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Using therapeutic community principles to improve the functioning of a high care psychiatric ward in the UK

Authors

  • Willm Mistral,

    1. Mental Health Research & Development Unit (a joint unit of the University of Bath and Avon & Wiltshire Partnership Mental Health Care NHS Trust), Bath, United Kingdom
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  • Adam Hall,

    1. Mental Health Research & Development Unit (a joint unit of the University of Bath and Avon & Wiltshire Partnership Mental Health Care NHS Trust), Bath, United Kingdom
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  • Patrick McKee

    1. Mental Health Research & Development Unit (a joint unit of the University of Bath and Avon & Wiltshire Partnership Mental Health Care NHS Trust), Bath, United Kingdom
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  • Willm Mistral, BSc, MSc, PhD.

  • Adam Hall, BSc.

  • Patrick McKee, BSc, Dipl. Man., RMN, RGN.

Correspondence: Willm Mistral Mental Health Research & Development Unit, Avon & Wiltshire Partnership Trust, University of Bath 3E 2.10, Bath BA2 7AY, United Kingdom. Email: W.Mistral@bath.ac.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.

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