The NSW Government is investing $20 million to help hospital managers improve the therapeutic environment inside acute mental health units – isn’t that great news!

Julie and I have had a lot of conversations over the years about designing our ideal mental health inpatient unit and in this blog we discuss some of the main points.

Our ideal mental health unit would be able to cater for the people in the unit on many levels. It would be able to cater for mental health needs and some areas would be calming, whilst other areas would be suitable for socialising, creativity or exercise. It would be able to cater for the different sensory needs and some areas would be really quiet and low scent, while other areas would support loud music and strong sensations. People would be able to freely move to the areas that they needed in order to change how they felt through using their senses. This could include to a reading nook or a soothing garden, or a zone with sensory modulation equipment. The design would use trauma informed principles so it would have a homely feel and there wouldn’t be disinfectant smells and fluorescent lights and same curtains everywhere. It would have interesting, helpful and creative activities on the units……. We had so many ideas that we decided to write chapters in our book* on it!

The book has a section on designing or renovating sensational spaces in hospitals, mental health units and aged care facilities. This includes the concept of sensory zones so that people are able to move to the zone that meets their sensory need at the time. In the book there are 19 zones with equipment suggestions and design needs for each of them. 5 of the 19 zones are listed below:

Exercise zone or gym

• non slip mats on the floor with vinyl rectangular cushions sectioning off the area so it is not walked over

• ideally near a wall. On the wall could be posters with exercises that could assist with anger (e.g. wall pushups, simple yoga and stretches)

• equipment including weights, basketball hoops and an exercise ball to sit on or bounce     

Low stimulation zone

• eye masks

• ear plugs, noise-cancelling headphones, music and earphones

• wrap or blanket

• comfortable, rocking or swinging chair

• lower light, light with dimmer switch, low lamp

• white noise or soundproofing of zone

• nil odour (takes away the scent)

• no talking in zone.

Sensory modulation item zone

Sensory modulation items set up for individuals to access

• weighted cushions, wraps

• blankets, shawls

• textured cushions

• cardboard boxes to personalise a distress tolerance kit

• scented items

• icy spray

• fidget items

• books for sudoku or crosswords

• warheads, sour lollies, mints

• dencorub, eucalyptus rub.

 *Items are assessed and selected with the intention of clients using them independently, without needing a staff member to access or unlock them.

Calm garden zone

• garden with variety of plants including variety of leaf shapes and textures

• scent to be carefully considered. Would not recommend strong scents in garden zone. Could have a separate zone with scented plants (scent exploration zone)

• good to have soothing quality to plants and zone

• water feature e.g. pond or waterfall or water sculpture

• no hidden or dark zones to assist with soothing (so can let go of hypervigilance).

• area for ball games.

 Family interaction zone

• indoor or (ideally) outdoor area for parents and children

• swings or playground equipment that promotes interaction, connection and co-regulation

• sandpit or water play

• games table

References:

*“Sensory Modulation Resource Manual (2018)” , J O’ Sullivan and C Fitzgibbon.

https://www.barnesandnoble.com/w/sensory-modulation-carolyn-fitzgibbon/1128221915

https://www.pinterest.com.au/SensoryMod/mental-health-unit-design/

https://www.health.nsw.gov.au/patients/mentalhealth/Factsheets/built-therapeutic-environment.pdf