Challenging Assumptions: Making a Success of Multi-Storey Mental Health

Synopsis

‘HBN 03-01 Adult mental health units: planning and design’ states that ‘Ground floor ward accommodation is recommended’ but does not provide any further qualification. In this presentation, Mark will discuss principles and assumptions, drawing on a range of case studies that explore approaches to ground floor and multi-storey mental health accommodation, to test this statement.

Mark will review potential implications if the guidance is always taken at face value, and mental health inpatient accommodation is only provided in a single storey. These include:

• Cost and affordability
• Capacity, development density and site context
• De- stigmatisation of mental health services

Mark will also review some of the common challenges associated with multi-storey mental health that have contributed to the provision of the guidance. These include:

• Autonomy and access to outdoor space
• Safety and security (including fire)
• Staffing models

He will then demonstrate how these challenges can be overcome through thoughtful mental health facility design, drawing upon recent case studies that demonstrate cost-effective multi-storey mental health facilities that provide a therapeutic environment for the recovery of patients.

This includes evaluation of the performance of the Blossom Court inpatient unit at St Ann’s Hospital which opened in 2020. The two-storey arrangement sees four wards stacked around two terraced courtyards, creating a therapeutic environment which promotes direct and independent access to outdoor space on both floors. Since completion, the Trust has reported that compared to the previous accommodation, seclusion and rapid tranquilisation of patients has significantly reduced, while physical restraint has almost entirely stopped, allowing better focus on the recovery of patients.