[Opening up an acute psychiatric ward as a complex intervention].

Area of Science:

• Psychiatry
• Clinical Psychology
• Healthcare Management

Background:

• Open-door policies in inpatient psychiatric settings may reduce conflicts and aggression.
• Reducing containment measures is a key goal in modern psychiatric care.

Purpose of the Study:

• To evaluate the impact of an open-door policy combined with a complex intervention on deescalating conflicts and reducing containment in an acute psychiatric ward.
• To assess the feasibility and staff perception of an open-door policy in inpatient psychiatric care.

Main Methods:

• Implemented a complex intervention including opening ward doors, intensive staff training in deescalation and nonviolent communication, rule liberalization, and access to a time-out room and secure garden.
• The open-door policy was established permanently after initial feasibility assessment.

Main Results:

• The open-door policy was feasible and permanently implemented.
• Incidents involving aggression decreased following the intervention.
• Containment measures did not decrease; staff found the open-door policy less important than other intervention components.

Conclusions:

• Opening a closed psychiatric ward should be part of a broader, autonomy-focused intervention.
• Sufficient well-trained staff and ward architectural features may be more critical for deescalation than the open-door policy alone.