Environmental Change in a Psychiatric Setting

Abstract

The extensive physical remodeling of a psychiatric admissions ward was conducted to investigate the relationship between ward design and patient behavior. This paper presents an analysis of important changes in the ward social system, including staff role relationships, distribution of power, and communication styles, which were generated by the physical changes and mediated the effects on patient behavior. The social system impacts are conceptualized as operating through a time-ordered process of environmental change involving four phases-petrification, unfreezing, resistance, and personalization. Psychological issues underlying the translation of environmental change into change at the level of the ward social system are discussed. Finally, comparisons are drawn between interventions based on environmental strategies and those based on organizational development techniques.