Changing the ethos of a locked ward to one that is more recovery-focused led to greater independence for service users, says Jeanette Henderson

Care of service users in a locked mental health ward can be improved if risk-averse attitudes among staff are changed. A more appropriate mindset encourages measured risk-taking and supports individuals to address their own physical, intellectual, emotional and social needs.

This article describes the nursing care and ethos in a locked mental health ward in Scotland, the need for change and the principles underlying the improved care now being delivered. The use of the tidal model is discussed and the changes made over a nine-month period while practice-related values and beliefs were adopted. The aim was to change what were custodial surroundings to a recovery-focused environment. Service users, who previously believed that there was a stigma attached to being in this ward, experienced supported autonomy and independence.