title: The psychiatric ward as a therapeutic space: systematic review.
abstract: BACKGROUND
  Hospital care is still an integral part of mental healthcare services. But the impact of ward design on treatment outcomes is unclear.
  
  
  OBJECTIVE
  To review the effects of ward design on patient outcomes and patient and staff well-being.
  
  
  METHODS
  A systematic review of literature was carried out on Medline, Embase and PsycINFO. Papers on psychogeriatric and child and adolescent wards were excluded as these necessitate specific safety features.
  
  
  RESULTS
  Twenty-three papers were identified. No strong causal links between design and clinical outcomes were found. Private spaces and a homely environment may contribute to patient well-being. Different stakeholders may experience ward design in conflicting ways; design has a symbolic and social dimension for patients.
  
  
  CONCLUSIONS
  Data on the impact of design on treatment outcomes are inconclusive. Rigorous randomised controlled trials, qualitative studies and novel methods are called for. Different stakeholders' responses to the ward as a symbolic environment merit further investigation.
authors.affiliation: Constantina Papoulias, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Emese Csipke, PhD, Department of Psychology, Institute of Psychiatry, King's College London; Diana Rose, PhD, Susie McKellar, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Til Wykes, PhD, Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Constantina
authors.initials: C
authors.lastname: Papoulias
authors.affiliation: Constantina Papoulias, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Emese Csipke, PhD, Department of Psychology, Institute of Psychiatry, King's College London; Diana Rose, PhD, Susie McKellar, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Til Wykes, PhD, Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Emese
authors.initials: E
authors.lastname: Csipke
authors.affiliation: Constantina Papoulias, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Emese Csipke, PhD, Department of Psychology, Institute of Psychiatry, King's College London; Diana Rose, PhD, Susie McKellar, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Til Wykes, PhD, Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Diana
authors.initials: D
authors.lastname: Rose
authors.affiliation: Constantina Papoulias, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Emese Csipke, PhD, Department of Psychology, Institute of Psychiatry, King's College London; Diana Rose, PhD, Susie McKellar, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Til Wykes, PhD, Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Susie
authors.initials: S
authors.lastname: McKellar
authors.affiliation: Constantina Papoulias, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Emese Csipke, PhD, Department of Psychology, Institute of Psychiatry, King's College London; Diana Rose, PhD, Susie McKellar, PhD, Service User Research Enterprise, Institute of Psychiatry, King's College London; Til Wykes, PhD, Department of Psychology, Institute of Psychiatry, King's College London, UK.
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
mesh_terms: D006801:Humans; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services; D011567:Psychiatric Department, Hospital; D016896:Treatment Outcome