This blog will outline the auditory sensitivities and sensory processing challenges of people admitted to Mental Health Units and offer recommendations with respect to the design of these environments.
People admitted to Mental Health inpatient Units present with a wide range of mental health disorders including schizophrenia, Borderline Personality Disorder, Post Traumatic Stress Disorder and Autism Spectrum Disorder. It is now understood that people with these diagnoses experience a higher rate of sensory sensitivities and other sensory processing challenges compared to the general population (Stromberg et al).
The sensory system we will focus on today is the Auditory system.
Auditory Processing difficulties have been recognised and explored across a range of research areas including:
Occupational Therapy research of sensory processing difficulties (eg Harrison et al)
Lived experience research such as Autistics, people with schizophrenia (eg Stromberg et al)
Neuroscience research of Auditory State Response gating (eg Sugiyama et al )
Diagnostic Criteria such as hypervigilance to sounds in PTSD and sensory over-responsivity in Autism Spectrum Disorder.
Sensory Modulation Brisbane recommends that Mental Health Units respond to the needs of people with auditory processing difficulties by implementing sensory modulation techniques and Universal Health Design features such as:
Availability of earplugs, headphones, other devices for reducing sounds (eg white/brown/pink noise machines) or providing personally preferred input
Sound proofing, acoustic consultants and co-design by Autistics and others with lived experience.
No fluorescent lights (due to the sounds)
No ticking clocks
Alarms on the unit be either visual or vibration or sound is reduced in some way.
Allocated spaces on the ward with lower sound levels
Allocated spaces on the ward where people can listen to preferred sound
Sound to be considered as a possible contributor for distress and agitation.
Problem solving to address sounds that are identified as problematic by people on the ward
Consideration of separate eating areas or other strategies for people with misophonia (unable to stand sounds of others eating) or who need lower sound levels in order to comfortably eat.
Consideration of background sound when speaking with someone on the ward
Further information on this topic is available on the On demand course:
References:
Harrison LA, Kats A, Williams ME, Aziz-Zadeh L. The Importance of Sensory Processing in Mental Health: A Proposed Addition to the Research Domain Criteria (RDoC) and Suggestions for RDoC 2.0. Front Psychol. 2019 Feb 5;10:103. doi: 10.3389/fpsyg.2019.00103. PMID: 30804830; PMCID: PMC6370662.
Maria Strömberg, Lina Liman, Peter Bang, and Kajsa Igelström.Experiences of Sensory Overload and Communication Barriers by Autistic Adults in Health Care Settings.Autism in Adulthood.Mar 2022.66-75.http://doi.org/10.1089/aut.2020.0074
Sugiyama S, Ohi K, Kuramitsu A, Takai K, Muto Y, Taniguchi T, Kinukawa T, Takeuchi N, Motomura E,
Nishihara M, Shioiri T and Inui K (2021) The Auditory Steady-State Response: Electrophysiological Index for Sensory Processing Dysfunction in Psychiatric Disorders. Front. Psychiatry 12:644541. doi: 10.3389/fpsyt.2021.644541