Ward culture and atmosphere

Abstract

Violence and aggression in the inpatient psychiatric setting has long been a major cause for concern in the UK, and continues to be the subject of a considerable amount of research, official reports, and policy documents (Lowe, Wellman, &Taylor, 2003). This is also true of Switzerland and a number of other European countries, in particular Sweden, Finland, Norway, and, to some extent, Italy, where an increasing amount of attention has been given to this subject (Bowers et al., 1999). In contrast, a great deal of work has been conducted in America and the work of Morrison (1998) has been significant in this field of research but more from an organizational and cultural perspective. The literature concerning aggression and violence in psychiatry from a broader perspective is extensive and indicative of concerns surrounding a problem which has been investigated from a number of angles. While this has commonly involved the characteristics of staff and patients, a range of other factors external to the two parties or associated with their relationships and interactions has also been examined (Secker et al., 2004). The influence of the ward atmosphere on the incidence of aggression, for example, is one area that has been acknowledged for some time, particularly since the reported negative impact of the institution. Despite the processes of deinstitutionalization however, the hospital setting remains the hub of mental health services in many countries.