Should severely disturbed psychiatric patients be distributed or concentrated in specialized wards? An empirical study on the effects of hospital organization on ward atmosphere, aggressive behavior, and sexual molestation

Abstract

SummaryThis study examines whether ward atmosphere, aggressive behavior, and sexual molestation will change after severely disturbed patients have been distributed over several wards determined by their place of residence, instead of concentrating them in locked single-sex wards. Four wards for predominantly psychotic patients were investigated with the German version of the Ward Atmosphere Scale (WAS), and some further questions about the observation of aggressive behavior and sexual molestation once before and twice after internal sectorisation, partial ward opening, and mixing the sexes were asked. Questionnaires (345: 162 staff members, 183 patients) were evaluated. After the structural changes, a significant improvement of ward atmosphere and a reduction of aggressive behavior was found on average in all wards, whereas the impact on sexual molestation remained unclear. Internal sectorisation and sex integration policy, resulting in distributing rather than concentrating severely disturbed patients, have beneficial effects on the social climate of acute wards.