situations usually have to be taken to the psychiatric ward of Klagenfurt Regional Hospital by the paramedics. In this way, the decision of whether those affected can “just about” be treated in an open ward or be transferred to Klagenfurt Regional Hospital is imposed on the staff. Also from a legal liability perspective, it appears unjustified to transfer such a responsibility to the medical and nursing staff, when it could be avoided in a specific organisation. This causes stress and demotivates, and can ultimately be to the detriment of the affected patients. It must also be considered that the legal entity behind the medical facility must ensure that patients are treated according to the principles and recognised methods of medical science. The medical facility is thus bound by the obligation to consider whether it will be possible to fulfil the treatment contract with the existing human and spatial resources when admitting the patient. The NPM thus still insists that the ward for hospitalisation of persons with mental illnesses in Villach Regional Hospital be extended as an interim solution before the planned completion of the psychiatric facility and the structural changes in Villach and Klagenfurt, which can be expected in 2020/2021 at the earliest. XX  Local care of the patients must be ensured as part of the regionalisation of psychiatry. XX  Time-consuming transports must be avoided by setting up decentralised accommodation areas for patients in acute situations. 2.2.7 De-escalation training programmes The CPT standards stipulate that initial attempts to bring agitated or violent patients under control should not be of a physical nature in as far as possible (e.g. use of verbal orders). Staff in psychiatric facilities should thus be trained both in non-physical and manual control techniques. This should enable the staff to apply the appropriate technique in difficult situations, with which the risk of injury to the patients but also to the staff can be substantially reduced. Training in non-physical control techniques In this context however, the NPM observed that only some of the staff completed the relevant training programmes. A visit to the Otto Wagner Hospital indicated that almost all of the nursing staff (95%) had completed the basic de-escalation management training. In contrast, only a small minority 57

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