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Treatment of the mentally ill in the Federal Republic of Germany

Sectioning practice, legal framework, medical practice and key differences between Germany and the UK

Psychiatric Department County of Verden/Lower Saxony, Lindhooper Straβe 67, D-27283, Verden Aller;

Peter Lepping, Wirral and West Cheshire Community NHS Trust

West Cheshire Hospital, Liverpool Road, Chester CH2 1UL

Aims and method The legal provisions concerning the admission to hospital, holding powers and compulsory treatment of the mentally ill in Germany are illustrated. The essential legal concepts are compared to the situation in Great Britain.

Results Whereas British law gives key powers to multi-professional decision-making and relatives, German law requests formal court decisions even in routine cases. This reflects a different understanding of individual rights and their protection. German mental health law is motivated by the experiences of the totalitarian national socialist regime. It tries to protect patients' rights by restricting physicians', hospitals' and family members' influence. British law, on the other hand, assumes that experts as well as family members act benevolently in the patient's interest, prefers less formal mechanisms and expresses more trust in professional ethics.

Conclusion Further research is desirable to analyse the situations in other countries and to determine which of these approaches is the most adequate from the point of view of the mentally ill. This is even more important inview of further European integration which will undoubtedly touch these questions and accelerate a convergence in medico-legal issues.