Physical characteristics of residential psychiatric and substance abuse programs: Organizational determinants and patient outcomes

Abstract

Described the Physical and Architectural Characteristics Inventory (PACI), which assesses the physical characteristics of hospital- and community-based psychiatric and substance abuse residential treatment programs for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physical features that add convenience, aid recreation, and provide support for patients, and space for patient and staff functions. In comparison to community-based programs (n = 63), hospital programs (n = 31) had more social-recreational and prosthetic aids, safety features, staff facilities, and space. The PACI dimensions were also related to other organizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and were more likely to successfully complete the program and be discharged to independent living situations and paid jobs. Programs with more social-recreational and prosthetic aids, space, and access to community resources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potential applications of the PACI and the full inventory of which it is a part are discussed.

Built Environment and Mental Health

“…[32][33][34][35] Timko 36 showed that better physical amenities in psychiatric facilities (e.g., hallway decorations, weather protection at entryways) were significantly related to multiple indicators of psychological adjustment.…”

From Principles to Practice: A Study of Implementation of Supported Housing for Psychiatric Consumers

“…The close proximity to community resources is a salutary feature of SIL programs because prior studies in other mental health residential settings have noted a significant role that resource accessibility plays in enabling residents' integration (Kruzich, 1985;Segal & Aviram, 1978;Segal & Everett-Dille, 1980;Timko, 1996).…”

“…The Accessibility of Community Resources Scale (Timko, 1996) was adapted to include 18 different types of resources, including commercial establishments (e.g., retail stores and movie theaters), government facilities (e.g., post offices and libraries), health-related establishments (e.g., public health clinics and mental heath centers), voluntary organizations (e.g., faith-based organizations and community organizations), and public transportation (subway and train stations). Because of the variability in the number of establishments per resource type (ranging from 9 public health clinics to 2123 faith-based organizations), standardized scores were generated for each resource type and then averaged for an aggregate score of resource accessibility.…”

Facilitating Recovery from Drug and Alcohol Problems — Reflections on Interviews with Service Users in Scotland

“…The institutional environment of a social work office may also be off-putting. Visiting service users in their own homes or in other 'safe' places that are negotiated with them offers the possibility of a less formal, perhaps even more 'normal' relationship; research suggests that environment is an important factor in recovery (Moos 1996;Timko 1996;Wilton and Deverteuil 2006). However, on the negative, social workers may have justified concerns about lone visiting in service users' homes, especially when they may be under the influence of substances, and personal safety issues should never be underestimated.…”