Mental health is high on the government’s health agenda at the moment. It is predicted that the number of people in Britain suffering with dementia will double in the next 20 years. But mental health is not just an issue for the elderly. It is a growing problem among society as a whole. One in four people are expected to develop a problem, such as a form of depression or anxiety, during 2016 and suicide is now the leading cause of death for men under the age of 50. Mental health is clearly an issue that no-one can afford to ignore. Pulse looks at some of the initiatives designed to provide safe, quality care for sufferers.
The Prime Minister, David Cameron, has made improved care for dementia sufferers a personal issue. His Dementia Challenge has raised the profile of this devastating condition and the UK’s mission to be a world-leader in the fight against dementia. The recently published dementia implementation plan sets out how dementia sufferers and their families will benefit from more transparency in care, safer services 7-days of the week and a personalised care plan. It follows the publication of a dementia declaration, which pledged to deliver better quality post-diagnostic services, care and support. Funding for the UK’s first Dementia Research Institute has also been confirmed.
David Cameron has also pledged to deliver a revolution in general mental health treatment, focusing on new mums, teenagers and young people with eating disorders, speeding up treatment for those with psychosis, introducing crisis home resolution teams to transform mental healthcare in the community and ensuring every Emergency Department is equipped to support people with mental health problems who turn up at A&E.
The pressure is on to improve services and care for an increasing number of patients, which, given their particular needs, requires greater consideration of the entire infrastructure around them. Steve Woodhead, Managing Director of Intastop, which specialises in supplying the mental health sector with a range of products, offers this advice to Trusts: “Create an open forum for requirements and solutions, with live tests, where Trusts and suppliers are involved with the design process.”
Anti-ligature
Barely three years ago, a walk around a typical Trust would find in the region of 3,000 ligature risks. Working with Intastop, one Trust has recently reduced its ligature risks from 5,000 to just 500, says Woodhead.
Intastop has been in business since 1981 supplying door protection products. Its continuous hinge was found to be an ideal product for mental health Trusts and for a number of years Intastop has been designing products for the mental health market.
Intastop specialises in people protection with an ongoing programme of new product development and a commitment to the continual improvement of existing products. “We are not standing still,” says Woodhead.
Last year, Intastop redesigned its continuous hinge. The result was the introduction of the new SECURA™Hinge, a full length continuous geared hinge with anti-ligature features that Intastop reports are unique. It has a tapered tip, which benefits from being tamper proof via a secure fastener, and reduced gaps around the bearings in both the open and closed positions, making it more difficult for anything to be inserted into the gap. New, slimline bearings use a specialist composite material that prevents cracking and are profiled to greatly reduce ligature risk plus minimise self-harm - for instance, by rubbing a wrist continuously along the hinge of an open door.
Privacy panels
Intastop also supplies vision panels and last year introduced a new range of iVision Panels which help to improve the patient experience by offering better aesthetics and visibility. Traditional vision panels use an etched glass system, with fine lines etched across the glass, but Intastop’s new iVision Panels offer almost 100% visibility. The technology is close to that of ‘smart’ glass but without the complicated installation process, as smart glass requires power. The glass in the iVision panels changes from opaque to clear, giving a modern, contemporary and stylish finish that is comforting and less institutional.
Testing
Intastop always builds thorough testing into the overall design process. It has its own in-house testing facility, carries out recommended third party testing and also advocates the importance of live testing on a ward. “We don’t want a product failure that will put staff and patients at risk.”
Intastop follows specific guidelines on testing where they are available and often tests to beyond recommended levels. Its cycle and destruction tests are particularly rigorous. Woodhead believes there is a need for more rigid testing with third party accreditation and more practical tests. “The industry should try to legitimise some of the testing. There are some recognised standards, but in ligature, for instance, there are many products calling themselves anti-ligature hinges that shouldn’t be.”
Consider carpets
Supportive and welcoming environments can have a positive effect on all users of a facility. Research also suggests that recovery times can improve when an individual is cared for in an attractive and therapeutic environment.
Carpets may not be suitable for all areas of a mental health facility but in corridors, communal areas and bedrooms carpets can have a profound effect on improving what can be a very clinical environment. Carpet supplier, danfloor, constantly seeks advice and recommendations from industry experts and has consulted Ian Callaghan, National Service User Lead for My Shared Pathway, and an ex-service user himself. Callaghan visits secure units and notes that: “Some carpeting would enormously improve an otherwise ‘cold’ environment. People like myself in secure units are often there for many years, and home comforts are few and far between. A carpet could therefore make a real difference.”
There are several reasons why carpet should be considered when designing a mental health facility.
Acoustics - By installing carpets much of the sound within a room is absorbed thereby reducing reverberation and impact noise. This relates to the control of sound from one space to another and helps to create a calm and peaceful environment which is essential for mental health facilities. Sleep is vital for maintaining a clear state of mind and for recovery. Lack of sleep can affect mental and physical wellbeing. Mental Health facilities can be noisy places, therefore the installation of carpets within corridors and bedrooms can assist with absorbing unwanted noise, aiding relaxation and reducing stress levels.
Indoor air quality - Carpets can also help to improve indoor air quality by trapping fine dust particles that circulate in the air and in turn contribute to a healthier living environment. This is especially beneficial for allergy sufferers and those with respiratory problems such as asthma.
Cleaning and infection control - “I think the argument against carpet on the grounds of infection control is a spurious one as I know there are many products on the market that help guard against such risks,” says Ian Callaghan. “I spent some time on a ward where there were carpets in all bedrooms and communal areas and infection control was certainly not an issue.”
The Economix range and Equinox Collection from danfloor are suitable for the mental health sector, as they include an anti-microbial coating which deactivates harmful micro-organisms, including MRSA, when they come into contact with the surface of the carpet. In addition, the structure of the carpet yarn makes them easy to clean and maintain.
Cost savings - Research suggests that when compared with hard flooring finishes, carpets save money on a number of different levels. They improve energy consumption due to a lower level of heat conduction, lifecycle costs of installation and maintenance have been proven to be more economical and cleaning costs are also said to be lower.
Creating a Therapeutic Environment - Ian Callaghan is also convinced that carpet can help to create an environment which encourages healing and relaxation: “Communal areas in many wards often have a very institutional feel and as a result are underused. Many people prefer to stay in their rooms and miss out on social interactions that can be so important to recovery.
“A more homely feel, which carpets can help provide, could encourage people to take advantage of lounges and other areas. Many services have invested in good quality, comfortable and safe furniture, but neglect other features that can promote a sense of wellbeing and a relaxed, inviting atmosphere. Carpets and other informal floor coverings could help enormously with this.”
Case study - Service users get creative in West London
Service users have created poetry, inspired artworks and helped to design the interior of Thames Lodge, a new Medium Secure Unit at St Bernard’s Hospital in West London, which opened in February 2016.
Replacing older buildings to create fit-for-purpose accommodation, Thames Lodge provides a bright, welcoming environment which will enable hospital staff to deliver excellent care for service users.
Leading arts and health consultant Willis Newson was appointed by the West London Mental Health NHS Trust to work with David Morley Architects to integrate art into the new building.
Working with writer Sue Mayfield and artist Ali Brown, Willis Newson devised a series of creative workshops, engaging service users in the design process to build a sense of pride and ownership of the new Unit.
Beginning with simple drawing exercises, Brown’s visual arts workshops enabled service users to contribute their ideas and visions for the new centre, including generating concepts around the theme of ‘rivers’ for the colour palette and artworks of the new building.
Creative writing workshops then developed the theme further.
Artist Alison Milner was selected to create the final artworks for Thames Lodge, using the colours, theme and ideas selected by service users, as well as taking inspiration from local landscapes and weaving lines of their poetry into her designs.
This integrated approach to art and interiors has resulted in a welcoming, appropriate and cohesive identity which flows through the whole Unit to create a supportive, therapeutic environment for staff and service users.
