None listed
Conditions
Brief summary
The acute mental health ward is the modern equivalent of the old mental asylum but little is known about factors informing its design and use or the underpinning philosophy of care upon which these facilities are based and if they could benefit from improvements. This multidisciplinary three year study will draw on perspectives from social science, psychiatry, nursing and architecture to understand the architectural design, therapeutic philosophy and social regime of the modern acute mental health unit in New Zealand. It will examine as case studies, three acute adult psychiatric wards in New Zealand. Using multiple existing sources of data, including architects plans, briefs and grey literature and collecting new data via in-depth interviews and small focus groups with mental health consumers resident in the wards, staff and other ward users and stakeholders, the findings from this research will inform a much needed evidence base for optimal acute psychiatric facility design in NZ. This research is funded by a Marsden Fast Start.
Interventions
The conditions being observed are the acute mental health ward users' perspectives and experiences of the ward environment (not any specific health outcome).
The exposure is the physical building and interior of the acute mental health ward.
The planned period of observation will be the 8 weeks in which the data are collected by the researchers (interview data and focus groups).
There are three main components to this observational study:
1. Face-to-face interviews with 3 groups will be cond
The conditions being observed are the acute mental health ward users' perspectives and experiences of the ward environment (not any specific health outcome). The exposure is the physical building and interior of the acute mental health ward. The planned period of observation will be the 8 weeks in which the data are collected by the researchers (interview data and focus groups). There are three main components to this observational study: 1. Face-to-face interviews with 3 groups will be conducted to find out ward users perspectives and expereinces of the design of the ward environment, asking about specific architectural features and related issues. The three groups to be interviewed are: Service users residing in the acute mental health ward, staff working in the ward, and a family member who visits the ward (and who is nominated by the service user interviewed). 2. Stakeholder specific walking focus groups: Stakeholder focus groups led by the architect on this project and the PI will include consenting individuals from five key stakeholder groups. Each stakeholder group will be led around the ward with the architect and the PI and will be asked what the spaces are used for and how they function for these purposes. The building is used as a prompt for discussion. The five stakeholder groups will be: -Mental health service users resident in the ward -Nursing and other staff -Visiting health and allied professionals (social workers, Chaplains, consumer advocates, psychologists and psychiatrists) -Policy makers/planners, district inspectors, and DHB managers and designers -Maori stakeholders 3. Architectural analysis of plans and consultation documents. Data sources: Architects’ plans, building specifications and photographs. Method: Plans will be requested by PI from the appropriate personnel in participating DHBs. Photographs will be taken by the PI and architect of the inside and outside of the facility. Inside will include photographs of rooms and corridors (to show room color, layout and furnishings) and key physical features (fixtures and fittings). Photographs will be taken at a time convenient to ward users and care will be taken to ensure no-one is captured in the photographs. Photographs of private sleeping quarters will only be taken either a) when the rooms are unoccupied - vacant of people and possessions or b) with written prior consent of the mental health service user. Photographs of bedrooms with personal belongings are important for showing the degree of personalisation and choice enjoyed by the occupants. Analysis: Plans and photographs will be analysed using a 215 item validated check-list designed in accordance with normalisation theory. Data gleaned will include ward location, size, internal layout and allocation of space (public, private, intimate), room function and purpose, interior decoration, security and other architectural qualities.
Sponsors
University of Otago, Wellington
Eligibility
Sex/Gender
All
Age
20 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Interviews Mental health service users resident in the ward - all adult acute mental health service users who are competent to consent (competence will be assessed by the lead clinician) to participate. are eligible. As there is no restriction on the length of time they have been in the ward, those who have only just arrived will be eligible. Nominated family member - any familiy member nominated by a consenting mental health service user, who agrees to participate is eligible for inclusion in the study. Staff - all staff members who work in the ward will be eligible to participate in the study. Stakeholder focus groups: Stakeholder focus groups led by the architect on this project and the PI will include consenting individuals from these five key stakeholder groups: -Mental health service users resident in the ward (same eligibility criteria as for interviews above) -Nursing and other staff (same criteria as for interviews) -Visiting health and allied professionals (social workers, Chaplains, consumer advocates, psychologists and psychiatrists). - identified by staff members will be eligible to participate in the focus groups. -Policy makers/planners, district inspectors, and DHB managers and designers identified by staff will be eligible to participate. -Maori stakeholders - identiifed by staff members and through any additional Maori consultation process for each DHB will be eligible to participate.
Exclusion criteria
Mental health service users: any service user deemed not competent to consent at the time of the interview or focus group will be excluded (this includes any patient in seclusion at the time). Family member/family friend - only family members nominated by a service user who has consented to be interviewed will be eligible to participate. Any stakeholder unavailable at the time of the interview or focus group will be excluded.
Outcome results
None listed