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The Importance of Nidotherapy and Environmental Change in the Management of People with Complex Mental Disorders

Centre for Psychiatry, Imperial College, London W12 0NN, UK
Int. J. Environ. Res. Public Health 2018, 15(5), 972; https://doi.org/10.3390/ijerph15050972
Received: 12 April 2018 / Revised: 10 May 2018 / Accepted: 10 May 2018 / Published: 13 May 2018
(This article belongs to the Special Issue Mental Health and Social Care and Social Interventions)
Much has been done in the last 50 years to achieve a better understanding of the psychosocial causes and other factors influencing the manifestation of mental illness, but there has been a conspicuous omission. Although gross environmental deficiencies were exposed in old mental institutions, 70 years ago the more subtle maladaptive settings that reinforce chronicity in mental illness have often been forgotten. In this review, the potential of systematic environmental manipulation as a treatment (nidotherapy) and other similar forms of management, used many times in the past but now mainly in forensic settings, is examined. There is now accumulating evidence, reinforced by controlled trials, that planned environmental change, preferably carried out with the full cooperation of the patient, can be a major contributor to therapeutic benefit. It is also very cost-effective. All forms of the environment, physical, social and personal, can be addressed in making assessments, and once a planned way forward has been chosen, progress can be monitored by personnel with limited mental health experience. These interventions have applications in general mental health and occupational health services and deserve much wider use. View Full-Text
Keywords: nidotherapy; environmental change; forensic psychiatry; milieu therapy; therapeutic community; cost-effectiveness nidotherapy; environmental change; forensic psychiatry; milieu therapy; therapeutic community; cost-effectiveness
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Tyrer, P. The Importance of Nidotherapy and Environmental Change in the Management of People with Complex Mental Disorders. Int. J. Environ. Res. Public Health 2018, 15, 972.

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