Consumer satisfaction with institutional and community care.

Rather than addressing the psychiatric patients' preference between institutional and community care, research has addressed the consumers' satisfaction with the respective milieus. Studies of overall satisfaction have found that at least 50% of patients approve of the overall treatment strategies in both settings. However, the discriminative power of overall analyses is limited. This paper reviews those studies which have evaluated consumer satisfaction with components of treatment across four dimensions; characteristics of staff, treatment services, the physical environment, and activities that foster autonomy. Inpatients are pleased with the quality of staff relationships and the hospital surroundings but find that talk therapy can be a nuisance and do not like the loss of freedom and privacy characteristic of a locked ward. Far less research has been completed on outpatient samples such that the four dimensions cannot be readily applied. Community consumers express similar approval of staff and are less critical of medication interventions than inpatients. Research suggests though, that consumer satisfaction in part reflects patient characteristics. Results of this summary have implications for addressing program development in both institutional and community settings.