A comparison of the psychosocial environment of two types of residences for persons with severe mental illness: Small congregate community residences and psychiatric inpatient settings

Background: Legislation was passed in Sweden to stimulate the development of different housing solutions for persons suffering from severe mental illness. Among these solutions are small congregate residences built in the community to provide suitable housing and support for those not able or willing to live independently. Aims: The general aim of the present study was to compare the psychosocial environment of two types of residences for the persons with severe mental illness - congregate community residences and psychiatric inpatient settings. A specific aim was to see if the former provided higher levels of autonomy than the latter. Methods: In this cross-sectional study the real version of the Community Oriented Program Environmental Scale (COPES) was administered to residents, patients and staff members. Results: The study showed that the psychosocial environment differs between the two types of settings. Residents and staff in small congregate residences rated higher levels of Autonomy and lower levels of Practical Orientation, Anger and Aggression and Order and Organisation than patients and staff in inpatient settings. Conclusions: The psychosocial environment profiles for psychiatric settings in different phases of the care process may vary in terms of the aforementioned subscales.