Contemporary issues in acute mental health facility design: insights from the Aotearoa-New Zealand experience

Abstract

Renewed focus on mental health has put the spotlight on the 'black box' that is the acute mental health facility. Drawing on a larger programme of research, key issues relevant to the planning and design of mental health units were identified from in-depth interviews with those using the facilities. Contemporary issues included visibility from the outside and wayfinding, the need to accommodate cultural needs extending to the family and community, safety and violence, the need for access to nature and fresh air, and facilitating meaningful activities. Stigma and its spatial expression were a crosscutting theme throughout.Trial registration: Australian New Zealand Clinical Trials Registry; identifier: ACTRN12617001469303.

Impact of the design of adult mental health inpatient facilities on healthcare staff: a mixed methods systematic review

“…Simultaneously, it is worth noting that many design elements, while vital to staff, also resonate with service users. For instance, amenities like gyms and natural spaces, though crucial for staff breaks,29 are also valued by service users for their contribution to well-being 48. The topic of open layouts draws attention to these shared experiences.…”

“…Additionally, the review highlighted that the isolated location of mental health facilities impacts staff recruitment and retention, leading to feelings of isolation 24 27. Concurrently, service users associated such remote locations with societal stigma 48. Though for distinct reasons, both groups agree that these facilities should not be overly isolated.…”

“…For instance, amenities like gyms and natural spaces, though crucial for staff breaks, 29 are also valued by service users for their contribution to well-being. 48 The topic of open layouts draws attention to these shared experiences. Staff appreciate open designs for the safety they provide to everyone in the unit, a feeling shared by service users who prioritise safety and seek environments that offer a sense of security.…”

“… 24 27 Concurrently, service users associated such remote locations with societal stigma. 48 Though for distinct reasons, both groups agree that these facilities should not be overly isolated. The broader visibility of these units becomes pivotal, not just for societal acknowledgement but also for enhancing workplace perceptions and recruitment.…”

Solving the shortage of psychiatric – mental health nurses in acute inpatient care settings

“…Although not a new phenomenon, the issue of non‐nursing tasks taking from therapeutic time must be challenged (Bekker et al, 2015; Grosso et al, 2021), while the architectural design of acute mental health units also requires review to ensure the best milieu is achieved (Jenkins, McIntosh, et al, 2022). The prospect of being blamed in an organizational culture defined by risk management (Manuel & Crowe, 2014) also weighs heavily in the minds of mental health nurses.…”