Einfluss einer-Offenen-Tür-Politik auf die Stationsatmosphäre: Auswirkungen auf die Behandlungsqualität

Objective To compare the ward atmosphere, safety, therapeutic hold, and patients' coherence on recently opened (1 year), opened (4 years) and open (>?20 years) psychiatric wards in a longitudinal naturalistic study design. The question was if a patient shift from formerly locked to open wards might deteriorate the ward atmosphere on the open and opened wards. Methods Ward atmosphere on two recently opened (n?=?2), opened (n?=?2) and open (n?=?2) wards was examined using the Essen Climate Evaluation Schema (EssenCES) in a follow-up study after 4 years. Structural as well as clinical data were extracted. Results Global ward atmosphere, safety, and patients' coherence on the recently opened wards was significantly increased; on always opened wards and long-term opened wards it remained unchanged. Coercive measures and discharges against medical advice decreased during the open door process. Conclusion Opening locked psychiatric wards can help to establish a positive therapeutic atmosphere without changing the therapeutic climate on the other already open wards. A better ward atmosphere might be connected with a better therapeutic quality.