title: Using therapeutic community principles to improve the functioning of a high care psychiatric ward in the UK.
abstract: The effects of interventions within a high-care psychiatric ward, based upon the principles of a therapeutic community, were evaluated. Interventions included an enhanced physical environment, improved communication, clear rules and aims, and improved safety procedures. A Ward Atmosphere Scale, an Attitude Scale, and interviews with staff indicated improvements in ward atmosphere and staff attitudes. Ward records showed a substantial reduction in the use of seclusion for aggressive patient behaviour, and a 62% reduction over 2 years in short-term staff illness. The authors conclude that similar interventions could be used to improve the functioning of other psychiatric wards.
authors.affiliation: Mental Health Research & Development Unit, University of Bath and Avon & Wiltshire Partnership Mental Health Care NHS Trust, Bath BA2 7AY, United Kingdom. W.Mistral@bath.ac.uk
authors.forename: Willm
authors.initials: W
authors.lastname: Mistral
authors.forename: Adam
authors.initials: A
authors.lastname: Hall
authors.forename: Patrick
authors.initials: P
authors.lastname: McKee
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D004739:England; D006272:Health Facility Environment; D007722:Health Knowledge, Attitudes, Practice; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007588:Job Satisfaction; D009013:Morale; D009723:Nurse-Patient Relations; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D015397:Program Evaluation; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011568:Psychiatric Nursing / Q000193:education / Q000458:organization & administration*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration; D011795:Surveys and Questionnaires; D013808:Therapeutic Community