restrictions increase, however, the level of aggression rises as well. In accordance with the recommendation of the NPM, the Federal Ministry of Health prohibited the use of psychiatric intensive beds (net beds) as well as other “cage-like beds” by way of a decree in July 2014. Owners and operators of hospitals and nursing homes were given a one-year transition period until 1 July 2015 (see NPM Report 2014, p. 43 et seq.). Alternatives after the prohibition of net beds During their visits, Commissions 3 and 4 found that this decree to end the use of net beds was implemented by the responsible owners and operators in a timely manner. During a visit in Otto Wagner Hospital, Commission 4 observed that due to intensive ward-internal preparations and working groups, a number of alternatives to forced placement in net beds had been implemented. The hospital is trying to act proactively to de-escalate situations and to offer patients more opportunities for dialogue. Nursing staff is increasingly called in when drip infusions are administered. According to concurring statements, the flexible cooperation of the care teams with the doctors is working. However, in several wards, the requested equipment (e.g. motion-sensitive floor mats, low-profile beds) had not yet been completely delivered one month after the decree prohibiting net beds became effective. Despite the occasionally noticeable scepticism about being able to deal with the new challenges, a setting has been created under difficult framework conditions and existing space constraints that could prevent an increase of measures that restrict freedom and sustainably improve patient care. This must be recognised as an achievement and a success of an organisation that opposed the prohibition of net beds for so many years. Intensive preparation in the Otto Wagner Hospital The NPM has suggested that additional Standard Operating Procedures (SOP) be developed for dealing with confinement in locked rooms and that qualification and training measures – in particular with regard to situation-appropriate selection of milder measures and how they are deployed – be continued. However, Commission 4 emphasised concerns regarding human rights because one of the wards has constant video monitoring in all rooms, including the communal areas and outdoors. This is a disproportionate restriction of privacy and furthermore, could be counter-productive when delusional disorders are present, because this could increase the latent perception of defencelessness and helplessness. Figures were requested which would show the quantitative and qualitative development of measures that restrict freedom in Otto Wagner Hospital. They will be analysed and follow-up visits are planned for 2016. In 2014, the NPM took a decisive stance against having private security company employees assisting in carrying out measures that restrict Caution in the deployment of 46