Ward atmosphere as a factor in irregular discharge from an alcohol rehabilitation unit

A 20-bed alcohol rehabilitation unit with a high patient retention rate had the experience of a sudden increase in irregular discharges. Administration of the Ward Atmosphere Scale developed by Rudolph Moos showed a drop in various therapeutic aspects of the ward environment that paralleled the increase in irregular discharges. These results were discussed with staff, and soon after the number of irregular discharges diminished. The Ward Atmosphere Scale was readministered and showed a move toward a more therapeutic atmosphere. The reasons for these fluctuations are discussed.