DESIGN IN MENTAL HEALTH CONFERENCE 2019
views on the ward, and access to green spaces, as well as thinking about comfort and control, noise levels, acuity levels, and whether there is a sense of both physical and psychological safety.
Availability of seclusion rooms “We will also be looking at the availability of seclusion and de-escalation rooms. My experience is that psychiatric wards adopt varying practice – ranging from having no seclusion rooms, with perhaps ‘sensory spaces’ instead, to using rooms that are a kind of ‘halfway house’.”
Professor Reavey explained that the study team would be taking both quantitative and qualitative data, and examining service-user demographics, as well as diagnoses, levels of aggression, and the frequency and duration of physical restraint, seclusion, and de-escalation episodes. She said: “We are going to collate comprehensive records of such practices, to try to link what is going on in the ward at the time with those quantitative components.”
The study will also, she explained, examine records of the number of staff on shift during periods of restrictive interventions – including bank staff, who the Professor said ‘came up again and again’ as being a factor behind service-user unrest on inpatient wards – in that the patients might well not be familiar with the individual delivering their care – and the impact that this has on restrictive interventions. Also considered would be ward activities at the time of any such interventions – such as occupational therapy. She said: “We will also be using a very well-established scale, the ‘Ward Atmosphere scale’, which looks at a number of different elements – thinking about the relationships on the wards, as well as the lighting, the sounds, the atmosphere. This is a really difficult thing to capture, but we will be harnessing a quantitative scale to do so.”
they feel. We want this comprehensive qualitative and quantitative outlook; we want to capture the lived experience in its totality, as far as we can.”
Occupational therapy is a key element of the care and treatment regime on the Endcliffe Ward.
Impact of staff stress
Another factor considered would be what the Professor dubbed ‘the very important factor of staff stress’. She said: “We focus so much on what is wrong with service- users at the time of restrictive interventions and seclusion, but staff stress levels are really key too.” For the qualitative component, the study team would be examining service-users’ experiences, i.e. ‘how they use the ward, and how they feel about it and about the staff’. The DiMHN Research and Education Workstream lead explained that ‘visual qualitative methods’ would be included. She said: “One of the approaches I have developed – and subsequently used many times – is to get people – both service-users and staff – to take photographs of the ward spaces, what they do within them, and how
An approach to admire Indeed, Professor Reavey explained, both service-users and staff would be ‘interviewed’, with the key focus being ‘that lived experience approach’. In essence, she said, the joint study team would be looking to understand how restrictive interventions come about why and how are they used, and whether there are alternatives. She said: “I think Dave Riley of Mersey Care’s presentation earlier in this session – on an initiative by his team at the Mersey Care NHS Foundation Trust to reduce the use of restrictive interventions – really resonated with the approach I would like to see used much more frequently; this idea of collaboration, flexibility, and relationality. We will also, however, be thinking about how we, as academics, researchers, and designers, concerned with mental healthcare, can design environments that make people feel better about themselves and the care they are receiving, as well as the key considerations for the staff using such environments.”
With that Professor Reavey closed her presentation, and introduced the session’s final speaker, Alex Senciuc, an architect at Medical Architecture, whose conference address focused on ‘Assembling a standard design for a multi-purpose seclusion unit’. n
Touch solutions for recovery We offer touch solutions f or a
To sustainable r
The Cardio Wall, an ‘activity feature’ that patients on the Endcliffe Ward enjoy.
erecovery, which
are suited for different leve ls of security. Our apps a re designed for use in cris is
care and centered arou nd aiding recovery.
The app library consist s of
different kinds of apps, ea ch with their own purpos e.
Some examples of apps a re
personal photos and video s, relaxing themes, games a nd video calling.
+31 (0)6 51640640
info@recornect.com
www.recornect.com
THE NETWORK | JULY 2019
21
©Dr Hamid Alhaj
©Dr Hamid Alhaj
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