Design in Mental Health 2015 Keynotes
20 years ago on arriving at a mental health hospital, when my first experience was the smell of urine dominating the facility. You don’t have that very often now, but when we design dementia care units and units for the elderly and frail, can we please design buildings that ensure we can cope with people who may occasionally be incontinent? We should also think about floor designs – about whether to specify carpets or vinyl floors; these are really important. You may open a building brand new, and in five years’ time, given the ensuing wear and tear, it might smell completely different. One of the other things I still look to do on viewing an old people’s unit is to inspect the toilet and bathroom areas, because these are vitally important.”
Acute ward design has developed considerably in recent years, as these contrasting images of ‘older’ (left) and ‘newer’ (right) such accommodation show.
SOUND – A NEGLECTED FIELD Focusing on the fourth sense, ‘sound’, John Short considered this one of the ‘five senses’ that designers and builders of mental healthcare facilities still paid insufficient attention to. He said: “In the past five years we’ve been focused on nice big entrances to units, and high ceilings in atrium and day areas. However, we then have to spend a fortune putting in sound baffles, because we find that, having built these large spaces, people can’t hear. We still also invariably put large loud televisions in reception areas. If you then put in 16 service-users, five staff, and have trollies running about, it’s really difficult to hear what is being said, or indeed to find somewhere really quiet.”
In the past 2-3 years, during his visits to inpatient units across the country, John Short said he had seen ‘one or two really innovative designs’, but also, including in his own service, ‘some really poor designs in relation to noise
and sound’. He said: “This is despite noise and sound being really important to service-users. One of the things many tell me is that they want to be in quiet areas; to be able to sleep, concentrate, and feel comfortable, and here excessive noise can be a real problem.”
A CAUTIONARY TALE As a cautionary tale of what could can happen should noise considerations not be properly addressed, he briefly discussed an adolescent and forensic inpatient unit opened by his Trust last year. He said: “It had a fantastic design; and we wanted it all off a large central atrium. “However, what we’ve ended up with is five sets of doors that slam about once a minute,
24 hours a day. Consequently we’ve spent a lot of money re-designing the doors and putting in sound baffles to address the issue. When I talk to inpatient service-users, one of the key things they complain about is not being able to sleep because doors are banging.” Focusing next on ‘sight’, John Short said: “Given that we judge and experience much of the world with our eyes, having designs which are really pleasing on the eye is clearly important, and I am pleased to say that, generally, the visual and aesthetic characteristics of mental health inpatient units have come on in leaps and bounds over the past decade.
“I look to make good use of all my senses during my many visits to inpatient units,” he explained. “I use them when I go onto a ward alongside my professional skills, and I am keen that all in our profession are properly doing so when we are designing wards and going on to test them out.”
LISTENING SKILLS
Alongside using their senses, and deploying their professional skills – ‘whether gained through two or 20 years’ experience’ as a nurse, clinician, designer, architect, or estates professional, John Short emphasised the importance of listening to service-users and staff. “Equally,” he added, “use your own personal experience and senses in relation to the design of the units you work on. Don’t
The interior of an ‘old’ rehabilitation ward, characterised by ‘narrow, airless, windowless corridors’, and ‘tiny rooms’, and a lighter, brighter, more spacious, modern-day inpatient ‘rehab’ corridor.
‘Lots of mental health Trusts have farmed out rehabilitation services in recent years. Some such facilities are in pretty grim accommodation’
THE NETWORK J u l y 201 5 15
Photos courtesy of Birmingham and Solihull Mental Health NHS Foundation Trust.
Photos courtesy of Birmingham and Solihull Mental Health NHS Foundation Trust.
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