Psychiatric care and environments


As you might expect, in work with services for people with complex needs, the history and the origins of the psychologically informed environment approach is quite multi-faceted; but one of the more significant strands in this history was the development of 'social psychiatry' in the second half of the 20th Century.

From here came the inspiration, the  practice and many of the actual ideas  that fed into the original recognition of the emergence of the psychologically informed environment, as a phenomenon. (Also many of the challenges, in articulating a new way of thinking and working - see: 'a cautionary tale': and also 'learning from the CPA') .

Charting how psychologically informed environments seemed to work, in practice, began in the context of homelessness services, But very quickly it began to branch out to realise the relevance in many other related areas.

History tells how a similar spreading of the ideas had happened earlier with the therapeutic community approach, which later morphed into enabling environments, which was one of the more immediate origins of the PIE. Currently this thinking seems to be morphing again and broadening still further,  into the 'relational practice' idea.

Then and now

With a growing number of psychiatric in-patient services now showing an interest in the PIE approach, we are now seeing a return of these ideas and principles to their origins.

For the moment, much of the focus seems to be on attempting to introduce - or re-introduce - a culture of enquiry, through reflective practice at ward or unit level. In some cases, this may take the form of, or be combined with, 'formulation' discussions.

We have no information so far on examples of actual changes to the physical or social environment of wards, where many of the rules ands roles are still quite 'orthodox', and responsiveness is often still seen primarily in either clinical or 'critical incident' terms.

But it would be very interesting to hear more from these services about how in practice this re-introduction goes; and any examples of changes in ward practice, stemming from these discussions..

Further background reading/listening/viewing

Introducing PIEs through reflective practice in Bristol mental health services (video)


PIElink pages

Is it all just about homelessness? : HERE

A single framework : HERE

From PIEs 1 to PIEs 2.0 : HERE

Library items

(Please note: you will need to be registered and logged in, to access items from the members' Library.)

Is a PIE just about homelessness?HERE

Social Psychiatry and Social Policy for the 21st Century - new concepts for new needs, Part One: the ‘Psychologically Informed Environment’ Johnson & Haigh, 2010

The 'complex trauma guide (DCLG & NMHDU 2010) : HERE

Memes: a cautionary tale, Part One  (on TCs and the PIE as ideas)  : HERE 

Key Learning from the history of the CPA in mental health : HERE

Relational practice specification (draft): HERE

Implementing psychological formulation (NB: in hostels`) : HERE


The therapeutic community model in mental health (Johnson, 2015)