Changing from mixed-sex to all-male provision in acute psychiatric care: a case study of staff experiences

Background: British government policy advocates the availability of single-sex inpatient mental health services (Department of Health, 2003), but there is relatively little literature comparing single-sex and mixed-sex service provision and less still describing transitions between the two. Aims: To describe the experience of nursing staff on an acute psychiatric ward during the transition from mixed-sex to all-male provision and the following 9 months and to suggest how this might have been improved. Method: All nursing staff working on the ward at the time of the change were asked to complete questionnaires 3 and 9 months later. Results: Response rates were 75% and 50% at 3 and 9 months respectively. Staff generally experienced the change negatively, with particular concerns about the ward environment becoming less therapeutic and more aggressive, and jobs becoming more stressful. These concerns did not diminish over time. Other concerns were related to the process and administrative consequences of change. Conclusions: The transition to single-sex provision can be a difficult one, and staff should be involved as fully as possible in the process of change. Working with all-male populations can present particular challenges and staff are likely to benefit from specific training and support to meet these