Some patterns of disturbed behaviour in a dosed ward environment

This article is concerned with identifying some of the causes of disturbed behaviours which are related to the psychological environment in a locked ward of a mental hospital. As part of a research project concerned with reducing the frequency of disturbed and disruptive behaviour, such incidents have been monitored and analysed with a view to better understanding their antecedents and thus establishing more effective management policies. Of special interest has been a group of disturbed forms of behaviour which appear to be related to each other by what we have termed ‘psychological factors’ in the closed setting. Specifically, these arise from and are maintained by the expectations that staff and patients have regarding normative behaviour in a locked ward. It is suggested that the closed setting implicitly defines certain disturbed behaviour as acceptable and that there are direct links between these norms and the level and particular variety of disturbed behaviour on the ward. The dangers of failing to recognize the relationship between disturbed behaviour and the psychological implications of security and illness and particularly of over‐reacting to apparent increases in disturbance are discussed.