The changeover to single sex accommodation in psychiatric hospitals was intended to strengthen patients' dignity, safety and privacy (DoH 2000). Previous research on patients' attitudes to single sex accommodation suggests that female patients in particular are in favour, although the views of staff are less well known. Our aim was to examine both patient and staff perspectives on single-sex accommodation. We surveyed patients in acute psychiatric wards using a patient questionnaire that covered satisfaction of care and preference for single or mixed sex accommodation. In addition we undertook brief in-depth interviews using a semi-structured questionnaire with patients and staff in order to gain a better understanding of this issue. The results revealed that safety is a major concern in determining patient satisfaction with services. Female patients were much more likely to prefer segregated accommodation than men (Ï‡2 = 26.56, df = two, p < 0.0000). Patients suggest that diagnosis, severity of illness, and age are equally important in determining hospital accommodation and a safe, therapeutic environment. Male staff are concerned with potential allegations of sexual harassment, while women staff view single-sex accommodation as a threat to creating a more natural environment for patients. We conclude that while the majority of women patients favour single sex accommodation. The results of this study indicate that the views of patient and staff are more complex. Patient concerns of safety on psychiatric wards may not be wholly resolved by the introduction of single-sex accommodation. Clear policy guidelines and training must also be provided for staff members.