Accommodation of mentally ill people in accordance with the PsychKHG
A court can order the placement of a mentally ill person in a psychiatric hospital against their will.
A medical examination must take place beforehand.
The mentally ill person must be accommodated, treated and cared for in such a way that the interference with their personal freedom is minimised. However, they must tolerate measures that ensure safety and order in the institution or protect themselves.
Special security measures that largely or completely remove a person's ability to move (restraint involving deprivation of liberty) for more than a short period of time are only permitted at the request of the recognised facility providing treatment following a prior court order. This does not apply in the event of imminent danger if such an order is issued.
Children and adolescents should be accommodated and cared for separately in accordance with their illness and stage of development. Treatment should take place in specialised child and adolescent psychiatric wards.
During the placement, the mentally ill person is entitled to the necessary treatment. The treatment also includes examination measures as well as measures that are necessary to enable the accommodated person to live independently in the community after release.
Treatment requires the consent of the person accommodated. Consent must be based on the free will of the person capable of giving consent.
The person must have been adequately informed by a doctor beforehand. However, consent is not required from the person being accommodated if, due to their illness, they are unable to recognise the need for treatment in order to prevent further harm.
Responsible authority
- For the placement order: The guardianship court (local court), or the juvenile division
- For the application for placement: The competent lower administrative authority and the recognised facility in accordance with the PsychKHG if the mentally ill person is already there.
The lower administrative authority is
- if their place of residence is in an urban district: The city administration
- if their place of residence is in a rural district: The district administration or, in large district towns and communities, the district administration itself
Contact
Details
Prerequisite
- The person is ill or disabled due to a mental disorder.
- The mentally ill person significantly jeopardises their life or health as a result of their mental disorder or disability or the mentally ill person poses a significant current danger to the legal interests of others as a result of their mental disorder or disability.
- The threat or danger cannot be averted in any other way.
Procedure
The authority must first apply for the placement in writing to the care court. Only then can the court order it.
This also applies to
- provisional placement,
- a placement for observation and the preparation of an expert report.
If the court orders the placement, the lower administrative authority is responsible for implementing the placement. For example, it selects the appropriate facility. When making its choice, it should take into account the wishes of the mentally ill person as well as therapeutic aspects. The authority also endeavours to place them as close to their place of residence as possible.
Note: In urgent cases, a recognised facility under the PsychKHG may admit or detain a person before placement has been applied for or ordered. The reasons for this caring admission and detention must be documented by a medical certificate.
In the case of caring admission and restraint:
The institution must send the application for placement to the court no later than the end of the second day following the caring admission or restraint. If the admission or restraint falls on a Friday, the application for accommodation must be submitted by Monday, 12 noon at the latest. If it is not sent, the patient must be discharged.
However, the mentally ill person can also remain in the facility voluntarily.
The accommodated person must be discharged if
- the placement period has expired and no further placement has been ordered,
- the placement order has been cancelled,
- the court has not ordered placement by the end of the day following receipt of the application at the latest in the case of care and detention,
- the reason for the placement has ceased to exist.
Note: If the continuation of the placement is necessary, the recognised institution must apply to the court in good time for the continuation of the placement.
Deadlines
The recognised institution must send the application for a placement order immediately, but no later than by the end of the second day following admission or detention, if further placement appears necessary against the wishes of the person concerned. If the admission or detention falls on a Friday, the application must be submitted by the following Monday at noon at the latest.
Required documents
- Presentation of the facts by the lower administrative authority
- Medical certificate from a health authority. It should state:
- Current state of illness,
- Need for accommodation,
- expected duration of treatment,
- Information as to whether the court can hear the person concerned orally without significant detriment to their state of health.
The certificate of a doctor from a recognised institution can replace the certificate from the health authority. However, it must be signed by a specialist in psychiatry and psychotherapy. In the case of children and adolescents, a specialist in child and adolescent psychiatry and psychotherapy must sign the certificate.
Note: If a certificate is not yet available at the time of application, it must be submitted as soon as possible.
Costs
No costs are incurred for the activities of the lower administrative authorities.
Please note: The costs for the accommodation itself must be borne by the person being accommodated, their cost bearer (e.g. the health insurance fund) or the debtor.
Miscellaneous
In addition to placement in accordance with the PsychKHG (placement under public law), there are other forms of placement, for example placement in accordance with the German Civil Code (placement under civil law) or placement in a psychiatric hospital.
Legal basis
Psychisch-Kranken-Hilfe-Gesetz (PsychKHG):
- §§ 1 - 31
Release note
Machine generated, based on the German release by: Sozialministerium Baden-Württemberg, 17.04.2025