4 June 2024 Seminars

09:15 - 09:45

Good Design, Human Value

Speaker:

09:45 - 10:30

Keynote: Designing A Mentally Healthier Nation?

Inequalities in mental health are deep and entrenched. But they are not inevitable. Centre for Mental Health has explored what causes mental health inequalities and what can change them. We’ll explore the evidence for what would create a mentally healthier society for us all, and how mental health services can be more equitable: a design for a mentally healthier future.

Speaker:

  • Andy Bell Chief Executive - Centre for Mental Health
10:30 - 11:00

Break

11:00 - 11:30

Crafting for Design in Mental Health: Personalisation, Participation and Production

The idea of 'crafting' has gained significant attention in studies of design and manufacturing processes in recent years. Design in mental health is a specialised practice, placing particular demands on how design and architectural projects are approached and emphasising the pivotal role of mental health service users. Design may also be directly informed by biographies and lived experience; it is not uncommon for members of the Design in Mental Health Network to express a personal stake in their work. In this paper I want to consider how the idea of 'crafting' might help to make this relationship between design and lived experience more visible. Specifically, I want to focus on three key practices: 1) the ways in which staff seek to modify the built environment through projects which personalise ward space in ways that are meaningful to both service users and staff; 2) how service user participation in art projects can be understood as a form of crafting which intervenes within the inpatient space rather than as a therapeutic practice; 3) the extent to which the idea of crafting can be enable an alternative approach to personalisation and what the scope is for expanding this idea within the standards which govern design choices within inpatient settings.

Speaker:

11:00 - 11:30

Design for Health and Well-being – Design Suggestions For Interior Design in Compulsory Care Facilities

We will present research on the significance of the physical environment for health and well-being in various closed settings such as forensic psychiatry, youth homes (SiS), and prisons.
Moreover, we will propose design suggestions that may have the potential to improve people’s wellbeing and health in these settings.

The healthcare environment serves as an active agent in the rehabilitation and habilitation of patients in psychiatric closed care. The design of the physical environment in psychiatric settings has been compared to the need for high-tech equipment in somatic healthcare. The physical environment itself becomes both a tool and support for patients and staff, primarily through its stress-reducing function, as highlighted by the field of Evidence Based Design (EBD). Our research shows that the environment can support the therapeutic alliance between patient/client and staff, especially by conveying a sense of trust, security, and autonomy. It is also reasonable to assume that the environment itself can reinforce or "redirect" and change the identity we carry.

The staff constitutes the essence of the care provided, and therefore, their need for a safe and secure working environment should be an integral part of the environment's design. Only then can the conditions for good care and interpersonal encounters be established.

In any closed facility the feeling of confinement is at the forefront, accompanied by many losses. The question is whether the environment can compensate for these losses, or at least not exacerbate them. Despite the limited living conditions within institutional care, there are ample opportunities through environmental design to promote well-being. We see that physical and mental health could be positively influenced by designs that encourage e.g. physical movement both indoors and outdoors, a better designed sleep environment, and not least a sense of belonging.

Speakers:

11:00 - 12:00

DrawnOut! Mental Health Sketch Workshop

This interactive workshop revolves around the stories of an architectural designer and her lived experience and a healthcare planner whose family experienced a loved one in crisis and the ripple effect on their lives. Through the lens of sketching of the inpatient psychiatric units both experienced as both patient and visitor, they share best practices and evidence-based design strategies for mental health environments. Participants are paired off and given an empathy exercise to help mitigate bias and built a rapport around a patient persona experiencing post-partum depression. The paired participants use these collective inputs to sketch a visitation suite, typically the only area of inpatient psychiatric hospital the public can experience. These sketches are shared in a rapid fire, round-robin style crit that fosters an open dialogue around stigma, design and hope. Together we can defy stigma by design. This workshop has been featured 4 times in North America, with each batch of sketches collected for a future exhibit.

Speaker:

11:00 - 11:30

Promoting Mental Health Through Inclusive and Trauma-Informed Design Strategies

There is plentiful overlap between inclusive design, mental health design and trauma-informed design, especially in mental health inpatient facilities, but they are often used in isolation or only for a post-crisis setting.  For the last decade, there has been a movement to include these design strategies into mental health spaces to promote healing and recovery. Designing the physical environment to support mental health healing should not just be applied to clinical spaces but to all spaces in our communities. Mental health crises don’t often happen in clinical settings.  What if designers not only incorporated thoughtful design into inpatient mental health settings, but also outpatient clinics, transitional housing, or even traditional healthcare or education settings?  Using these design strategies in tandem with one another can improve outcomes and also create a proactive environment when it comes to restoration, regulation and de-escalation.

Applying these design strategies in other areas of our communities represents a mindset shift toward regulation and prevention. While important, a physiologically informed environment just focused on inpatient/hospital settings misses opportunities to help individuals thrive in everyday community spaces. A moment of crisis could happen to a sexual assault survivor in a lobby who needs high-back seating so no one can approach unexpectedly. It could happen to a neurodiverse student who needs respite space between classes. Scenarios like this are all too common but often not addressed in the built environment. Inclusive design, mental health design and trauma-informed design can limit an environmental trigger response while also providing space for de-escalation, potentially preventing an acute mental health crisis.

This presentation will explore design strategies that enable the physical environment to be a tool in promoting individual regulation, de-escalation and mental health management in both mental health care spaces and other spaces in our communities.

Speaker:

  • Stephanie Vito Vice President and Mental Health Architect/Planner - Cannon Design
11:30

Medium-secure Spaces That Promote a Meaningful Day for Patients: Sycamore at Northgate Hospital

It is well recognised that in secure mental health inpatient units, boredom leads to challenging behaviours and poor physical health. This presentation will explore how considered planning and design can ensure ‘a meaningful day’ for all patients, promoting recovery through activity. The newly completed Sycamore at Northgate Hospital will be used as a case study to demonstrate this principle, with insight on the building design from Paul Yeomans (Medical Architecture).

Speaker:

11:30 - 12:00

Patient and Staff Lived Experience of Social Spaces

In collaboration with a large NHS Foundation Trust based in the North of England, this research project aims to understand the psychological dimensions of acute inpatient ward social spaces and explore the interplay of inhabitants and in both existing and newly developed acute environments. Acute wards are collective spaces of care, monitored and supported by clinical staff. Such spaces include inhabitants with individual and shared identities embracing diverse backgrounds and support needs. Social spaces on these wards constitute vital sources of social interaction offering core benefits related to recovery. However, they are complex spaces involving boredom, noise, social conflict and other challenges. There is currently a lack of research relating to experiences of social spaces, for those living and working in inpatient environments despite their importance in hospital life.

An interdisciplinary team of academics specialising in mental health and cognitive neuroscience research aim to capture emerging feelings, thoughts, and perceptions of inhabitant experiences and their bodily senses as they interact with old and new contemporary environments. Two studies will be outlined from this overall project, undertaken in acute mental health wards with staff and inpatients. The first adopts a well-established visual qualitative, photo-production methodological approach (Reavey, 2011; 2020) in a current hospital and the second uses a 3D visualisation approach using virtual reality with integrated eye-tracking to simulate a new hospital environment not yet built. The aim is to ascertain how patients and staff experience existing social spaces in acute environments in the first study and to then explore their experiences of social spaces in new (albeit virtual) ones as a means of comparison.

Through an ecological approach, a better understanding of these unique and complex spaces in acute mental health wards will be developed, furthering knowledge on the design and management of these vital social spaces.

Speaker:

  • Donna Ciarlo Doctoral Student - London Southbank University
11:30 - 12:00

What is Co-production and How Can You do it in the Context of the Built Environment?

In this presentation Raf will discuss his role as expert by experience lead within the largest independent provider of mental health services with the UK and give a working definition of co-production, recovery and lived experience. This will allow for the opportunity to understand the context of the presentation..

He will showcase various co-produced projects on the built environment, demonstrating how co-production and enhancements can in turn lead to improved patient outcomes and staff experience as well as a reduction in incidents and the use of force (i.e restraint, seclusion etc)

Raf will also take us on a journey to reflect on the unique proposition and insights people with lived experience bring to the table which has significantly improved patient safety from a built environment standpoint by being able to identify and mitigate risks whilst also balancing this with least restrictive practice.

Speaker:

12:00 - 13:30

Lunch

13:30 - 14:30

Keynote: Striving to become an Anti-racism Organisation in Mental Health: NHS England’s Patient and Carer Race Equality Framework

Speaker:

  • Dr Jacqui Dyer MBE Chair of the Advancing Mental Health Equalities Taskforce and the Patient and Carer Race Equality Framework Steering Group - NHS England
14:30 - 15:00

A Sheltered Retreat for the Specialist Treatment of Eating Disorders: Kimmeridge Court

Speaker:

14:30 - 15:00

Integrating Mental and Physical Health

Advances in medical care and treatments mean that more people are living longer and there is an increased prevalence of people being diagnosed with two or more co-morbidities. Individuals are no longer divided into a mental health or physical health silo; there are a number of evidenced links between the two which identifies the need for integration. As a result, it’s important to consider the whole person and the impact of a physical condition on the mind, which if left untreated can exacerbate both illnesses and drive up the cost of an episode of care.

Speakers:

14:30 - 15:00

Rethinking ‘The Therapy Room’: Flexible Spaces for Mental Health Work

Over the past 50 or so years we have seen the proliferation of ‘the therapy room’ as the primary environment for individuals to work through their mental distress with the professional other. At the same time there is a large issue across mental health services in relation to certain groups of people not accessing services and if they do there is an issue with service drop out. Therefore, in this presentation we consider if ‘the therapy room’ and mental health support needs a rethink in relation to the spaces, places, environments, and activities which constitute it. Drawing on theory and research, this paper will discuss the ways in which physical environments afford particular ways of seeing and being. We will highlight how prominent understandings of mental health work and the ‘the therapy room’ are understood by people who are traditionally characterized as ‘hard to reach’. This enables us to challenge the notion that particular groups are ‘hard to reach’ and suggest that it is the spaces, environments, and mental health practices are not appropriate for the mental health understandings and support needs of a variety of people. We conclude with the suggestion that if we are to provide mental health support to a broader population and address issues of equality, we need to start by thinking about the type of spaces and places we are building for mental health work to occur and how these spaces and places afford particular ways of ‘doing’ mental health work.

Speaker:

14:30 - 15:30

Workshop: Informed Choices – How Do I Choose the Right Safety Level of Product For My Patient Group?

A workshop for clinicians and people pledging support to the take up of the Informed Choices testing standard. Discussing the new CQC and Nursing Directorate guidance for ligature reduction in mental health settings in the light of the Informed Choices testing standard.

Speakers:

15:00 - 15:30

Backworth: A Holistic Approach to Living Well: A Model for Future Communities?

Active and integrated communities, designed with wellbeing at their heart are known to be more supportive, and have the potential to reduce hospital admissions.

The Ageing Well Village in Backworth is an ambitious scheme for later living. A collaboration between Northumberland Estates, Local Authority, specialist healthcare providers, and third sector organisations, the scheme creates an environment where people can live well into older age.

Initiated through the North Tyneside Ageing Well Board, the scheme was shaped by specialist stakeholders to offer a comprehensive range of residential options, integrated health and care services in one place. The team considered what influences health and happiness in older age, seeking to address not just health and care needs but also non-medical factors such as loneliness. The accommodation responds to different lifestyle demands. Accessible apartments, bungalows and ‘right sizer’ houses sit alongside an apartment building and Extra Care facility; all designed to encourage interaction and incidental meetings, fostering a strong community.

Enhancing step-up and step-down care models, the site includes a 40-bed intermediate care facility with rehabilitation and general medicine facilities, staffed by health and social care professionals. At the heart of the site a Wellbeing Hub provides a vibrant community facility with therapy rooms, hydrotherapy pool, and multi-functional spaces for classes, talks and hobby groups. The site also includes a nursery, which uses communal facilities and outdoor spaces, creating intergenerational contact.

The presentation will outline the aims and ambitions of this new senior living concept, looking at design principles and the challenges faced: from building the right project team, with involvement from multiple organisations, to making the financial case, and securing planning permission. Backworth demonstrates how the collaborative ambition and effort of health & social care, can produce a model for success to tackle some of the greatest challenges faced by health and social care today.

Speaker:

15:00 - 15:30

Challenging The Norm – Designing Bespoke Environments for Learning Disabilities

Reflections on the new £32m Aspen Wood Low Secure Learning Disabilities Unit Project, Maghull, for Mersey Care NHS Foundation Trust. Including national context re LD services, service aspirations/key drivers, Service user engagement, cross sector learnings, Sensory design, security challenges, Landscape design, the Arts, construction delivery through COVID. Lessons learned/Influence and on two subsequent GDA LD specific projects currently in design in Lancashire and the Black Country (ie Blundell Brooke LD Unit and Heath Lane LD recovery Hub). Continuity of briefing/risk approach across different Trust clients. Finally, lessons learned and impact on wider Mental Health design best practice not just LD.

Speakers:

15:00 - 15:30

The Bedroom Evolved: the Thought, Theory and Lessons Learnt From a Collaborative Project to Further Mental Health Spaces

The Bedroom Evolved was Darwin Group's exhibition at DiMH 2023, constructed by Darwin Group in collaboration with numerous exhibiting consultants including Safehinge Primera, Medical Architecture, Polar and Tough Furniture.

With the ambition of progressing discussion around Mental Health bedroom design, the project went from being a concept to a physical space in a matter of weeks. Initial meetings started in February 2023, construction commenced in May, and the final project was successfully unveiled at the Design in Mental Health conference on June 7 2023.

Everyone who worked on the project had the same vision – to create a ‘real’ room that felt homely and less like a clinical setting, but at the same time, was as safe as we could possibly make it.

The result was a fully realised prototype; a 12 tonne, 32sqm space including a bedroom, en-suite and connecting corridor constructed entirely by Darwin Group in their Shropshire factory, elevating the potential of Darwin Group's approach to MMC within the Mental Health sector. With everything fitted off site, the completed room made the short trip to Coventry where it was craned into place.

In this presentation, Louis Sullivan, Principal Architect at healthcare construction specialist Darwin Group, will chronologically walk through the design of this project, exploring some of the thought process behind decisions, recollect on some of the insightful discussions we had over the two day conference, and finally share the lessons learnt and good design we will take forward into future projects.

It is hoped that through this presentation, we will be able to share some of the insightful feedback we received from fellow architects, consultants, Trusts, and experts-by-experience, with the hope that learning from the Bedroom Evolved will make its way into future built projects.

Speaker:

15:30 - 16:00

Break

16:00 - 16:20

Breathing Life into Bedlam – How Improved Ventilation can be Achieved Within Mental Health Facilities

The mental health estate forms a substantial part of the estates portfolio which fails to meet current guidance around ventilation. It also has specific requirements. Many facilities are in older buildings that are difficult to manage. The purpose of the talk is to make the invisible (air) visible with a view to aiding designers and staff improve ventilation in a patient centric manner.
Whilst ventilation isn't as visual as art or lighting, its impact can have significant consequences within mental health. High carbon dioxide levels can affect cognitive function and potentially aggression. Even in areas that appear to comply with current practice pathogens can produce high viral loads and airborne disease can transmit or transfer rapidly. The talk will use examples from within existing ward installations, ECT suites and also reference long term data to show that effective use of the new guidance can enable change with a rapid return on investment.
In addition, the talk will also cover the use of approaches defined within HTM03.01 (ventilation standard) for mechanically ventilated areas which can offer easy enhancement to existing areas.

Speaker:

Chair:

16:00 - 16:20

Human Conscious Design Principles – Creating Spaces Where Everyone Can Thrive

We are all unique, our differences - shaped by age, gender, ethnicity, and ability - make up our multi-faceted and interconnected world. Over the last two years Tarkett have been carrying out research to understand how our different human make-up affects us as we go through life in education, at work and in elder care. This research has helped create 'Human Conscious Design Principles'.
For communities, organisations, and businesses to truly thrive everyone in society needs to be able to flourish. Design has a pivotal role to play here; to create spaces that foster inclusivity is imperative and this presentation looks at several neurotypes, in particular ADHD, autism and dementia, their signs and symptoms and the effect a well-designed, inclusive environment can have on the individual.
Inclusive design celebrates the vast diversity of human experiences by putting people at the heart of the process from the start. But it’s not about designing to the common denominator, nor at the expense of creativity. The presentation looks at specific challenges and individual needs focussing on sensory processing, executive functioning, and emotional regulation. It then looks at how we can design for life highlighting key considerations for designing environments specifically with hypersensitivities and hyposensitivities in mind, as well as dementia.

By the time the event takes place, there will be a RIBA accredited CPD and a virtual reality empathy platform to showcase a truly inclusive environment.

Speaker:

16:00 - 17:00

It’s No Fun Getting Older

In this interactive workshop we help designers experience the world from the perspective of an older person and one who is living with dementia. Using aids including a gerontology ageing suit and prompts (including feeding attendees chocolate) we explore how we experience and navigate buildings and complete tasks when our body and mind are receiving information differently and processing it in a different way to that of our younger years.

Speaker:

  • Andrea Harman Concept Developer Healthcare - Saint-Gobain Ecophon
16:00 - 16:20

The Challenges of Communicating Specifications When Designing a Bespoke Home Environment. What Do we Mean by “Robust”

The Safe Home Environment Assessment (SHEA) was developed as a pragmatic way to capture risk issues and sensory preferences that need to be considered when designing a more bespoke home for someone. It was originally focused on the transforming care agenda where suitable housing has been acknowledged to be one of the potential barriers to someone leaving hospital.

Speaker:

16:20 - 16:40

A Therapeutic Approach to Mental Health Design

This DiMHN presentation would explore the possibility that allowing service-users to engage in a greater variety of meaningful activities independently or with some degree of supervision reduces negative incidents. The new in-patient facilities at the Springfield University Hospital in South London are test cases to see whether designing for therapeutic benefit generates better outcomes. The initial data shows a significant reduction of incidents. Perhaps the path to safer environments doesn’t only mean designing-out risks. Perhaps environments where service-users are empowered to engage in meaningful activities of their own choice can lead towards a safer model of mental healthcare.

Designing out risk is the prevalent attitude of NHS management, consultants, designers and clinicians. The industry that provides products for mental health facilities is likewise directly responding to the possibility that terrible things can, and on rare occasions, do happen. This means that mental health products and facilities are designed primarily to address risks of self-harm or violent attack; as a result, they are heavy, uncomfortable, visually unappealing and stigmatising. They reinforce the subtle but unmistakable message of underlying control, threat and danger.

A set of primary design aspirations repeatedly surfaced in over 650 service-user consultations; these are the basis of an approach that designs around risk:
• Less Dreary: Avoiding monotony, providing opportunities to engage in beneficial, self-guided activities.
• Greener and Freer: Free access to gardens and outdoor space.
• Quieter: Full sound insulation between rooms. Acoustic dampening of airborne sound.
• Brighter: Ample daylight and views of the sky. External views.
• Fresher: Plentiful fresh air and natural ventilation. Comfort cooling of common rooms.
• Safer: ‘Avoidability’ – providing a choice of routes to get from A to B. Good sightlines and visibility for both staff and service users.
• Avoiding Stigma: A hospital where service users, staff and carers feel comfortable, valued and safe

Speakers:

16:20 - 16:40

Service User Led Design: Designing Therapeutic Personal Spaces for Autism/CAMHS Environments

Over the last 12 months the teams at Gilling Dod, Kingsway Group and Britplas have undertaken research, development, and collaboration to explore patient centred design around next generation CAMHS bedroom environments and in particular design responses around Autism, Neurodiversity and eating disorders.  The project is a vehicle to stimulate meaningful engagement and collaboration with a broad range of Service users, Experts by Experience, Clinical practitioners, carers, and providers in the sector. To give service user voices a platform, to stimulate design innovation/insight/learning and bring in supply chain experts/innovators to respond to bespoke needs. Aim was to create an innovative, responsive, sensory bedroom concept design which could be used to promote discussion/feedback/insights/learnings via real world mock ups to be encountered/explored/evolved with stakeholders moving forward.

Key to this project was engagement and we approached this is numerous ways. POE from previous CAMHS clients, reaching out to MH charities, advocates and champions in the field, and approaching leading figures in Autism centred services. This included The Caudwell Children’s charity who we have worked with collaboratively in developing the brief and even taking part in their Family fun day event meeting/engaging with young people, families, ambassadors and clinical practitioners to understand the key issues/drivers/triggers. Same experts then helped refine the initial concepts into a working design.

Designs were then developed with an assembled group of innovative suppliers (Kingsway Group, Britplas, Pineapple, Thorlux etc) to help create actual 1 to 1 mock up located either end of the country and with a view to engaging with key stakeholders over time to help evolve the understanding/stimulate the conversation. A chance to challenge the norm, go beyond the P23 repeatable room model, and promote design aspiration and expectations on MH build projects across all pathways.

 

Speaker:

  • Hannah Lee Interior Designer - Gilling Dod Interior Design
16:20 - 16:40

The Limitations of HTM 04-01 in Mental Health Built Environments

In light of increased concerns over water safety in healthcare settings, where antibiotic resistance and other tolerances have been documented, a question mark remains as to whether-or-not the current Water Quality and Safety guidance suitably caters for the complex and additional demands which the mental health sector must contend with.

The requirement of mental health, to ensure maximisation of risk management processes, extends beyond infection and scald risk when considering the specific requirements of the user and must also vitally consider ligature risk when choosing sanitary options. The limitations to the implementation of typical risk management processes, typically implemented across other healthcare sectors, caused by such ligature resistant requirements are considered to compromise infection control measures.

Additional guidance regarding water safety, published by BSI, outlines consideration for detail in prescribed plans to control water-borne pathogens. The notion of a Water Safety Plan is somewhat established in healthcare; however, debate remains about the necessary details regarding such plans, particularly the mitigating factors in sectors such as mental health.

We seek to present considerations for discussion in the design of facilities in the mental health sector to ensure proportional measures between infection, scald and ligature risk are adequately considered to allow a safer installation, commissioning, testing and operation for users during future occupation.

Speaker:

Chair:

16:40 - 17:00

Presenting and Informing Integrated Estates: A Systematic Tool

Speakers:

  • Mark Nugent Associate Director - Medical Architecture
  • Michelle Evans Associate Director of Capital - Midlands Partnership NHS Foundation Trust
16:40 - 17:00

Safe and Hygienic Access to Drinking Water as a Vital Element in our Duty of Care

Summary: We understand the importance of water for hydration, and well-being and the need for hygiene within the mental health and general healthcare sector with drinking water. There is a duty of care to ensure that everyone has access to clean, fresh water, free from pathogens and bacteria. Our speaker proposal would cover the following topical content:

Duty of care
Everyone to have access to hydration, clean drinking water.
Clean, safe water is fundamental to life.
Clean, safe water is also essential to recovery and well-being.

Safety
The Porpoise, anti-ligature, shallow, safe, surface mounted drinking water tap.
Anti-ligature faucets allows vulnerable people to safely pour their own drinking water without any fear that that faucet could cause them harm.
The Porpoise has an exceptionally shallow and smooth profile in a single case design, it is both robust and vandal proof.
Being able to self-serve drinking water ensures a balance between being hydrated and healthy.

Hygiene and infection control
UV-C LED – technology to reduce bacteria and viruses which could be present in water – ensuring clean and safe drinking water.
Carbonless filtration – maintaining chlorine levels for increased disinfection.
SensorBeam® / advanced technology – completely touchless drinking water dispense, no pedals of buttons to clean or which may harbour bacteria.
Antimicrobial – using silver ion technology to stop reproduction of bacteria.
E6 chilled only water dispenser has been designed to include all of the above and a single water path throughout the system to eliminate chances of pipework dead legs.

Speaker:

Chair:

17:00 - 19:30

Awards Ceremony