In a psychiatric ward, a good therapeutic environment is vital to good mental health. Staff and the actual physical environment are vital to providing a positive space for recovery.

Staff

Many people feel positively about the staff on their ward. They believe that the care and attention they receive hugely aids in their recovery. However, a single negative encounter with a staff member can have a profound impact on a patient’s attitude.

Insufficient staffing levels, poor security, and safety concerns hamper a person’s recovery. The sense of trust placed in staff is broken when staff disrespect or ignore a patient’s concerns.

Physical Space

For many patients, the design and physical appearance of the ward is a statement of how much they are valued. A dirty, unkempt environment is demoralizing. It’s an affront to the dignity of a person. Fresh air, exercise and recreation is essential for the wellbeing of a person.

A number of patients emphasize concerns regarding the access to, and lack of choice and poor quality of, hospital food. There’s a substantial body of evidence that shows a positive relationship between physical activity and mental health. Research proves a negative impact of the intense boredom experienced by respondents. Enjoyable activities are a critical way to improve self-esteem and promote recovery. They are not a luxury.

Research 

In a research project by Ward Watch in the U.K., just one in five (20 per cent) patients felt they were treated with respect and dignity by hospital staff. Almost the same proportion (17 per cent) said they were never treated with respect and dignity by staff.

Measures need to be put in place to improve staff recruitment and retention. Where agency staff are used, it’s essential that they have the necessary skills to work in a mental health setting, are properly briefed on the patients they are caring for, and are effectively monitored by management.

What Patients Say 

“The staff did not encourage patients to participate in the few therapeutic activities that were available. They often overreacted to situations, which made them worse. Making sure that patients were given access to fresh air and exercise was not considered to be a priority.”

“It is extraordinary just how bad it is. The nurses create an atmosphere of threat and fear. I have observed staff deliberately provoke people on the basis of sexuality, then threaten them with the secure ward because they are crying.”

“The staff were go, go, go all day. They were pushed by management to breaking point.”

“Staff are courteous and efficient, but there is a very evident lack of resources and staffing levels are inadequate. It was 11 days before I was given the information leaflet that explained my rights and what would happen to me in hospital. Staff do not have the time to sit and talk to the patients.”

“In one nurse’s own words, the staff were there to ‘control the environment’ rather than healing and recovery.”

“Staff are often locked in their office not talking to patients. It is the loneliest place in the world.”

What Can Be Done