A new era in mental health inpatient care…

I was invited to visit and have a look around my local trusts new mental health hospital but it got me to thinking of my first ever impression of a mental health hospital was being driven up the hill to a brand new build where I was to be admitted but passing the derelict red brick asylum buildings with their imposing shadow and being terrified of what was to greet me at the brow of the hill. As it was to turn out the hospital where I was to stay was state of the art and had only opened mere months before I arrived but I will never forget my fear at the fenced off terror I imagined behind the overgrown shrubbery.

My time on that ward was mentally very difficult but made somewhat easier by the comfort of the environment with a single ensuite room, a garden to sit in and a modern, light feel to the overall hospital. Now fast forward seven years which contained another admission in a different ward within that same hospital and then my nursing degree which I have now completed so I have spent time on many wards within the same mental health foundation trust, some more modern than others but all state of the art when they opened.

During my nursing degree I became a foundation trust governor as I wanted to ensure that the voice of the service user was heard at a strategic level within the organisation which had done so much to save my life when mental illness had me in its clutches. Within my role as a governor I was given the opportunity to have a look around another new hospital within the trust which is due to open for its first admissions during mid August.

I went expecting to find a similar hospital to the one where I spent five months and four months respectively during my two admissions, that hospital was only opened eight years ago so things couldn’t be that different, could they?

As I walked in I was greeted by colour co-ordinated walls and furniture with just the right level of natural materials to make you wonder for a moment whether you are indoors or in a garden but without the historical ‘public sector green’ which seemed to be obligatory in all hospitals until recent years. The architectural lines appeared simple to my lay eyes, nothing fancy, clean square lines but with a welcoming feel. There are nods to local culture from the moment you step foot inside in subtle recognition of the history in the area of coal I mining, of the stunning coastline and of the mental health hospital which has been on the site since 1895.

The art is thoughtful and inspiring, it has taken on board the locality of the hospital and even the poetry which is enscribed in the wood on the walls in the cafe when read aloud is reminiscent of the sound of the local industry. The artist recorded the sound and ensured that the poems tempo reflected this.

Entrance

Entrance

Reception area

Reception area

Art work in cafe hope which has a poem which when read alound reflects the local sounds of the coal industry

Art work in cafe hope which has a poem which when read alound reflects the local sounds of the coal industry

I went down the stairs to ‘Cafe Hope’ which will offer food and drink to staff, patients and visitors once the hospital opens, this area has a reasonably sized area with tables and chairs to enjoy a meal but evolves into a more relaxed lounge with sofas and easy chairs encased by a wall of glass which can open when warm enough to make the garden become another area to escape the hustle and bustle of clinical areas. When estate agents write up the details of a two up, two down terrace house and use the term ‘outdoor space’ to describe a yard which barely fits the wheelie bin the they sound ridiculous but outdoor space is the perfect term to describe this tranquil area. It is an area which I can see coming alive with the sound of chatter and hopefully laughter as people enjoy the sunshine, this area is the hub of the hospital and it is a shared space between service users and staff. I wasn’t sure about the name when I first heard it but it seems quite fitting now.

The lounge area

The lounge area

After this we began a look around this main atrium of the hospital which contains functions which are available to everyone and not restricted to individual wards. First we looked at the chapel which is a room I found great comfort in during my admissions, I enjoyed the silence of the area, somewhere I could think clearly. I find comfort in my faith, especially when unwell but I acknowledge that not everyone follows a particular religion. The wonderful thing about this chapel is that it doesn’t exclude those people with religious imagery, I believe that a person can be spiritual without religion and this peaceful and highly accessible area encourages that. The art work displayed on the glass within the chapel is of pomegranates which at first glance appears an unusual choice but actually the pomegranate fruit is something which is depicted in symbolism by many of the worlds religions including Hinduism, Buddhism, Judaism, Christianity and Islam. When I was in hospital and in the grips of severe anxiety I struggled to settle so tried many ways to occupy myself and one of those ways is what we now affectionately refer to as ‘pomegranate therapy’ as it is such a fiddly fruit which I had to concentrate on and it helped me to regulate my breathing and get beyond those periods of anxiety so those pictures of fruit on the glass had a special meaning for me.

The window in the chapel

The window in the chapel

From here we went to the room which will become the gym, this room is again somewhere which can be accessed by both service users and staff, it opens onto another outdoor space which is to be fitted with outdoor gym equipment, kind of like an adult park! Along the same corridor is a selection of rooms for therapeutic use of by physiotherapists and art therapists amongst others.

From here we went to visit one of the wards, this hospital site will have 122 beds over six wards, it will also include a psychiatric intensive care unit (PICU) and a male and female high dependency unit (HDU) but as they were still being finished. From first glance at the ward the attention to detail was phenomenal, even the colour co-ordinated floor outside the ward to aid memory if someone forgets the name of the ward with a picture embedded in the floor echoing the art work throughout the hospital and with colour shared with the décor on the ward.

You can just see the picture depicted in the floor outside the ward to aid memory

You can just see the picture depicted in the floor outside the ward to aid memory

From stepping on to the ward into the security airlock there is a family visiting room with a family visitors toilet to enable visits to be facilitated even when safeguarding concerns are apparent as some visitors may never step further onto the ward. This also means that visits with children where the service user does not have section 17 leave prescribed to leave the ward can enjoy their visit without possible interruptions from other people on the ward. Three and a half years ago when I was last an inpatient I felt comfortable for my then four year old to visit on the ward however due to budget cuts forcing bed closures the nature of acute ward environments has changed greatly meaning only the most acutely unwell are admitted for inpatient treatment. I have seen the inpatient environment change during my time training to be a mental health nurse with a combination of intensive care bed numbers having reduced and more treatment being carried out in the community meaning that acute wards can often be a noisy and challenging environment which is sometimes unsuitable for young children so these entrance based family visiting rooms will provide a vital way for contact to continue with their family whilst in hospital. This feature would be very important to me if I were ever to need another admission.

One of the ward courtyard gardens that all bedrooms open onto.

One of the ward courtyard gardens that all bedrooms open onto.

Not the best picture but this is a bedroom - sorry its dark

Not the best picture but this is a bedroom – sorry its dark

Ward dining area

Ward dining area

Between the wards

Between the wards

Stepping on to the main ward area there is a feeling of light with a spacious yet comfortable feel, not at all like a hospital. The clinical areas of the ward are separate from the living areas which will hopefully add to the recovery focused care these wards are able to offer once they fill with patients next month. Each bedroom has a single bed, a dressing table and wardrobe area with care taken to ensure all fixtures are without a ligature risk. Safety is the paramount concern with all aspects of the interior design, the mirrors are plastic and have rounded edges although at first glance you would not notice this. A key difference which over summer months will make a huge difference to the experience of the people who will stay in these rooms is that the windows have a see through mesh on the outside which means they can be opened fully and not just a couple of inches as on other sites. The mesh is unobtrusive and does not feel like a prison although I can see how without seeing it it may sound that way. As every bedroom (yes every bedroom) looks to outside the hospital it also reduces the concern over illicit substances being passed in which is something wards have struggled with in the past.

Each bedroom is ensuite and as we were informed yesterday even the design of the toilet seat has been subject of much thought to ensure that it is comfortable and of the right height but also that it does not pose a ligature risk whilst still ensuring that it is a hard wearing item which will stand the test of time! Who knew a loo seat could cause such debate?!?!?!

Highly researched loo!!!

Highly researched loo!!!

The bedrooms are certainly somewhere if I were a patient I could feel safe, comfortable and able to relax in my own space away from the clinical activity of the ward environment. The use of glass on the main corridor on which the bedrooms are again serves to bring natural light into the building, every single bedroom opens onto a corridor which has a glass panel opposite the door ward showing onto a court yard garden with the design bringing outdoors inside again.

There are several small lounges on each ward to be used for various purposes, in fact a conscious decision was taken not to name these rooms as this tends to pigeon hole rooms into only being used for said purpose and these are ‘rooms with no name’ for a purpose, they can be used for everything from quiet time to therapy sessions and informal discussions of care plans through to student nurses having sessions with their educators or mentors, truly multi faceted. Each ward also has occupational therapy rooms where crafts etc can take place.

Sociable lounge areas with TV and pool tables etc are also available so as people work towards wellness they can occupy their time. No one wants to be in hospital but the attention to detail here is awe inspiring and the team behind it which includes staff and service users as well as architects etc ought to be very proud. Its a work of art with considerations of care and recovery in every detail.

Even the seclusion room on the ward has been designed to offer a therapeutic, low stimulus environment which has been considered in depth to ensure it has some natural light but with encased blinds to that if the sun is bothering someone this can be blocked. The seclusion room has the option for a patients MP3 player to play music in if they feel this will benefit them whilst this distressing period passes for them. The seclusion room is basic but this is dictated by legislation and not simply architects.

Each ward has a staff room which is spacious like the rest of the ward and very different to some of the cramped and overcrowded staff rooms I have grown used to on some placements. Its important to remember that the clinical staff do a really tough job and this deserves to be recognised in the environment in which they work which has definitely happened here.

Staff room

Staff room

The ward had two gardens with various seating areas in them, these can be accessed directly within the ward without the need for section 17 leave to be prescribed as they are in the courtyard which is central to the ward. This means that even when someone is first admitted they are able to experience the simple pleasures in life such as feeling the sun on their skin and the wind in their hair without restrictions. Fresh air should always be a right and not a privilege.

Overall my impression both as a nurse and as someone who has been an inpatient is positive, it is evident how well planned this is and how the tax payer has got value for their money. It is noteworthy that this hospital is capital expenditure meaning it was funded through the public purse and not Private Finance Initiative (PFI) as was true of many new builds a decade ago and for which we face the legacy for years to come.

The overall design and the public open days will hopefully work to break down the stigma and fear surrounding mental health hospitals. Hopefully the old buildings will be either renovated and reused (as posh flats of whatever!) or knocked down as I will always remember the fear the old buildings induced in me.

Things I asked about yesterday included whether a childrens play park could be put in the grounds as I know from experience of when I was an inpatient that to be able to spend sometime off the ward doing ‘normal’ activities with my daughter. I was informed that there was to be discussions with the hospice which backs on to our trusts hospital to see if we could have shared use of a park area. I believe passionately in the need for this so hope it happens.

I also asked whether wifi would be available for inpatients as I feel this is so important especially since beds will be located on fewer locations within the trust modern technology such as face time and skype is vital to stay in touch with those important to recovery. I understand there are considerations to security etc however as schools are able to offer wifi with appropriate restrictions in place so I see no good reason as to why we can’t and will continue to use my role as a service user governor to fight for this as a standard we offer all patients.

I was interested to learn that we already own an attached portion of land with planning position in place to build a further two wards if the reductions in bed numbers prove unworkable in the future. I do wonder if services will come full circle and expand again as the pressures on current wards sometimes make for difficult decisions having to be made. I guess I feel reassured by the fact that that land is there with planning permission should the need arise. I do worry that with services changing and this being the one site on that side of the trusts geographic area that there will be one less 136 suite and hope this doesn’t lead to unwell people being in police cells as this is never acceptable. Whilst I mention the changes to services I feel it is important to recognise that whilst a modern environment is important so is being close to friends and family. As my local service had closed my nearest ward was around 25 miles away which meant a £150 per week petrol bill that took us nearly to years to pay off as a family due to me not working at the time and money being tight. Just because someone has access to a car does not mean that a hospital stay several miles away is any easier. I know from having done a placement in one of our older sites where the bedrooms don’t have ensuite and is on the second floor with no access to garden without either staff escort or section 17 leave and yet some service users who were admitted to a more modern hospital with far better facilities due to no bed space at the older unit at time of admission still request a transfer to the older unit to be closer to friends and family once a bed space is available.

Overall I am in awe of the environment which is conductive for recovery and well-being and believe that the patients and staff who move over in mid August will feel this way too. I would be happy to work there but more importantly if I needed it I would be happy to be nursed there. There are open days next week on Wednesday and Saturday so worth a look if you are local to the North East, I think you will be impressed.

4 thoughts on “A new era in mental health inpatient care…

  1. As project architect, thank you so much for your kind words. I am thankful and humbled. All the extra time and effort is made worthwhile when you see comments like these. We are really proud of the project and hope patients and staff love it too.

    Thanks
    Paul

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    • Wow I’m pleased you can across my blog and that you like what I had to say. As I put in my blog I have a fairly unique insight into both staff and inpatient so it was fab to look around. It’s great also that it evidently means so much to you and wasn’t ‘just a job’
      Thanks again for your feedback.
      Claire

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  2. Spectacular building, the architect has really given this some thought to make it look modern and appealing. Just need to ensure that it becomes integrated into the community so people don’t become disenfranchised from being admitted to such a large unit.

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    • Another site within the trust has done this rather well with baby groups running on site and using the hydrotherapy pool etc so maybe Hopewood can learn from their example to become a community hun as well as a place of sanctuary for those who need it.

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