FEATURE
Mental health care in the UK is at a crossroads and its future is anything but clear. Many mental health care facilities remain rooted in the past, while others are world class, and demand for services is escalating rapidly, unmatched by any fundamental alterations in the way mental health care is perceived and delivered.
Held back by concerns over NHS funding, mental health care across the UK still remains second in line to physical health services: it is invisible and therefore more easily ignored. A new approach to mental health care is needed, which will find its physical expression in modern, thoughtful design; better community integration; and a focus on rehabilitation and recovery.
MODERN, INNOVATIVE DESIGN One barrier to effective mental health care in the UK is a lack of NHS funding. Despite a five-year mental health care plan from the government introduced in 2016, and an extra £1 billion of funding committed by Secretary of State for Health and Social Care, Jeremy Hunt, a lack of financial and political stability in the country has leſt mental health services deprived and underserviced.
Many facilities are old-fashioned and decaying, and there is little money available to fix them. Building effective mental health facilities can be difficult, as developers need to create an environment that is robust and efficient, yet fluid and scalable. However, better care doesn’t have to cost more to build – it just has to be thoughtfully planned.
Recent studies have highlighted the importance of space and access to light in mental health care facilities. Old hospitals can lack privacy and dignity, fresh air and space, however new facilities have shown that clever design can be one of the most important factors in ensuring excellent service. Design features can be as simple as ensuring good acoustics, ample daylight, natural ventilation, and access to gardens and outdoor spaces. These features don’t need to be expensive, but the inclusion of such careful, considered design can significantly improve a patient’s care experience.
South West London and St George’s Mental Health NHS Trust (SWLSTG) offers
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an outstanding example of this new approach to mental health care. Surplus land at the Springfield University Hospital site in South London will be repurposed to create a new set of buildings, including residential facilities which will ultimately make the project self-funding. The new health facility is designed to offer best in class modern care through technological sophistication combined with a humanised medical environment. Despite being spacious, SWLSTG is designed to feel safe and welcoming, with green, active, pro-social and safe areas for patients to interact. Importantly, the facility is easy to maintain due to its well-considered design e.g. a brick façade which is durable, looks great and will last a long time.
COMMUNITY INTEGRATION For many inpatients, the loneliness and isolation that comes with being treated away from home can make their treatment an overwhelmingly negative experience. This is one reason why community integration has become such a critical factor when designing and building new healthcare facilities. While it is important for mental health care developments to minimise risk and maximize patient safety, it is equally important patients’ should not feel isolated, and this means that mental health care facilities must not be cut off from the wider community.
This approach has been demonstrated by a new generation of hospital builds, including SWLSTG, which aims to be a destination in itself and includes not only two new mental health buildings but associated community facilities, including a primary school, homes, a park, amphitheater and park spaces – creating much-needed housing in the area and considerably improving it for community use. Working with the community and with housing and welfare providers helps move patients through the system more effectively and reduces out-of-area placements so patients are treated closer to home.
REHABILITATION
AND RECOVERY The UK has begun to adopt a new model of treating mental health issues, moving away from costly, bed-based
provisions to a system of rehabilitation and recovery. There are opportunities for design to give patients more control over their environments, with buildings enabling people to begin to rebuild and regain their lives.
“There needs to be a revolution in how the
treatment of mental health is delivered, ensuring that people can get access to the care that they need.”
By improving step-down, rehabilitation and recovery services, and helping users and staff to feel valued and remain a part of their community, hospitals need not merely be treatment areas – they can also be calming and safe environments for patients and staff. This is why thoughtful design, including plenty of air, light and outside space, is vital. Indeed, studies have shown that green space is associated with a reduction of stress and depression and improved mental functioning. A slight sense of recovery, not institutionalization, is important even for those patients whose treatment takes a long time – arguably it is for these patients that outside space is most vital.
Specialised facilities can also help with rehabilitation and recovery. Patients with eating disorders, for example, can benefit from shared rooms, which help foster a sense of group responsibility, while dementia sufferers benefit from buildings which avoid reflective or dark spaces, or confusing patterns in flooring and paving. Another option, introduced in Australia, could be specialised facilities for particular age groups or specific trauma groups.
There needs to be a revolution in how the treatment of mental health is delivered, ensuring that people can get access to the care that they need, when they need it. Modernising and streamlining the care pathway, altering the funding model and improving outcomes for patients must take place, and fast.
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