Auswirkungen des Betreuungsgesetzes im wiedervereinigten Deutschland (1992-2009).

Background: The Guardianship Law became effective in the year 1992 with the intention of replacing the paternalistic-restrictive model by a model based on the principles of participation and empowerment. Methods: Data from the Federal Ministry of Justice were used to examine the development of 12 legal guardianship parameters over a period of 17 years (1992-2009) at the level of federal states. Due to the completely different practise in both parts of Germany before reunification, the development will be analysed separately for the old and the new federal states. Results: All examined parameters indicate an increase of legal guardianship. The highest increases were found for enlargement of the task scope (+606%) and for approval of contention measures (+868%). With the exception of involuntary commitment rates, in the new federal states the mean values of all variables score higher than in the old federal states. Legal guardianship installation only increased for the old federal states significantly (T(9)=6.64; p=0.007); however, the guardianship expenses were higher, but not significantly, for the new federal states. Discussion: In spite of the legal changes in the direction of a dynamic instrument in mental health care, the practise of the Legal Guardianship Law indicates a continuous increase of guardianship orders since 1992. It is necessary to recognise that a slowdown of the upward trend is not in sight. Therefore it is pertinent to call those persons in charge of regulating legal guardianship to consider their daily practise carefully. On the other hand it is a task of mental health services research to analyse the driving factors of the presented developments. [ABSTRACT FROM AUTHOR]