The evolution of a therapeutic environment for patients with long-term mental illness as measured by the Ward Atmosphere Scale

Abstract

This paper reports the results of the measurement of the effects of planned changes on the therapeutic environment provided by a hospital ward for the long-term mentally ill. Using the Ward Atmosphere Scale, the ward was initially observed to have a sub-optimal profile on all dimensions (relationships, treatment and system maintenance). A year after the implementation of a therapeutic rehabilitation programme, the ward profile was far closer to that tentatively described as desirable in the literature for this patient group; these changes were maintained over the next two years. There is a paucity of research in this area, partly as a result of methodological problems. However, this study demonstrates that a treatment environment can be rendered more therapeutic, and points to the need for more focused research on the relationship between treatment environment and outcome in long-term mental illness.