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Large psychiatric hospitals are notoriously resistant to change. Their size and organisational complexity inevitably hinder their capacity to keep pace with trends. The serious consequences of a system that has ceased to adapt have been documented many times. Stereotyped routines and practices combine with rigid and bureaucratic management structures to produce the phenomenon of staff ‘burn out’, the “I've seen it all before and it doesn't work” syndrome.
We were asked to do some research into the needs of people with long-term mental health problems who were living in the community. The main questions which sprang to mind were WHO, WHAT, and HOW to approach this.
This is an attempt to evaluate the results of planned changes on a long-stay rehabilitation ward in a traditional mental hospital in England. The ward was housing a mixture of groups of patients of differing types and needs. The results of our study suggest that it is possible to improve patient care and staff morale on similar wards without extra staff, money or structural changes. Good planning, collaborative teamwork and dedication were the main tools.