DESIGN IN MENTAL HEALTH 2023


A patient standpoint on the PICU experience


Presenting at June’s Design in Mental Health 2023 Conference, Dr Stephen Dye, a consultant psychiatrist at Norfolk & Suffolk Foundation Trust, and the Assistant Editor of the Journal of Psychiatric Intensive Care, and one of his former patients, Bernard Fox, discussed ‘Physical environments of PICUs from the patient perspective’. They painted a vivid picture of how factors such as being presented with too much choice when psychotic, and not having the purpose of components such as CCTV cameras properly explained to them, can be disturbing for someone in a state of psychosis or altered mental state. The Network’s editor, Jonathan Baillie, reports.


The two speakers in a fascinating joint conference presentation on the event’s opening morning were introduced by the session chair, Roland Dix, who started his mental health career as a Nursing Assistant in 1984, became an Enrolled Nurse in 1988, a Staff Nurse in 1992, and was appointed Unit Manager and Clinical Nurse Specialist for the Greyfriars Psychiatric Intensive Care Unit at Wotton Lawn Hospital, Gloucester in 1993. During 1996 – with others – he formed the National PICU Group, the forerunner of the National Association of Psychiatric Intensive Care Units (NAPICU). Between 1993 and 2000 he worked as a Matron Manager and Research Consultant for Gloucestershire Health Authority, and in 2001 was appointed a Visiting Research Fellow to the University of The West of England. The founding Editor-in-Chief of NAPICU’s Journal of Psychiatric Intensive Care, he is an Executive Committee member of the Association, and also


‘an active commentator on psychiatric intensive care both within the UK and abroad’. Roland Dix told the audience: “I’m an


approved nurse, an approved clinician, and am able to act as Responsible Clinician for people detained under the Mental Health Act. We now have very interesting joint address to look forward to from consultant psychiatrist, Dr. Stephen Dye, and Bernard Fox, a farmer, and a contributor for many years now to national mental health policy development – predominantly within psychiatric intensive care. Bernard has considerable lived experience, including with Steve as a professional within an inpatient service. Over to them to tell their story.”


A long-standing connection Stephen Dye explained that he and Bernard Fox had known eachother since 2002, when the latter was an inpatient on


a psychiatric intensive care unit or ‘PICU’ where he worked. Dr Dye said: “Despite his illness at the time, there was clarity and sound thinking from him about both how services should be run, and the environment within which patients were cared for. I thought his ideas were really interesting, and tried to persuade him to come on board with NAPICU. He didn’t do so at time, but he remembered the conversation, and me, well – and when I later met him in a different PICU in Oxford, he remembered, and eventually we ‘clicked’ together within the National Association of Psychiatric Intensive Care Units. He has since become a heavyweight campaigner on mental health issues, and is heavily involved in NAPICU’s work.” Dr Dye continued: “What we normally do when we co-present is that Bernard introduces himself, and we do a bit of an interview. However, Bernard is very keen to tell his


Stephen Dye said: “When somebody is then gradually recovering from that state, they realise there are perhaps other choices, and this can then sometimes overwhelm people.”


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Bernard Fox said: “Had I invested the vast amount of money, resource, and time that healthcare providers had to create a totally controlled environment, I would have rightly expected it all to work.”


AUGUST 2023 | THE NETWORK


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