Patient Perspectives on Open-Door Policies in Psychiatry: Mixed Methods Study.

Area of Science:

• Psychiatry and Mental Health Research
• Patient-Centered Care Studies
• Clinical Psychology and Treatment Models

Background:

• Open-door policies in psychiatric wards are increasingly recommended to reduce coercion and improve patient autonomy.
• Limited evidence exists integrating patient perspectives on ward openness and safety measures.
• Traditional qualitative methods may not fully capture the complexity of patient views on ward environments.

Purpose of the Study:

• To systematically explore psychiatric patients' perspectives on open-door versus locked-ward treatment.
• To identify key themes and quantify patient preferences regarding ward openness and safety.
• To provide a large clinical sample perspective on treatment environment preferences.

Main Methods:

• A hybrid questionnaire survey was conducted with 604 former psychiatric inpatients.
• The survey assessed psychiatric service usage and factors like ward relationships, autonomy, and coercion.
• Latent Dirichlet allocation (LDA) topic modeling was used to analyze open-ended patient responses.

Main Results:

• 63.8% of patients rated open-door treatment as 'very important'.
• 70.4% explicitly rejected voluntary treatment in locked wards, with only 21.0% accepting.
• LDA identified themes of 'Restriction and Institutionalization' versus 'Autonomy and Self-Determination'.

Conclusions:

• Psychiatric patients overwhelmingly prioritize open-door policies for enhanced autonomy, trust, and therapeutic engagement.
• Locked wards carry significant psychological and social costs; patient-centered models are crucial.
• Age and diagnosis influence acceptance of locked settings, necessitating tailored approaches to mental healthcare.