Providing an effective healing environment for patients facing a wide range of mental health issues, while balancing their needs with security, safety, and affordability considerations, will be key area of focus at this year’s Design in Mental Health (DIMH) conference and exhibition, taking place from 13-14 May at the National Motorcycle Museum in Bickenhill near Solihull.
As HEJ editor, Jonathan Baillie, reports, conference speakers will include the director of estates and new business at the Priory Group; the chief executive of mental health charity, Mind; architects and designers with substantial mental healthcare experience; top academics, and service-users – all with their own perspective on the 2014 conference theme, ‘Improving facilities, transforming attitudes’.
The 2014 Design in Mental Health (DIMH) Conference and Exhibition will – like last year’s event – be held at the National Motorcycle Museum near Solihull, and is again being jointly organised by the Design in Mental Health Network (DIMHN) in partnership with Step Exhibitions, which also organises IHEEM’s flagship annual event, Healthcare Estates. Supporters of this year’s show include IHEEM, Architects for Health (AfH), BRE, and ProCure21+.
Such was the success of Design in Mental Health 2013 that, while last year’s conference and exhibition programme ran over 1.5 days, this year’s event will extend to a full two; there will also be a broader range of speakers, more exhibitors, and, it is hoped, an increase in visitor and delegate numbers, as well as a new feature – a Dinner and Awards ceremony on 13 May. (see panel, page 44)
Involving service users
The 2014 conference presentations begin on 13 May with a welcome address by Joe Forster, a highly experienced mental health nurse practitioner, and the current chair of the Design in Mental Health Network, which has brought together people involved in designing and using mental healthcare facilities since 2005. Having entered nursing in 1978 as a student nurse at the North Manchester School of Nursing, Joe Forster was until recently clinical lead nurse at the Mersey Care NHS Trust, but in late February this year left to set up his own healthcare design consultancy. Still a registered mental healthcare nurse, his particular research interests are in expressed emotion and design. He is also a strong believer in involving service-users in service provision and innovation and design.
Morning conference sessions following Joe Forster’s opening address on Day One will include a presentation by Clare Allan, author of ‘Poppy Shakespeare’, a debut novel shaped by the author’s own experiences of a decade ‘in and out’ of the mental healthcare system. Her presentation, ‘Positive Space’, will focus on the impact of the physical environment on mental well-being, and on ‘Why design matters’.
Novel an ‘electrifying debut’
‘Poppy Shakespeare’ was first published in hardback in 2006, and was subsequently shortlisted for the Guardian First Book Award, the Orange Prize for New Writers, and the Mind Book of the Year Award, later being adapted for television. The book is set in a fictitious North London day hospital, and tells the story of two women who meet there, and their experiences. It was described by The Guardian as ‘Catch-22 meets One Flew Over the Cuckoo’s Nest... an electrifying debut... surreal, raucous, infuriating, and very funny’.
Having, as she put it in a March 2008 Daily Mail interview, ‘ricocheted around the mental health system’ for over a decade, Clare Allan is now a regular columnist in The Guardian, where she writes, often in campaigning style, on issues ranging from the potentially damaging impact of Internet ‘trolls’, to what she sees as lack of parity between spending on mental healthcare and on treating other illnesses.
Also speaking on the first morning will be Paul Farmer, chief executive of Mind, whose presentation, ‘New Approaches in a New World’, will cover topics including ‘NHS reform since 2013’; the implications of mental health strategy; ‘changing understanding of what works’, and ‘Programmes such as ecotherapy’. Paul Farmer has been Mind’s chief executive since May 2006, and is also chair of both the Disability Charities Consortium and the NHS England Mental Health Patient Safety Board. An advisor to the Catholic Bishops on mental health, he also served on the independent Commission on Mental Health and Policing. After a short coffee break, Jenny Gill, chair of the Design in Mental Health Network, will then chair a session on ‘Commissioning’.
‘Lawyer and poet’ to speak
Taking strong account of service users’ standpoints when designing accommodation is now something of a ‘given’ in mental healthcare circles. Addressing the conference in a Day One pre-lunch session reflecting this, entitled ‘Service-users’ views and experiences’, will be David Neita, a lawyer and published poet, who is also the founder and director of arts and poetry consultancy, ELECT. A member of the legal team that brought the UK’s largest group action claim on behalf of thousands of South African asbestos miners, David Neita has worked extensively in the local London community, including with pupils excluded from school, to help them build confidence, raise achievement, and develop leadership. He runs a project that employs poetry as a vehicle for expression for users and carers within mental health services, and assists users to draft parliamentary questions to the Government expressing their political concerns.
Architecture in the spotlight
Changing topic, and architecture will be firmly spotlighted in an early afternoon Architects for Health session on 13 May. Speakers will include Sam McCumiskey, TIME deputy project director at Mersey Care NHS Trust, discussing ‘Developing comprehensive local mental healthcare in Merseyside and Southport’, and Martha McSweeney, studio principal at IBI Associates, who will describe ‘CHAT’ – ‘a multidisciplinary network’ of people who ‘participate in workshops to review the important issues affecting the design of mental health facilities, and gain a better understanding of how design impacts service-users, staff, family, and carers’. Wendy DeSilva, a director at P+HS, will later discuss, in her presentation, ‘Building for the Recovery model’ – what this means in practice, drawing on her experience as part of the design team for the 86-bed inpatient mental healthcare facility at Kingsley Green near Radlett, currently under construction for the Hertfordshire Partnership University NHS Foundation Trust.
From recovery to repeatable design
Afternoon conference content, firstly in a session dedicated to ‘Recovery’, will include presentations by Dr Jan Golembiewski, associate partner at Medical Architecture, and Michael McKeown, principal lecturer at the University of Central Lancashire’s School of Health. The title of the former’s presentation will be ‘The elephant in the room; what recovery-centred mental health design looks like, and why it can’t be found’. The concluding Day One session – on ‘ProCure21+’ – will see David Kershaw, the framework’s programme director, focus on good repeatable design and component standardisation in mental healthcare facilities.
Mental healthcare providers have, of course, increasingly recognised the considerable impact of a high quality environment on speed and extent of patient recovery, as well as staff morale, performance, and productivity.
‘Not just bricks and mortar’
Addressing this topic jointly in a morning keynote on Day Two – 14 May, titled ‘Mental health units – not just bricks and mortar’, will be Professor Chris Thompson, a psychiatrist ‘with a strong track record of leadership in business, research, education, and clinical practice’, who has been chief medical officer at the Priory Group since 2004. Reportedly the UK’s largest independent provider of mental health, specialist care, and specialist education services by number of beds, the Priory Group currently treats over 70 different mental health conditions via a network of some 280 UK facilities. Its extensive estate includes mental healthcare hospitals and clinics, medium and low secure facilities, complex care and neuro-rehabilitation facilities, specialist schools and colleges, supported residential facilities and homes, and care homes for older people, throughout England, Wales, Scotland, and Northern Ireland.
Managing a large property portfolio
While Professor Thompson will focus on the psychiatric elements of good mental healthcare accommodation, co-speaker, Adrian Dallison, the Priory Group’s director of estates and new business, will describe some of the challenges he and his estates team face in managing such a large and diverse property portfolio, and particularly in balancing the need for security, safety, and an environment within which staff can deliver optimal care, with a desire to create accommodation that is, as he puts it, ‘of a standard that if I would want to live in’.
He said: “One of my key messages is that, by being that little bit more innovative, for instance by working closely with suppliers and contractors who really understand and appreciate the requirements of mental healthcare accommodation, and who can, if required, adapt their existing products to meet a care provider’s needs, you can go one better than simply creating a functional, efficient, care environment. I often say, when visiting our facilities, that I would like them to be at least as comfortable and pleasant inside as my own home, or a good hotel. Surely those already going through a difficult period in their lives deserve a recuperative environment which makes them feel welcome, comfortable, safe, calm, and as ‘at home’ as possible? In some of our low and medium secure facilities we of course have a particular imperative to balance comfort with security, but the trick is to achieve this while still maintaining a humane, and, as far as possible, non-institutional feel.
Strong supplier relationships
“One of the ways we have innovated at the Priory” he continued, “has been to develop strong, direct relationships with suppliers, cutting out the ‘middleman’, since we find that this fosters a close collaborative relationship that results in us obtaining higher quality, more ‘tailored’ products. Suppliers that take a flexible approach also benefit, in that by adapting, say, a piece of furniture, to meet specific needs, they also gain a new line or product type they can sell elsewhere.”
Adrian Dallison joined the Priory Group in April 2006, initially as director of new business. Today he is responsible for overall management of the Group’s property portfolio, and for identifying new sites, and site extension and wider development opportunities. Before joining the Group, he held board and other senior management positions with various UK and international businesses. He said: “My original background is as a Chartered Accountant. In 2007 I was asked to take on the role of director of estates at The Priory Group alongside my existing role. It has been a fascinating and enlightening experience. It is really exciting to visit a site being refurbished, and to see how, with the right creative thinking, strong interior design, a knowledgeable and expert contractor, and multidisciplinary input, a perhaps ageing and ‘tired’ building that is no longer fit for purpose can be transformed, improving life both for its patients, and staff.
Flat management structure
“We are lucky to have a flat management structure here, and can thus quickly pool ideas, consult with colleagues from, for instance, clinical and nursing teams, finance, and IT, and then devise really effective new build and refurbishment strategies. I am keen to share some of this philosophy at this year’s Design in Mental Health event, which I am attending for the first time, and also look forward to meeting counterparts from across the sector, and to seeing some of the leading suppliers’ latest innovations.”
Adrian Dallison’s estates team includes a deputy estates director; two major project managers, who advise on, and take day-to-day responsibility for, new build and refurbishment schemes; an interior design director, Sally Tyler, who will join him in speaking at the conference, and a team of area surveyors, typically chartered surveyors, plus an electrical and mechanical surveyor whose specific remit is to ensure the efficient and reliable operation of, for example, key building services plant.
He explained: “Although we are in daily contact as a team, we also meet weekly or fortnightly to make sure we spot and address property or plant-related issues, and regularly review our development strategy and priorities. Our property portfolio is extensive, and includes facilities ranging from large former country houses to purpose-built new inpatient facilities and small houses. We strive to ensure that all our accommodation is fit for 21st-century care, and have largely moved towards single-bed, en suite accommodation.
Monitoring estates outlay
“Alongside striving to provide comfortable, modern, well-designed, safe, and secure accommodation, appropriate to patient acuity, monitoring our estates outlay is a high priority. We also place considerable emphasis on reducing our carbon footprint, whether via investigating alternative and renewable energy sources, or, as an example of a relatively simple, but effective, switch we made that has paid dividends, replacing old CRT televisions with less energy-intensive LED and LCD sets. I foresee increasing opportunity for us to buy renewable energy plant, although this is not always straightforward. For example, we have investigated biomass boilers, but are not yet convinced that there is sufficient reliable supply of fuel. Lighting technologies are advancing all the time; a few years ago low energy lamps had drawbacks, but some of the LED technologies we are seeing now are startling – they really improve lighting levels, and make significant energy savings too. Equally, while we recognise photovoltaic solar panels’ benefits, many of our properties are surrounded by trees. We have, however, increasingly looked to replace old, inefficient plant and equipment, and always have one eye on the efficiency and sustainability of our activities.”
Chance to learn from others
Asked what he was particularly looking forward to about DIMH 2014, Adrian Dallison said: “It will be great to have the chance to share some of our experience in managing and operating our estate with counterparts from both the NHS and private sector, as well as to hear from others who may have valuable lessons for us.”
Following the joint Priory Group presentation, Professor David Morris, professor of Mental Health, Inclusion and Community, and director, at the University of Central Lancashire’s Centre for Citizenship and Community, will discuss ‘how the advent of personalisation in mental health requires the pursuit of an individualised approach to recovery’, and how current policy is increasingly focusing on the role of the public or civil society in ‘co-producing the health or social care services on which people may rely’. ‘Both policy strands impact on design’s place in mental health’.
International perspectives
Other highlights of the conference’s second day programme will include an international session, where speakers will include Francis Pitts, President of Architecture+ in the US, focusing on ‘some new challenges to our preconceptions about the built environment’, and discussing ‘how client and community expectations are challenging long-held convictions about the environmental primacy of normalcy and the familiar’. Dr Evangelina Chrysikou, owner of Synthesis Architects, will discuss ‘Evidence-based design and the evaluation of psychiatric facilities’, while Teva Hesse, head of Branch at CF Moller Architects UK, will examine ‘how risk is defined and mitigated on mental health wards’.
The Day Two post-lunch programme will include a Forensic and Secure Session; speakers will include BRE Global’s scheme manager for Electronic Security, Jim Westlake, before the conference concludes with a Dementia Design session, where among the presentations will be a joint address by John Carson, capital development manager, Estates & Facilities Department, at Northumberland, Tyne & Wear NHS Foundation Trust, and Lianne Knotts, associate director at Medical Architecture. The pair’s presentation, ‘Roker and Mowbray: A kind of living, rather than a kind of dying’, will cover topics including:
• ‘Avoiding death by boredom’.
• Aiming for a reduction in challenging behaviour.
• Creation of a Centre of Excellence.
• Fostering independence and reducing anxiety.
For more information on the Design in Mental Health 2014 conference, and on the exhibition – at which around 50 companies that manufacture and supply products to the mental healthcare sector will showcase their innovations, visit: www.designinmentalhealth.com Visit: www.designinmentalhealth.com/book to register. Further details on attending or exhibiting are also available from Step Exhibitions, on 01892 518877, or by emailing: dimh@stepex.com
Photo Credit: Courtesy of The National Motorcycle Museum
