Recent research suggests that the physical environment is important for psychiatric rehabilitation. Even small improvements can create a more caring environment and increase the social interaction among psychiatric patients who are typically characterized by rigid spatial behavior. In planning those improvements, broad input among users, especially staff, has been recommended.
Based on the outcomes of a study that gathered staff input about the features that most needed improvement, this study evaluated staff response to specific design changes and individual design features (e.g., furniture, plants, wallpaper, paint, and lighting) in a day hall of a psychiatric ward.
The researcher surveyed psychiatric ward staff and asked them to rate environmental variables pre- and postrenovation. The investigator also collected behavioral mapping data for both patients and staff on one of the wards pre- and postrenovation.
The researcher reported that the new furnishings and plants improved staff’s assessment of these variables from pre- to postrenovation, with plants being assessed as the most uniformly positive addition. They also noted that the findings indicated that staff desired even brighter lights in the hallways and at the bedside. Further, the investigators stated that the patient population served and personal characteristics of staff were perceived to have a greater impact on staff perception than the environment. That is, staff members who cared for a less difficult population (i.e., geriatric patients) and staff members who were judged to have a higher morale rate environmental variables more favorably than staff caring for more clinically challenging populations (i.e., patients with neuropsychiatric or medical conditions). Finally, the study showed modest behavior change following the renovation, but the overall pattern remained the same (e.g., patients in the day hall and staff at the nursing station). The authors conclude that the outcomes of this study highlight the importance of supervisory support to maximize the benefit of environmental improvements.
The findings of this study have limited generalizability, as do all case studies. Other limitations of this study were that there was no control group and the renovation took place simultaneously, which makes it difficult to establish a cause and effect relationship between behavioral outcomes and individual variables. The variables rated as most important by staff (i.e., ventilation and acoustics) could not be attended to as a part of this study due to cost limitations.