Since 2006, the National Research Institute (NRI), the research arm of the National Association of State Mental Health Program Directors (NASMHPD) has been surveying state psychiatric facilities on their smoking policies and practices. In 2005, NRI performed the analysis of the initial environmental scan conducted by NASMHPD to develop a baseline of information. At that time, there was a 55% response rate and only 20% of facilities indicated that they prohibited smoking.
In 2006, NRI developed a refined survey with more variables, such as developing operational definitions of smoking and non-smoking; environmental and safety issues; staff training; and treatment options. Facilities self-identified whether they prohibit or allow smoking by the version of the survey they completed. The 2006 survey had an 82% response rate and 41% of facilities indicated that they prohibit smoking. In 2008, NRI refined the 2006 survey to provide a hierarchy of policy statements in order to refine and categorize facilities as either "prohibiting" or "allowing" smoking and adding questions to focus on treatment and continuity of care.
The 2008 survey had a 75% response rate and 49% of facilities were categorized as prohibiting smoking. The multi-year survey results indicate a clear movement toward facilities prohibiting smoking. In 2011, 79% of the facilities were categorized as prohibiting smoking (n=131), the vast majority of which (95%) are totally smoke-free campuses. For those facilities categorized as allowing smoking (n=34), 3% allow smoking inside the facility in designated smoking areas, 24% allow smoking outdoors, and 74% allow smoking outdoors only in designated areas. Three percent (3%) of the facilities that prohibit smoking and 41% of facilities that allow smoking also allow the use of sm
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