PHYSICAL CHARACTERISTICS OF RESIDENTIAL PSYCHIATRIC AND SUBSTANCE-ABUSE PROGRAMS - ORGANIZATIONAL DETERMINANTS AND PATIENT OUTCOMES

Described the Physical and Architectural Characteristics Inventory (PA CI), which assesses the physical characteristics of hospital- and comm unity-based psychiatric and substance abuse residential treatment prog rams for adults. Developed using data from 94 representative programs, the PACI has 7 dimensions that assess community accessibility, physic al features that add convenience, aid recreation and provide support f or patients, and space for patient and staff functions In comparison t o community-based programs (n = 63), hospital programs (n = 31) had mo re social-recreational and prosthetic aids, safety features, staff fac ilities, and space. The PACI dimensions were also related to other org anizational features, such as facility ownership and program size and staffing level. Programs with more physical amenities had patients who were more involved in self-initiated and community activities and wer e more likely to successfully complete the program and be discharged t o independent living situations and paid jobs. Programs with more soci al recreational and prosthetic aids, space, and access to community re sources also had better patient outcomes. In addition, PACI dimensions were related to observers' ratings of facility attractiveness. Potent ial applications of the PACI and the full inventory of which it is a p art are discussed.