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Risk and well being in psychiatric hospital design
Balancing the tensions between risk management and
well being for patients and staff is one of the most important
features in the design of psychiatric hospitals. Research by
Dr Victoria Wood, Professor Sarah Curtis and colleagues from
the ADVANCE team in the Mental Health Research Centre
explored the challenges involved in trying to mitigate risk and
enhance well being in a psychiatric care setting*. The research
team focused on an evaluation of the transition from an old
to new psychiatric inpatient facility. The study demonstrated
the need to balance features such as security and surveillance
with other features contributing towards the well being of
patients and staff, such as privacy and autonomy, and positive
personal interaction. A design permitting close observation
and surveillance orientated towards a reduction in harm,
including self-harm, was seen as very important, yet at the
same time new innovations such as CCTV, installed to deal
with this issue, raised concerns over the potential negative
psychological effect on patients and over-reliance on these
methods of observation. Research by the ADVANCE team
helped demonstrate that careful consideration about how to
balance these tensions when designing psychiatric inpatient
facilities is essential.
Key Finding: In the design of psychiatric hospitals a suitable
balance needs to be found between mitigating risks, by
carefully controlling the hospital environment and promoting
other aspects of well being for patients and staff. Over
reliance on surveillance technologies, for example CCTV, could
potentially have negative psychological effects, upsetting this
sensitive balance.
*Details in a forthcoming paper in Social Science and
Medicine entitled: ‘Compassionate containment?
Balancing technical safety and therapy in the design
of psychiatric wards’.
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