Abstract
Community-based psychiatric services and programs developed in accordance with the 1978 Italian psychiatric reform have now been in operation for a quarter of a century. The paper presents the results of a study in which three treatment environments of South-Verona, i.e. a general hospital psychiatric ward, a community mental health center (CMHC) and two residential facilities have been investigated using the Ward Atmosphere Scale (WAS) and the Community Oriented Programs Environment Scale (COPES). Staff and patient ratings have been collected in the three environments thus allowing comparisons between respondents and settings. For the ward and the CMHC, whose staff had already been interviewed almost twenty years before, a comparison between studies was also possible. Results seem to show that original policies, attitudes and staff commitment have successfully survived the passage of time with only minor adjustments and that the single-staff module of South-Verona may have effectively contributed in this respect.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bola J. R. & Mosher L. R. (2003). Treatment of acute psychosis without neuroleptics: Two-year outcomes from the Soteria project. Journal of Nervous and Mental Disease, 191, 219-229.
Brunt D. & Hansson L. (2002). A comparison of the psychosocial environment of two types of residences for persons with severe mental illness: small congregate community residences and psychiatric inpatient settings. International Journal of Social Psychiatry, 48, 243-252.
Burti L. & Guerriero E. (2003). Psychiatric rehabilitation. An open-network orientation. Epidemiologia e Psichiatria Sociale, 12, 160-166.
Burti L., Glick I. D., & Tansella M. (1990). Measuring the treatment environment of a psychiatric ward and a community mental health center after the Italian reform. Community Mental Health Journal, 26, 193-204.
Burti L. & Mosher L. R. (1986). Training psychiatrists in the community: a report of the Italian experience. American Journal of Psychiatry, 143, 1580-1584.
de Girolamo G. & Cozza M. (2000). The Italian psychiatric reform. A 20-year perspective. International Journal of Law and Psychiatry, 23, 197-214.
Eklund M. & Hansson L. (1997). Relationships between characteristics of the ward atmosphere and treatment outcome in a psychiatric day-care unit based on occupational therapy. Acta Psychiatrica Scandinavica, 95, 329-335.
Friis S. (1986). Measurements of the perceived ward milieu: a reevaluation of the Ward Atmosphere Scale. Acta Psychiatrica Scandinavica, 73, 589-599.
Gjerden P. & Moen H. (2001). Patient satisfaction and ward atmosphere during a crisis in an open psychiatric ward. Social Psychiatry and Psychiatric Epidemiology, 36, 529-532.
Higbee K. (2001). Stata 7: Performing multiple comparison tests following two-way ANOVA. http://www.stata.com/support/faqs/stat/multcomp.html
Jansson J. A. & Eklund M. (2002). Stability of perceived ward atmosphere over time, diagnosis and gender for patients with psychosis. Nordic Journal of Psychiatry, 56, 407-412.
Kasprow W. J., Frisman L. & Rosenheck R. A. (1999). Homeless veterans' satisfaction with residential treatment. Psychiatric Services, 50, 540-545.
Klass D. B., Growe G. A. & Strizich M. (1977). Ward treatment milieu and posthospital functioning. Archives of General Psychiatry, 34, 1047-1052.
Middelboe T., Schjodt T., Byrsting K. & Gjerris A. (2001) Ward atmosphere in acute psychiatric in-patient care: patients' perceptions, ideals and satisfaction. Acta Psychiatrica Scandinavica, 103, 212-219.
Moos R. H. (1974). Evaluating treatment environments. New York: Wiley.
Moos R. H. (1976). The human context: Environmental determinants of behavior. New York: Wiley.
Moos R. H. (1987a). Community oriented programs environment scale manual, 2nd ed. Palo Alto, Calif.: Consulting Psychologists Press.
Moos R. H. (1987b). Ward atmosphere scale manual. 2nd ed. Palo Alto, Calif.: Consulting Psychologists Press.
Mosher L. R. & Burti L. (1989). Community mental health: Principles and practice. New York: Norton.
Mosher L. R. & Burti L. (1994). Community mental health: A practical guide. New York: Norton.
Mosher L. R., Kresky-Wolff M., Matthews S. & Menn A. (1986). Milieu therapy in the 1980's: A comparison of two residential alternatives to hospitalization. Bulletin of the Menninger Clinic, 50, 257-268.
Murray H. (1938). Exploration in personality. New York: Oxford University Press.
Rossberg J. I. & Friis S. (2003). Do the Spontaneity and Anger and Aggression subscales of the Ward Atmosphere Scale form homogeneous dimensions? A cross-sectional study of 54 wards for psychotic patients. Acta Psychiatrica Scandinavica, 107, 118-123.
STATA Corporation (2002). STATA Statistical Software: Release 7.0. College Station, TX: STATA Corporation.
Way B. B., Stone B., Schwager M., Wagoner D. & Bassman R. (2002). Effectiveness of the New York State Office of Mental Health Core Curriculum: direct care staff training. Psychiatric Rehabilitation Journal, 25, 398-402.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Burti, L., Andreone, N. & Mazzi, M. Reassessing Treatment Environments After Two Decades: Client and Staff Perceptions of an Italian Community Mental Health Service Environment, Then and Now. Community Ment Health J 40, 199–210 (2004). https://doi.org/10.1023/B:COMH.0000026994.99157.c9
Issue Date:
DOI: https://doi.org/10.1023/B:COMH.0000026994.99157.c9