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Psychiatr Serv. 2013 Aug 1;64(8):789-95. doi: 10.1176/

Evaluating the built environment in inpatient psychiatric wards.

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Department of Emergency Medicine and Therapeutics, John Radcliffe Hospital, Headley Way, Headington, Oxford OX3 9DU, UK.



Research on inpatient psychiatric care has paid little attention to the built environment of psychiatric wards. This study described the built environment in a sample of inpatient psychiatric wards in England and investigated relationships between staff satisfaction with the built environment of the ward and objective design features of the environment.


Trained researchers completed a checklist of built-environment characteristics of 98 inpatient wards in England in 2007-2009. Interrater reliability was assessed and confirmed. Staff on these wards completed a three-item measure assessing the ward for overall design, fitness for purpose, and role in ensuring safety. Multilevel modeling was used to test relationships between built-environment features and staff satisfaction.


A total of 1,540 staff responded. The wards encompassed a wide variety of service types and built-environment features. Staff satisfaction with the built environment was associated with noncorridor design and with the provision of personal bathrooms for patients. No association with observability of patients, exterior views, or other facilities was found. There was no difference between nurses and other groups in satisfaction with overall design, but nurses rated ward environment lower on ensuring safety (p=.036) and on fitness for purpose (p=.012).


Objective measurement of the built environment in inpatient psychiatric settings is feasible and can be used to identify features that increase user satisfaction.

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