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Conference Room B Seminars
Look at the World of Autistics
Arts & Crafts Center in 'Shimon Village' for Autistic People (ASD), and Communication disorder
I was asked to design Arts & Crafts Center for low functioning autistic adults.
In this e process I faced the following challenges:
The first challenge was the gray building with cold finishing materials as gray floor tiles, an office acoustic ceiling and a gray color palette.
The second challenge was designing for low-functioning autistic people who might throw furniture in a fit of rage.
In order to deal with the challenges I faced, I consulted and talked with the village manager and the village staff, learned and researched about the daily life schedule in the village.
I watched the activities of the villagers, the various workshops, during the day, the dynamics of the work in the various crafts and the relationship between the tenants among themselves and the staff.
The work in the village combines work with ancient crafts, alongside activities of painting, movement and music, which allow for an artistic space of expression.
While looking at the paintings, the tenants open a window to the diverse, rich and unique world.
I discovered people with a unique point of view.
The inspiration for the design of the corridors was in fact the paintings of the tenants, I wanted to empower the tenants by enlarging their paintings. The paintings were the center and from them I drew the colors for the walls and benches along the corridors. I enlarged their works to an entire wall and thus created an exhibition in the common space in which they live,
The desire and need for self-expression that exists in every person and person, regardless of his abilities, can be learned from the world-famous autistic painter Jessica Park. "Painting can be pleasant and liberating for people who want to express themselves... and the paintings may help others look at the world of autistics and understand them a little," she said. The art of autistic people is authentic and pure, free from fashionable shackles, logic or interest. It is a visual language, which mediates between the inside and the outside and is always a free choice and personal expression in a particular moment. This is where a thought is close to birth!
I designed the work spaces in light birch wood pleasant to the touch that connects to nature and evokes feelings that industrialized materials don't give.
- Dalia Shilony Interior Designer
Can Five Minutes Activity Five Minutes Before a Meal Time Impact on the Health and Wellbeing of People Living with Dementia
L&M Healthcare's Whittle Hall in Warrington was shortlisted as a finalist in five awards last year, winning one and coming second in another for a pilot study they conducted to see if just five minutes of activity for just five minutes before a meal improved the health and well-being of its residents.
The study was designed to see if an improvement in weight, nutrition, socialisation & interaction could be achieved. 10 participants were selected from their two dementia plus units. (These were residents who have more complex needs and challenging behaviours and were the people who could potentially get the most benefit from this study.) Two different activities were alternated before lunch and teatime; a music based interactive activity called the Jolly Trolley and light projected interactive table-based activity called the Tovertafel and they then filmed what happened.
10 residents were chosen to take part and the project culminated with a pop-up restaurant experience which some family members attended.
Amazing results were achieved
• All but one participant gained weight, in total the group gained 10 kilos.
• Mealtimes were calmer.
• People who were usually assisted to eat ate by themselves
• People were more sociable.
• Positive behaviours were seen that we had not seen before.
Throughout the evaluation period all the residents were alert, engaged and participating in activities;
• Residents began communicating with each other. Despite aphasic (difficulty in comprehending or formulating) language, interaction was still present, non-verbal exchanges were often positive smiling, laughing and the tone of voice used was playful despite the absence of meaningful language.
• Hand function seemed to improve.
• Motor skills seemed to improve or be regained.
• Consumption of food and drink increased.
• There was an increase in autonomy and independence - people who normally required assistance began eating without support and poured themselves drinks.
• Increase in language/communications between residents and staff and with fellow residents
• Increase in eye contact and engagement.
Lovely vs Ugly – Where is the Interface Between Beauty and Safety in Mental Health Design?
This talk will explore the historical learning curve of mental health architecture and product design and pose the question of whether safety has become more important than beauty in mental health building design. When creating secure and therapeutic environments there is a balance between creating a therapeutic healing space and reducing risk to create safe 'zero risk' spaces but have we gone too far in reducing the risks and overlooked the therapeutic benefits of beauty? Who are we designing buildings for - is it to heal patients or is it to make it easier to clean and maintain?
- Karen Flatt Architect – Mental Health Lead - IBI Group
Examining the Environmental Conditions for Psychological Safety: Insight From a Study on De-escalation and Seclusion
The physical environment of inpatient psychiatric units can impact patients' levels of aggression and agitation and therefore, lead to increases in the use of restrictive interventions and seclusion. Many studies have focussed on the impact of the design of the ward on patients' wellbeing, experiences, and recovery. However, studies investigating the impact of the environment and experiences of seclusion on the experiences of escalation and de-escalation of patients is scarce. In this presentation, we present some preliminary findings relating to how the environment and experiences of restrictive interventions and seclusion impact patient and staff experiences of escalation and de-escalation.
A qualitative study was used. Data was gathered through semi-structured interviews using photo-production and photo-elicitation with staff and patients within an intensive care psychiatric unit within the United Kingdom. We will explore three themes in the presentation, including 'Not All Spaces Are Perceived Equally...' which included 2 subthemes exploring the features of the environment that are conductive to de-escalation and the unhelpful qualities of the environment. The second, 'The Seclusion Room Acts as an Antithesis of Its Purpose' explore a paradox between the need and use of seclusion and the negative impacts and associations of the seclusion room. The third , 'Relating and Alienating' includes two subthemes and explores how the relationship between staff and patients changes after seclusion and the impact of the time of the day on patient and staff relations. Running through this analysis is attention to the master theme of psychological safety and how environments might be designed to simultaneously prioritise both psychological and physical safety.
- Professor Paula Reavey Professor of Psychology and Mental Health - MSc Mental Health & Clinical Psychology London South Bank University
Improving the Patient Experience With a Standardised Design for Safety Suites
This is a unique case study that examines the value of standardisation. It illustrates how the same environment meets a range of service needs.
At Design in Mental Health 2019, Ian Tearle (HPFT), Alexandru Senciuc (Medical Architecture), and John Plum (Blu Building Consultants) presented 'Assembling a standard design for a multi-purpose seclusion unit'. They described a programme to improve the quality of seclusion units across all mental health services run by Hertfordshire Partnership University NHS Foundation Trust. Existing seclusion facilities were of varying design quality, facilities suffered frequent damage which was disrupting the provision of services, while the time and logistics of repair was proving costly. Adopting a holistic approach, the Trust adopted a new standardised design which was applied to seclusion spaces within a range of mental health services such as learning disabilities, low secure services, medium secure services, and others.
We can now present how this standard design has been realised, with three facilities completed to date. The presentation will illustrate:
• how a standard design can be applied to a variety of site-specific conditions, to create a consistent quality of space and a positive patient experience.
• lessons to be learnt from staff and patient feedback since the facilities have been in use. In particular: the impact that the new facilities have on the different services and the effect they have on patient outcomes.
• a preliminary set of guidelines for future design of seclusion and safety suite facilities.
Keynote – Room A: Designing a Mental Health System for Equality #BetterTogether
- Sarah Hughes Chief Executive - Centre for Mental Health
Springfield Village – Mental Health at the Heart of the Community
The regeneration of the Springfield University Hospital site will reduce the stigma of mental health conditions by integrating the organisation within the community. This is achieved by combining the vision of a forward-thinking NHS Trust, a progressive view of mental health provision and the innovative thinking of an architect, Springfield Village will modernise and transform the way that mental health services are delivered for over a million Londoners.
The project creates state-of-the-art Inpatient Forensic and Non-Forensic mental health facilities, including 8 new wards with 134 beds, as well as outpatient consulting rooms, office space, retail areas and plant rooms. The wider project includes over 800 new homes, including 20% affordable housing, alongside community shops and a café, a new care home and land available for a new school, all adjacent to a 32-acre new public park. Major parts of the project were funded by the sale of underused buildings and surplus land to residential developers, enabling new facilities to be built alongside live mental health services.
The guiding principles of the new mental health facilities focus on a variety of environments, both internal and external, to create a homely environment that avoids monotony. Gardens and external spaces are incorporated, for the benefit of service users, staff, and visitors. The design achieves a multi-level hospital on a relatively constrained site that links all areas with the internal circulation space, a hospital concourse leading to public facing functions such as shops, restaurant, and gym. The staff entrances are through daylit atriums that bring everyone together in a pleasant, shared environment.
The new facilities were designed with the clinicians and service users to provide the most supportive environment and innovative facilities for the delivery of mental health care.
The Co-design of Mental Health Facilities with Service Users and Clinical Staff
Derbyshire is an outlier for the use of dormitory style accommodation with one of the highest levels in England. This has a negative impact on privacy and dignity and patient safety plus it also impacts on A&E and Acute Trust flow in Derbyshire.
Derbyshire Healthcare were issued a Formal CQC requirement under regulation 15(1)c to eradicate the use of dormitories by 2024.
Derbyshire also has no Psychiatric Intensive Care Unit capacity for male of female patients leading to all Derbyshire patients being placed out of area for this level of care. This leads to poor patient journeys and a lack of social, familial and environmental connections which are all known to aid recovery. The NHS 5 Year Forward View and Long Term Plan has a stated aim to end inappropriate out of area placements by March 2021.
The Programme being delivered by the DHcFT Programme Delivery Team includes 6 projects, 4 of which are related to dormitory eradication and 2 related to ending the inappropriate use of out of areas PICUs. The Programme include 3 new builds and 3 major refurbishments.
The Programme Delivery Team includes a Clinical Project Manager (a ward manager from an adult acute background) and a Project Officer who is also a service user with a physical disability. These key individuals attend all design meetings and are the key links to the Clinical and Service User reference groups respectively. The design meetings include a wide range of key individuals from across the Trust including E&F leads, Health and Safety, Fire, Security, Clinical, Medical and Infection Prevention specialists.
The co-design approach is being applied to all 6 projects with key decisions on form, function, look and feel being informed by the Clinical and Service Users Reference Groups.
- Nick Richards Project Officer and Lived Patient Experience Lead - Derbyshire Healthcare NHS Foundation Trust
- Geoff Neild Programme Director - Derbyshire Healthcare NHS Foundation Trust
- Andy Donoghue Associate Director of Estates and Facilities - Derbyshire Healthcare NHS Foundation Trust
- Becki Priest Deputy Director of Practice and Transformation - Derbyshire Healthcare NHS Foundation Trust
New Hospital Design: A Person-Centred Approach
Bradford's Lynfield Mount Hospital is a typical example of late 20th century design mental health facility. Supposedly purpose-built to treat people with mental health issues, what we recognise now quite clearly is that the "of it's time" hospital does very little to support patients towards recovery, or support the staff who try their best to provide good care.
With a clear vision from the Trust to create a truly supportive environment for personalised and person-centred care, the design development of this new hospital project included full engagement from the outset. Whilst not yet completed, the design development shows how user experience, past and present, influenced decision making and continues to shape design.
More and more people are becoming time-poor. But engaging in the right way is still key to any successful project, be it a new design or a new way of working. Making the process accessible to everyone has evolved using varied tools to ask the right questions of the right stakeholders, so that everyone's voice is heard.
The presentation will share how engagement with all the Trust's stakeholders was successfully undertaken within the restrictions of the Covid-19 pandemic, using varying strategies and tools throughout the process to ensure everyone had the ability and confidence to make valuable contribution.
The presentation will also share some first-hand key insight shared by Stakeholders, particularly those with Lived Experience during their admission and time spent as inpatients, which directly influenced the overall building strategy and detailed building layouts, landscape and aesthetic.
The Ligature Risk Assessment App at BDCFT
The purpose of a ligature risk assessment (LRA) is for the Clinical Team, Estates and Health & Safety to work together to develop a shared understanding of ligature risks within clinical areas including how risks are eliminated, managed and/or mitigated. The assessment is comprehensive as the assessment team:
• identify all potential ligature points in all rooms within the ward,
• grade the risk presented from each anchor point as per the four risk factors
• assign mitigating actions (where required) to reduce risk
Traditionally the ward LRA is a lengthy documented MDT exercise involving follow up work to record, report and action the assessment and subsequent actions, which were in an Excel document that was susceptible to errors and mistakes.
The objective of the new way of working was to ensure a technological and sustainable solution to undertake LRA'S incorporating:
• App GUI front-end for review and update of LRA's
• Migration of existing data from current inpatient LRA's into a data warehouse
• Development of data analytical reports from the LRA data
• In-built future proofing for any changes to Policy approach
The LRA App was born from collaboration between the health & safety team, KPO, and informatics after possibility thinking and coaching workshops. The app was purpose built within the Office365 platform (Sharepoint & PowerApps), from the ground up in-house using Kaisen methodologies to improve the LRA process through technological methods. The benefits of the app are:
• Improved patient safety for ease of access to clinical review of environmental ligature risks
• Real time risk assessments and scoring, on site.
• Real time tracking of score.
• Reduced the time spent on risk assessment allows more time for proactive resolution.
• Automatic notification.
• Automatic action assignment.
• Real time tracking of actions and progress.
• Live view of each area's risks.
• Automation of impact
• Built in mistake proofing.
• Built in visual control.
• Removed duplication of work.
• Future proofing for any subsequent changes to assessment approac
- David Gibson Compliance and Governance Manager - Bradford District Care NHS Foundation Trust
HBN 03.04 Low and Medium Secure Guidance for Both Adults, and Children and Young People
- Rosemary Jenssen Director - Jenssen Architecture Ltd
Guidance Led Testing of Products in the Mental Health Environment
Drawing on practical experiences, this presentation will explore the process for product testing from our initial conversations through testing to a completed test report and the certification scheme being built off the back of this. This will include a deep dive into the three main segments of testing from the informed choices guidance – reduced ligature, robustness and anti-barricade, giving you an inside view of our process to assist with preparing samples to achieve a representative result and how this translates to a test report. Furthermore, it will outline the latest information from the upcoming certification scheme.
- Sean Taylor Consultant - BRE
Exhibition and Close
Keynote – Room A: Mental Health In Design
Before you are a Keynote speaker. An architect. A designer. A product developer. A secretary. A parent. Sibling. Friend. Neighbour. Or any other label that you are given.
You are a human being.
I believe everybody has mental health.
We all have history. We all have memories. We all have experiences, likes, dislikes, fears, phobias, moments of joy, excitement. etc
If we don't look after and take care of ourselves, we can't look after anybody else or even do our jobs properly.
By getting to know ourselves and knowing what we need to do to take care of ourselves, we can be better prepared for what may happen & carry on with our lives.
My work is about people learning to discover what they need and what they don't need in their lives. I encourage people to understand that they are not on their own and lots of us have difficult times. What might be difficult for you? Maybe easy for me. What might be easy for you may be impossible for me. Once we learn about ourselves, we can explain about ourselves when we can explain about ourselves, we can help other people feel comfortable in talking about what's going on for them.
My motto is, “No one is better off or worse off than anybody else?“
- Nick Smith Former Service User - Missing Peace Wellness and Support
Self-Harm Reduction – Lessons on the Built Environment from NHS Scotland
This will be based on key learning and recommendations from the Report on Self Harm Reduction. Generated from multi –disciplinary experiences across NHS Scotland including NHS Capital Planning & Estates, Clinicians, and Health & Safety teams, this report provides a framework for improvements to data collection, design, operation and knowledge sharing of mental health built environment, to reduce self-harm and suicide attempts.
Sex, Love and Rock ‘n Roll Baby Boomers – Unusual Insights, Issues and Solutions
Between 1946-1964 the largest generation was created. The "Baby Boomers" radically changed society at every stage of their lives, as they will do so in their senior years, "from considerations regarding drugs, sex, rebellion and rock and roll to ending of life issues" and "will challenge long term facilities to in state new policies" James Sibeski. They have lived through post war food rationing to Deliveroo, from telegrams to the Internet, from Perry Como to Black Sabbath. From "The Year of Love" to the bombing of Hiroshima. From Charlie Chaplin to Monty Python... Mods, Rockers, Skins, Hippies, Punks, Goths and beyond.
The "Baby Boomers" will redefine old age. This longer living, "toughing things out", cohort will face significant challenges from failing body systems to mental health issues from depression, Diabetes, Arthritis, Cataract, incontinence to loneliness and from Dementia to substance abuse or misuse.
The Silver Tsunami is about to reach landfall hoping to see 2020 Design Vision for a very different future. Not one that is visually and mentally debilitating, containing Parker Knoll derivatives, fireplaces, over-sized clocks, rocking chairs, menageries of grabrails, flock wallpaper, nicotine colour ways all saturated in a Biome of "senior home" smells, unsuccessfully masked by Rose/Lavender scents.
What would inhabit this new world? Oxygen bars, Snoezelen Spaces, VR to fly a kite in Hawaii, "Zimmer" band gigs, grannies boxing to reduce Parkinson tremors, Dementia Pubs and Cafes, sheds to rebuild motorbikes, invention workshops, robotics, exotic pets, LED pillows, body driers, Tomek fittings, Toto WCs, Amazon, Google, Microsoft digitized support and virtual mental health consultations.
Let us deconstruct, reconstruct and reboot today's obsolete concepts into forward-looking paradigms focusing on invisibly and symbiotically supportive features that create environments that offer experiences that empower.
- Richard Mazuch Director of Design Research and Innovation - IBI Group
Mental Health Inpatient Design and Build in Inherited Buildings
Review of 3 recent refurbishment projects:
- Beech Ward /Older Adults Mixed Functional Ward - 16 Bed Ward which was previously a Maternity Ward handed over to the Trust in 2012 and refurbished to current standard.
Design Focus was to improved Staff and Service User Welfare - present design development and what was achieved in final design - challenges - opening up spaces in Victorian Buildings, Asbestos, Drainage. Limited on what you can achieve. Ways to achieve what you want however through Interior Design.
- Graces Place/ Young Adults 16-24 LD/Autism Inpatient Service - 5 Bed Inpatient Facility previously a Children's Hospice handed over to the Trust in 2020 was newly refurbished end of life children's hospice environment. Design Focus was to create robust and safe environment while still creating and Autism Friendly Environment. Followed Design Principles provided by the Service Team and present how we achieved them. Challenges - this is a new service to the Trust - lack of standardised design guidance to how to achieve the right setting for safety while still providing autism friend design - i.e. ligature, barricade, security. - don't want it to feel like an inpatient ward, but still keeping it safe.
- Norbury Ward/ Female Mental Health Acute Inpatient Ward - 23 bed ward inherited from Acute Hospital Trust - present design wish list and how it was achieved in final design along with other design issues that arose during the design stage i.e. maintaining H&S of ward within new design/ wish list. Lack of space.
- Hope Ward/ Childrens 13-18 Mental health Inpatient Ward - 12 bed ward inherited from Acute Hospital Grid Corridor Ceiling - H&S Risk, cannot be refurbished to MF Ceiling while ward open. Further upgrades while ward was closed - challenges refurbishing in live environment.
- Sarah McCullough Capital Project Manager - Pennine Care Foundation Trust
Sound Design – a Person Centred, Sensory Approach to Room Acoustics
The information we receive from our senses helps us interpret the world around us. Sometimes this messaging can be affected especially when people are hypersensitive to sensory stimuli.
Whilst our senses do not work in isolation, noise in particular can have an identifiable negative impact on our health and well-being. Recognised as a stressor, noise forms a key aspect of our body's danger and alert mechanism; triggering a physiological and behavioural reaction.
The human response to sound links to and is affected by many factors including personality, age, previous experiences, mental health, health conditions, medication and neurodiversity.
Our reaction is often negative and emotional, varying from mild annoyance, to anger, agitation and feelings of helplessness. This is often reinforced when we are unable to affect or control the source of the noise; so when we cannot mute it, or switch it off.
By learning more about the impacts of poor acoustic design of a space and linking this to the possible effect it will have on users, buildings can be constructed to avoid common acoustic challenges that frequently result in a negative response. From this base consideration can then be given to how sound can be positively used and managed to meet the needs of individuals.
- Andrea Harman Concept Developer - Saint-Gobain Ecophon Ltd
Pivot and Succeed – The Story of how Book of Beasties Adapted to Champion Mental Health and Wellness in Lockdown and What Lies in the Future
This talk by Oisin Bishenden (CEO & Education Adviser) and Phil Tottman (Founder & Development Manager) will look at how, since winning our award in 2019, we weathered adapted to the new Mental Health challenges presented by COVID. Pivoting our approach to integrating Mental Health & Wellness across the curriculum in schools to match the hybrid school/home learning model. Specifically we will focus on the unique learning kits we successfully deployed which were downloaded over 10,000 times; helping teachers and parents with the vital issue of wellbeing in lockdown. Beyond this we will then present the recent charity work we have undertaken, the partnerships we have developed and how they have helped us grow what we do far beyond where we stood in 2019. Then, and by no means least, we will give a sneak peek into the wide range of products we are currently developing, the new ways we plan to leverage our core intervention and a quick insight into the principles that drive our pathway in supporting the next generation.
Transforming Ancient Stone Ruins into a Flagship Residential Home for Adults with Autism
As anybody who works within Health & Social Care can tell you, the level of regulation and restriction within the healthcare system can at times feel like a burden. Similarly, the level of regulatory oversight from planning and conservation officers when working with historic structures can also, sometimes, feel a little heavy handed.
We were well aware, therefore, that when our client approached us with the idea of transforming 800 year old, grade II listed, derelict stone barns into a flagship residential home for adults with conditions relating to autism, that the project would likely throw some challenges our way.
The West Aberthaw Barns project was truly one-of-a-kind, and posed some of the most interesting problems we have encountered. It was far from a vanity project though - our client did not choose these old stone ruins for the novelty or prestige.
Sometimes when talking about architecture we get trapped into thinking about buildings as stand-alone structures built in isolation, when, in reality, of the 5 senses that we could be thinking about when designing, all of them can be impacted for better or worse by a building’s location.
Set deep in the countryside, within view of the Welsh coast line, and bordered by the immense Aberthaw Power Station – this combination of quiet isolation, inspirational natural surroundings, intriguing large scale engineering, occasional salty tangs on the otherwise clean fresh air and robust and varied textures within the ancient stones of the buildings that made up the site itself all came together to create an environment that could not be achieved, through any amount of design, within the site by itself.
During this presentation we will explore how we overcame the challenges posed by these ancient structures, while making the most of the unique opportunities that they had to offer.