Organization and interaction in psychiatric day centres.

One of the major problems in the care of chronic patients is the design of suitable long-term environments. Following from the work of Tizard and his colleagues, a study is described which investigated the aspects of the organization, management practices and social interactions in 4 local authority day centres for the care of chronic patients in the community. It was found that these centres differed markedly in terms of their organization and management practices and that these differences were correlated with the nature and quality of staff-client (although not staff-staff) interactions. Client-oriented management attitudes were correlated with a more personal approach to clients' problems and a warmer quality of interaction. These differences did not seem attributable to different kinds of clients being involved in each centre. The results are discussed in terms of the possible causal mechanisms involved and their implications for designing systems of long-term care.