Use of first and last names and milieu characteristics

As a part of a cooperative study of 79 psychiatric wards in 18 Veterans Administration hospitals with 12,000 resident patients, data were obtained on how staff members and patients address each other. It was found that first name usage by staff members and patients correlates with certain characteristics of psychiatric wards. Predominant first name usage tended to occur on wards with a high degree of patient autonomy, patient participation in discharge planning, nursing personnel wearing street clothes, etc. These characteristics are consonant with a particular ward model, namely that of a therapeutic community.