The Ward Atmosphere Scale was used to assess the development of a therapeutic milieu in a clinical ward converted to a research unit at a state psychiatric hospital. The designated ward had been considered a “problem ward” with low staff moral, a high incidence of violence by patients, and high incidence of injuries to patients and staff. The scale was administered to patients and staff on two occasions. The results of the first administration were presented to staff, and from these consultation sessions, a therapeutic milieu developed. The scale was readministered 3 mo. after the implementation of the therapeutic milieu. Significant improvements were seen in staff's perception of the ward environment, incidence of patients' assaults, and staff use of seclusion and restraints.
Pathways to care and duration of untreated illness in patients attending a state psychiatric hospital
