Portfolio of services

Ward P1a is a protected, part-open psychiatric ward treating acute cases, with admissions of patients aged 18 and over. Patients with severe psychiatric disorders and experiencing episodes of crisis are treated here. During this acute phase of the disorder, the focus is placed on medical diagnosis and discussions, medicinal treatment and intensive psychiatric care.

The Ward has a particular competency in the acute treatment and diagnostic clarification of disorders from the entire spectrum of affective and psychotic illnesses. Treatment always takes place according to the latest standards and within the framework of a personalised therapy: each patient receives the most suitable and gentle treatment for their particular case and only with their consent. In most cases this will consist of a differentiated administration of pharmaceuticals, but does draw on other methods to achieve the best possible treatment outcome, for instance therapeutic sleep deprivation or electroconvulsive therapy (ECT).

The treatment of patients who, due to a mental illness, present a temporary risk to themselves or others is managed on this Ward based on the Saxon Act on the Assistance and Accommodation in cases of Mental Illness (SächsPsychKG) and the relevant paragraphs concerning guardianship law in the German Civil Code (BGB).

This Ward (P2a) focuses on the treatment of persons with substance-based addictive disorders. The main addictive substances are alcohol, prescription medication and illegal drugs. The Ward applies the system of Qualified Detoxification.

Qualified Detoxification

This procedure describes physical detoxification under medicinal treatment and alleviation of vegetative withdrawal symptoms, but also the recognition of imminent delirium and seizures. A second, obligatory part involves integration of the patient (i.e. the person suffering from an addictive disorder) within a complex therapeutic programme; the patients receive sustained support in developing a motivation for change, so the will to reduce intake of addictive substances, as well as in developing a determination to bring structure to their lives and successfully embrace abstinence. A Qualified Detoxification usually lasts between 14 and 21 days.
An important part of Qualified Detoxification is for the patient to take part in individual and group discussions addressing the issue of addiction and to make contact with the local self-help groups who organise informational events at the clinic.

Qualified Detoxification can only be one building block within the system of addiction services, so close cooperation is also maintained with the local outpatient addiction counselling centres and the supra-regional, specialist clinics; patients can be referred there immediately afterwards for therapeutic treatment, provided they show motivation to do so and the treatment is approved by their pension insurance institute. With the assistance of our Social Services, patients can make contact with outpatient addiction counselling centres during their stay as inpatients. All necessary steps are taken together to enable, where necessary and depending on the specific indication, addiction therapy in a specialist clinic or outpatient centre after detoxification.

Geronto-psychiatry deals with mental illnesses at an advanced age. Accordingly, this Ward (Ward P1b) mainly treats patients over the age of 60 who are suffering from depression, confusion (where dementia has already been diagnosed) or are experiencing increasingly pathological forgetfulness. In addition, older persons with a long-standing mental illness, e.g. schizophrenia or manic-depressive (bipolar) disorders, will be treated here where necessary.

The chief physician at the clinic, PD Dr. med. habil. Thomas Reuster, holds a certificate of expertise for the treatment of older persons with mental illnesses. This Certificate of Gerontopsychiatry, -psychotherapy and -psychosomatics has been awarded since 2012 by the German Association for Psychiatry, Psychotherapy and Psychosomatics (DGPPN) and the German Association for Gerontopsychiatry and Psychotherapy.

We collaborate closely with the other departments within our hospital with the aim of addressing the particular problems of mentally ill, older persons in diagnostics and therapy, as they frequently suffer additionally from physical, often cardiovascular, illnesses, physical disabilities or pain.

Following a thorough diagnostic phase examining the individual physical, mental and social circumstances, a treatment regimen comprising pharmaceutical, occupational and physiotherapy elements and other supplementary treatments is developed to suit each individual patient. Together with the patients, we attempt to ease their mental symptoms and to restore social competencies to such an extent that they are able to return to their familiar domestic environments. Where this is not possible, we check and discuss which additional assistance – including home nursing or outpatient care for senior citizens – might help to achieve this objective, and we then take the necessary organisational steps.

The main treatment objectives are as follows:

• Alleviation of current crises
• Reduction in psycho-physical symptoms
• Development of a motivation to change
• Reduction and change of dysfunctional behaviours
• Activation of resources
• Processing of life history events that trigger symptoms
• Acquisition of personal maturity
• Reorientation
• Empowerment to engage in outpatient psychotherapy or similar aftercare

We treat affected persons who are at least 18 years old. The following indications are treated, among others:

• Affective conditions (depression, bipolar disorder)
• Schizophrenia
• Anxiety disorders
• Compulsive disorders
• Sleep disorders
• Personality disorders
• Impulse control disorders

We apply a multi-modal treatment programme comprising differentiated pharmaceutical, psycho- and socio-therapeutic measures. An individual therapy plan is discussed and implemented with each patient.
Besides physicians qualified in behavioural therapy and depth psychology, psychologists and nursing staff with psychiatric and psychotherapeutic qualifications, the treatment team also includes social workers, occupational therapists, physiotherapists and creative form therapists. Among others, the following concrete treatment options are available in addition to medical and nursing services:

Pharmacotherapy

• Based on current standards

Psychotherapy

• Individual and group therapy based on behavioural therapy and depth psychology
• Communicative movement therapy
• Social competence training
• Mindfulness training
• Training of enjoyment
• Progressive muscle relaxation (PMR)
• Psycho-educative groups for specific indications
• Art and music therapy

Socio-therapy

• Occupational therapy
• Work therapy
• Movement and nutritional therapy
• Physical activation (sport, back school, yoga)

Other biological therapies

• Light therapy
• Physiotherapy

Quality assurance is guaranteed by:

• Team meetings, rounds by senior and chief physicians, regular external supervision
• Staff qualification

Admission is organised by the outpatient psychiatrist, the specialist psychotherapist, the GP (also by recommendation of a psychological psychotherapist). Patients are registered by telephone.

The treatment objectives play a fundamental role in ensuring a successful treatment outcome. They are therefore prepared and defined individually with each patient. Among other things, they depend on the initial situation:

1. Admission from outpatient treatment for

• intensification of a currently inadequate level of psychiatric-psychotherapeutic treatment, as well as optimisation of medical treatment
• crisis intervention/conflict management

2. Treatment following a period as an inpatient at a psychiatric facility for

• strengthening of mental and physical resilience
• testing of psycho-social resilience
• reintegration

The underlying treatment objective is to alleviate suffering and to strengthen psycho-social functions in relevant areas of life. An independent life structure should be promoted.

Treatment is open to women and men who are at least 18 years old and to suffer above all from the following mental illnesses:

• Affective disorders
• Schizophrenic disorders
• Anxiety disorders
• Compulsive disorders
• Personality and behavioural disorders, as well as pathological personality changes

An indication for treatment in the day clinic exists if inpatient therapy is not necessary or reasonable and outpatient treatment is not adequate. Acute suicide risk, pronounced dementia processes or the continued consumption of illegal drugs and alcohol are contraindicated. Patients must be able to manage daily travel to the clinic and spend their time outside of the therapy programme in their domestic environments.

We apply a multi-modal therapy concept comprising medicinal, psychotherapeutic (verbal and non-verbal), as well as socio-therapeutic measures. Each therapy plan is developed individually with the patient. Besides physicians qualified in behavioural therapy and depth psychology, psychologists and nursing staff with psychiatric and psychotherapeutic qualifications, the treatment team also includes social workers, occupational therapists, physiotherapists and creative form therapists.

In addition to medicinal-physician and nursing services, the following treatment options exist:

Pharmacotherapy

• Based on current standards

Psychotherapy

• Individual and group therapy based on behavioural therapy and depth psychology
• Psycho-educative groups for specific indications
• Creative form therapy
• Relaxation methods: Mindfulness, progressive muscle relaxation (PMR)
• Communicative movement therapy

Socio-therapy

• Occupational therapy
• Work therapy
• Movement and nutritional therapy
• Social competence training
• Physical activation (sport, back school, yoga)
• Training of enjoyment

Other biological therapies

• Light therapy
• Physiotherapy

Quality assurance is guaranteed by:

• Team meetings, rounds by senior and chief physicians, regular external supervision
• Staff qualification

Admission is organised by the outpatient psychiatrist, the specialist psychotherapist, the GP (also by recommendation of a psychological psychotherapist, or in some cases even on the request of the patient). An appointment for an initial consultation can be agreed by telephone with the competent senior physician, during which an admission date is usually set.

Admission is without undue delay and acute where necessary.

PIOC is an important connecting link between inpatient psychiatric treatment and outpatient and complementary services in the City and District of Görlitz. It is the first port of call in crisis situations and emergencies and can, when necessary, organise inpatient admission.
In other cases it helps with the reintegration of patients following a period in the hospital. Its services are mainly designed for persons with severe mental illnesses, who require a structured and diverse (multi-modal) treatment. A particular benefit is that all therapeutic services are available at a single location. The team at the outpatient centre is run by doctors, and consists of a social worker and an occupational therapist, in addition to two specialist physicians, three nurses and two psychologists. Together with the patients, we plan and implement the ideal treatment objective for their needs and ensure successful reintegration in their familiar surroundings.