What Makes a Good Psychiatric Ward?

It shouldn't make a significant difference whether a psychiatric ward is public or private. While resources may vary, both systems should be guided by the same fundamental principles: safety, dignity, recovery, collaboration, and hope.

When I moved from Nepean Psychiatric Hospital to the Hills Clinic following my manic and psychotic episode in 2023, the difference was striking. My experience in the public system was one of isolation. Although allied health staff visited the ward and occasionally facilitated activities, there was very little to do for most of the day. Recreational facilities had either been removed, were unavailable, or were no longer functioning. Formal therapy was limited. During my stay of more than three weeks, I only saw my psychiatrist a handful of times.

While some nurses embraced a collaborative approach and took the time to engage with patients, many interactions felt distant and task-focused. Much of the day was spent waiting—waiting for meals, medication, reviews, and eventually discharge. Healing seemed to rely largely on medication, rest, and support from other patients. In many ways, the strongest source of support came from the peer connections formed on the ward rather than from the system itself. The atmosphere often felt focused on containment and risk management rather than recovery.

My experience at the Hills Clinic was very different. Upon arrival, I received a comprehensive assessment and an individual treatment plan. Each day included several therapeutic groups covering approaches such as Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT), Cognitive Behavioural Therapy (CBT), and mindfulness. These sessions provided practical tools for understanding my experiences, managing distress, and rebuilding my life after the episode. I also saw my psychiatrist regularly. This allowed for ongoing adjustments to my treatment, medication, and recovery plan based on my day-to-day progress. Physical health was also recognised as an important part of recovery. The clinic had a well-equipped gym, and patients could participate in regular exercise programs, including fitness sessions and martial arts activities. The result was an environment that encouraged both physical and emotional well-being. There was still a strong sense of community among patients, but the structure of the program helped create more opportunities for engagement, growth, and recovery.

These experiences taught me an important lesson. A good psychiatric ward is not simply a place where symptoms are managed. It is a place where recovery is actively supported.

This includes access to regular therapy, meaningful activities, physical exercise, peer support, allied health services, and opportunities for consumers to participate in their own care. It means treating people as active participants in their recovery rather than passive recipients of treatment.

It also means creating a culture of collaboration rather than one of "us versus them."

The reality is that public mental health services often operate under enormous pressure with limited resources. Staff work in challenging environments and are required to manage significant levels of risk. Yet this does not change the fact that people recover best when they feel heard, respected, engaged, and involved in decisions about their care.

Looking back, what made the biggest difference was not simply the quality of the facilities or the amount of funding. It was the philosophy of care. The best psychiatric wards do more than keep people safe. They help people recover. They provide structure, connection, hope, and opportunities to rebuild a meaningful life beyond the crisis that brought them there. That, in my view, is what makes a good psychiatric ward.