Community Mental Health Journal

, Volume 26, Issue 2, pp 193–204 | Cite as

Measuring the treatment environment of a psychiatric ward and a community mental health center after the Italian reform

  • Lorenzo Burti
  • Ira D. Glick
  • Michele Tansella
International Articles

Abstract

In 1978 a major psychiatric reform drastically changed the Italian psychiatric system by the closing of admissions to mental hospitals and the development of psychiatric units in general hospitals and of alternative services in the community.

The paper presents the results of a study in which two treatment environments set up according to the reform, i.e a psychiatric unit in a general hospital and a community mental health center run by the same staff, were examined using the Ward Atmosphere Scale (WAS) and the Community Oriented Programs Environemt Scale (COPES). In addition, validity studies of the Italian versions of the WAS and COPES are presented. Both instruments were found to be feasible and useful, easily understood, easy to administer and relatively well accepted by the psychiatric staff. The quality of the two scales has been confirmed by psychometric analysis, with the exception of the independence of scales. No major differences between the two environments emerged, both showing characteristics consistent with the new treatment philosophy.

Keywords

Public Health General Hospital Health Psychology Validity Study Italian Version 

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References

  1. Basaglia, F., (ed.) (1968).L'Istituzione Negata. Torino: Einaudi.Google Scholar
  2. Burti, L. & Mosher, L.R. (1986). Training psychiatrists in the community: a report of the Italian experience.American Journal of Psychiatry. 143, 1580–1584.Google Scholar
  3. Burti, L., Garzotto, N., Siciliani, O., Zimmermann-Tansella, Ch. & Tansella, M. (1986). South-Verona's psychiatric service: an integrated system of community care.Hospital and Community Psychiatry. 37, 809–813.Google Scholar
  4. Cronkite, R.C., Moos R.H. & Finney J.W. (1983). The context of adaptation: an integrative perspective on community and treatment environments. In:Ccological Models in Clinical and Community Mental Health (eds. W.A. O'Connor & B. Lubin). New York: Wiley.Google Scholar
  5. Dauwalder, J.P., Chabloz, D. & Chappuis, J.M. (1978). L'échelle de l'atmosphère dans les services psychiatriques (EAS).Social Psychiatry. 13, 175–186.Google Scholar
  6. Faccincani, C., Burti, L., Garzotto, N., Mignolli, G., & Tansella, M. (1985). Organization aspects of community care. The South-Verona Mental Health Centre.New Trends in Experimental and Clinical Psychiatry. 1, 201–216.Google Scholar
  7. Friis, S. (1986a). Measurements of the perceived ward milieu: a reevaluation of the Ward Atmosphere Scale.Acta Psychiatrica Scandinavica. 73, 589–599.Google Scholar
  8. Friis, S. (1986b). Factors influencing the ward atmosphere.Acta Psychiatrica Scandinavica. 73, 600–606.Google Scholar
  9. Goffman, E. (1961).Asylums: Essays on the Social Situation of Mental Patients and Other Inmates. New York: Doubleday.Google Scholar
  10. Jones, M. (1953).The Therapeutic Community: A New Treatment Method in Psychiatry. New York: Basic Books.Google Scholar
  11. McNemar, Q. (1969).Psychological Statistics. New York: Wiley.Google Scholar
  12. Moos, R.H. (1974).Evaluating Treatment Environments. A Social Ecological Approach. New York: Wiley.Google Scholar
  13. Moos, R.H. (1974). Context and coping: toward a unifying conceptual framework.American Journal of Community Psychology. 12, 5–25.Google Scholar
  14. Moos, R.H. (1987a).Ward Atmosphere Scale Manual, Second Edition, Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  15. Moos, R.H. (1987b).Community Oriented Programs Environment Scale Manual, Second Edition. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
  16. Moos R.H. & Finney J.W. (1983). The expanding scope of alcoholism treatment evaluation.American Psychologist. 38, 1036–1044.Google Scholar
  17. Moos, R.H., Shelton, R. & Petty, C. (1973). Perceived ward climate and treatment outcome.Journal of Abnormal Psychology. 82, 291–298.Google Scholar
  18. Mosher, L.R. (1982). Italy's revolutionary mental health law: an assessment.American Journal of Psychiatry. 139, 199–203.Google Scholar
  19. Ryan, E., Bell M & Metcalf J. (1982). The development of a rehabilitation psychology program for schizophrenics: changes in the treatment environment.Journal of Rehabilitation Psychology. 27, 67–85.Google Scholar
  20. Stanton, A. & Schwartz, M. (1954).The Mental Hospital: a Study of Institutional Participation in Psychiatric Illness and Treatment. New York: Basic Books.Google Scholar
  21. Stern, G. (1970).People in Context. New York: Wiley.Google Scholar
  22. Stern, G., Stein, M. & Bloom, B. (1956).Methods in Personality Assessment. Glencow, Ill.: Free press.Google Scholar
  23. Tansella, M. (1989) Evaluating community psychiatric services. In:The Scope of Epidemiological Psychiatry (eds.) P. Williams, G. Wilkinson & K. Rawnsley). London: Routledge.Google Scholar
  24. Tansella, M., & Williams, P. (1987). The Italian experience and its implications.Psychological Medicine. 17, 283–289.Google Scholar
  25. Tansella, M., Meneghelli, G. & Siciliani, O. (1982). Implementing a community psychiatric service in South-Verona under the new Italian Mental Health Act. A two-year analysis.Psychiatry and Social Science. 2, 105–114.Google Scholar
  26. Tansella, M., De Salvia, D. & Williams, P. (1987). The Italian psychiatric reform: some quantitative evidence.Social Psychiatry. 22, 37–48.Google Scholar
  27. Tranchina, P., Archi, G. & Ferrara, M. (1981). The new legislation in Italian psychiatry: an advanced law originating from alternative practice.International Journal of Law and Psychiatry. 4, 181–190.Google Scholar
  28. Wendt, R.J., Mosher, L.R., Matthews, S.M. & Menn, A.Z. (1983). Comparison of two treatment environments for schizophrenia. In:Principles and Practices of Milieu Therapy. (eds.) J.G. Gunderson, O.A. Will Jr & L.R. Mosher). New York: Jason Aronson.Google Scholar
  29. Williams, P., De Salvia, D. & Tansella, M. (1986). Suicide, psychiatric reform and the provision of psychiatric services in Italy.Social Psychiatry 21, 89–95.Google Scholar
  30. Williams, P., De Salvia, D. & Tansella, M. (1987). Suicide and the Italian psychiatric reform. An appraisal of two data collection systems.European Archives of Psychiatry and Neurological Sciences. 236, 237–240.Google Scholar
  31. Zimmermann-Tansella, Ch., Burti, L., Faccincani, C., Garzotto, N., Siciliani, O. & Tansella, M. (1985). Bringing into action the psychiatric reform in South-Verona. A five-year experience.Acta Psychiatrica Scandinavica. Suppl. 316, 71–86.Google Scholar

Copyright information

© Human Sciences Press 1990

Authors and Affiliations

  • Lorenzo Burti
    • 1
    • 2
  • Ira D. Glick
    • 3
  • Michele Tansella
    • 4
  1. 1.Institute of PsychiatryUniversity of VeronaVerona-Borgo RomaItaly
  2. 2.South-Verona Community Psychiatric ServiceVerona-Borgo RomaItaly
  3. 3.Payne Whitney Psychiatric Clinic, The New York Hospital-Cornell UniveristyCornell Univeristy Medical College and Associate Director for Inpatient ServicesNew YorkUSA
  4. 4.Department of Medical Psychology, Institute of PsychiatryUniversity of Verona and Director of the South-Verona Mental Health CenterVerona-Borgo RomaItaly

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