Has the public taken notice of psychiatric reform? The image of psychiatric hospitals in Germany 1990-2011.

PURPOSE: In the context of mental health care reform in Germany, psychiatric hospitals have been transformed in terms of their infrastructure, staffing levels and therapeutic culture. The question arises as to what extent these improvements had an impact on the public image of these institutions.

METHODS: In 1990 and 2011, population surveys were conducted in the "old" states of Germany, using the same sampling procedure, interview mode and measures.

RESULTS: Over the last two decades, attitudes toward psychiatric hospitals have improved considerably. This improvement was particularly pronounced among those who had been in treatment for mental health problems. The public is now more inclined to regard psychiatric hospitals as similar to other hospitals, more ready to expect effective treatment in psychiatric hospitals, and less inclined to support the stereotype that psychiatric hospitals are primarily places where patients are locked away. However, there was a stronger tendency to agree with the notion that psychiatric hospitals are necessary to protect society from persons with mental illness.

CONCLUSIONS: The improvement of psychiatric care seems to pay off as regards the image of psychiatric hospitals among the general public. Further efforts are necessary to reduce the stigma attached to mentally ill people.