Alternatives to standard acute in-patient care for people with mental disorders: from systematic description to evaluative research.

Many service users and professionals are not satisfied with current hospital care: they call for a safer and more friendly environment, with greater freedom and less social distance between staff and patients. Phase 2 of the Alternatives Study was designed to improve the evidence base for such residential alternatives. Findings suggest that offering a more acceptable environment increases satisfaction with treatment, although it does not improve the clinical outcome. This set of coordinated studies also suggest that we should listen (and talk) more to our patients, and make our style of working in hospital and community facilities less paternalistic.