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Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective

Open doors in psychiatry have been a subject of controversy in recent years. While some studies postulate the clinical necessity of closed doors, others challenge the theoretical advantages of this setting, mention numerous drawbacks of closed wards, and focus on the advantages of open-door settings...

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Autores principales: Steinauer, Regine, Krückl, Jana S., Moeller, Julian, Vogel, Marc, Wiesbeck, Gerhard A., Walter, Marc, Lang, Undine E., Huber, Christian G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541831/
https://www.ncbi.nlm.nih.gov/pubmed/33192724
http://dx.doi.org/10.3389/fpsyt.2020.580885
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author Steinauer, Regine
Krückl, Jana S.
Moeller, Julian
Vogel, Marc
Wiesbeck, Gerhard A.
Walter, Marc
Lang, Undine E.
Huber, Christian G.
author_facet Steinauer, Regine
Krückl, Jana S.
Moeller, Julian
Vogel, Marc
Wiesbeck, Gerhard A.
Walter, Marc
Lang, Undine E.
Huber, Christian G.
author_sort Steinauer, Regine
collection PubMed
description Open doors in psychiatry have been a subject of controversy in recent years. While some studies postulate the clinical necessity of closed doors, others challenge the theoretical advantages of this setting, mention numerous drawbacks of closed wards, and focus on the advantages of open-door settings. With regard to patients diagnosed with substance use disorders (SUD), other standards may apply. Very little research has been done on this topic. Some studies adopted a consumer perspective (i.e. asking involved parties about their experience of the door status). To the authors’ knowledge, no study has so far addressed the ideal setting for the treatment of SUD. With our data from the opening of a specialized SUD ward, we take one step to closing this knowledge gap. Applying a qualitative design, we asked patients and health care professionals (HCP) to report changes following the opening of the ward. The results are mainly in line with the literature on the general psychiatric population. The newly introduced open-door setting was mostly perceived as positive, but some disadvantages were mentioned (e.g. less protection of patients, less control over who enters/leaves the ward, the theoretically increased risk of patients absconding). Moreover, HCP (but not patients) mentioned potentially increased substance use on the ward as an additional disadvantage that could arise. Opening a previously closed ward was generally perceived as a positive and progressive decision. These findings support the trend towards an overall open-door policy in psychiatry.
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spelling pubmed-75418312020-11-13 Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective Steinauer, Regine Krückl, Jana S. Moeller, Julian Vogel, Marc Wiesbeck, Gerhard A. Walter, Marc Lang, Undine E. Huber, Christian G. Front Psychiatry Psychiatry Open doors in psychiatry have been a subject of controversy in recent years. While some studies postulate the clinical necessity of closed doors, others challenge the theoretical advantages of this setting, mention numerous drawbacks of closed wards, and focus on the advantages of open-door settings. With regard to patients diagnosed with substance use disorders (SUD), other standards may apply. Very little research has been done on this topic. Some studies adopted a consumer perspective (i.e. asking involved parties about their experience of the door status). To the authors’ knowledge, no study has so far addressed the ideal setting for the treatment of SUD. With our data from the opening of a specialized SUD ward, we take one step to closing this knowledge gap. Applying a qualitative design, we asked patients and health care professionals (HCP) to report changes following the opening of the ward. The results are mainly in line with the literature on the general psychiatric population. The newly introduced open-door setting was mostly perceived as positive, but some disadvantages were mentioned (e.g. less protection of patients, less control over who enters/leaves the ward, the theoretically increased risk of patients absconding). Moreover, HCP (but not patients) mentioned potentially increased substance use on the ward as an additional disadvantage that could arise. Opening a previously closed ward was generally perceived as a positive and progressive decision. These findings support the trend towards an overall open-door policy in psychiatry. Frontiers Media S.A. 2020-09-24 /pmc/articles/PMC7541831/ /pubmed/33192724 http://dx.doi.org/10.3389/fpsyt.2020.580885 Text en Copyright © 2020 Steinauer, Krückl, Moeller, Vogel, Wiesbeck, Walter, Lang and Huber http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Steinauer, Regine
Krückl, Jana S.
Moeller, Julian
Vogel, Marc
Wiesbeck, Gerhard A.
Walter, Marc
Lang, Undine E.
Huber, Christian G.
Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title_full Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title_fullStr Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title_full_unstemmed Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title_short Opening the Doors of a Substance Use Disorder Ward—Benefits and Challenges From a Consumer Perspective
title_sort opening the doors of a substance use disorder ward—benefits and challenges from a consumer perspective
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541831/
https://www.ncbi.nlm.nih.gov/pubmed/33192724
http://dx.doi.org/10.3389/fpsyt.2020.580885
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