Head
Space
Architecture for Mental Health and Wellbeing
The
Contents
Challenge
1)
The Challenge
Designing spaces that support, enrich, and nurture good mental health and wellbeing is at the heart of what we do at Gilling Dod. Constantly evolving, Mental Health services face huge challenges as the need for pathway specific, neurodiverse, and productive care settings far outstrips budgets, land and political will. Following years of stigma surrounding Mental Health, increased awareness and advocacy has helped move the dial around the equity of esteem, and this has only acted to fuel the huge expectations for new designs and environments that meet the challenge. In an age of scarce resource, increasing acuity and sensory overload, person-centred design is our architectural antidote and underpins our ethos at Gilling Dod when it comes to mental health design. Giving a voice to Service Users and real co-production is the only way to create truly human friendly spaces. Balancing safety vs sensory criteria, standardisation vs personalisation, acuity vs informality is a constant theme and demands a design approach that is both innovative and adaptive. At Gilling Dod we understand the nuances of this most mis-understood building type, as well as the inherent pressures and contradictions that inhabit the day-to-day delivery of mental health services. It is this very challenge that drives us, and ultimately stimulates and informs the amazing architecture that is created across our projects. As Mental Health and wellbeing becomes a global issue one thing is abundantly clear. We all need good ‘Head Space’.
2) 3)
Person Centred Design
Pathways 4) Design Matters 5) Green Space 6) Personal Space 7) Crisis & Acuity
8) Detail and Compliance 9) Construction / Delivery 10) NZC / MMC 11) Refurb and Renew 12) The Future 13) About Us
Person Centred Design
Person centred Design cuts to the heart of designing environments for Mental Health and wellbeing. Only by empathy, understanding and appreciation can we as designers interpret emotional need into physical space. The complex and sometimes contradictory nature of Mental Health means we continuously need to return our design ideas back to the Service user, and by putting them at the heart of the process we can ensure this permeates the entire process. Collaboration and co-production is a cornerstone value at Gilling Dod, ensuring patient-centricity in all we do. By engaging with experts by experience, Service users, staff and stakeholders in a co-productive manner, our designs resonate with warmth and humanity, steering clear of clinical sterility and institution. Tailoring our approach to each project, we craft bespoke engagement strategies from inception, incorporating service user consultations and workshops to glean valuable insights. Utilising tools like games, role plays, art and drawing, models, videos, and VR walkthroughs, we enhance design comprehension. With the advancement of clinical pathway treatments, Neurodiversity and Trauma informed design, we have evolved our engagement to suit and work closely with Clinical and Nursing teams to ensure our understanding and influences are balanced and consistent. Person centred design takes on board clinical risk, physical health and complex health needs ensuring a fully sustainable and holistic design is created. Ultimately, communication is the key and through our numerous Award-winning projects, across all pathways, we have learned the importance of sometimes just listening.
The design of modern Mental Health settings has evolved well beyond the accepted principles of Safety, Robustness and Anti-ligature. Evolving alongside clinical advancements, design must cater to diverse care pathways like Autism, Learning Disabilities, Complex Needs, CAHMS and Dementia. Tailored responses to individual needs, sensory considerations, and spatial qualities are paramount. An appreciation of neurodiversity informs all our design responses and when coupled with post occupancy evaluation and true service user engagement, the solutions can be amazing. In an environment of standardised construction trends, our Mental Health design expertise prioritises person-centred solutions, enhancing efficiency without compromising individualised care. Adhering to compliance and best practices, means we excel in delivering designs across all areas of Mental Health, both in community and forensic settings and on projects of all values and locations. Our Award winning projects at the Lighthouse (Dementia), Red Kite View and Inspire (CAMHS), Ribblemere (Perinatal), The Curve (Community MH) and Aspen Wood (Learning Disabilites) are testimony to this apprach. Adhering to compliance and best practices, we excel in community and forensic contexts. Through engagement and co-production, we innovate, guided by our ethos: Design with People in Mind.
Pathways
Design
Matters Gilling Dod are all about delivering quality Architectural design on all our projects regardless of size and budget. Good design is not a luxury item. It is the biggest tool we have in delivering for our clients, service users and stakeholders and we will always bring innovation and aspiration to all our commissions. We do not have a house style and all our schemes relate to their context and setting. We begin each project with a conversation. An appreciation of the who, the how and the why. Through real co-production and collaboration a shared vision is established ensuring we create places not just spaces. Gilling Dod’s architecture prioritises wellbeing and recovery by crafting inviting, open spaces that instil a sense of place and identity, alongside hope and recovery. Utilising natural materials, calming hues, and bespoke artwork, environments promote emotional balance, support and comfort. A mixture of quiet and communal spaces serves to strike a balance between seeking solitude and embracing social opportunities. Therapeutic spaces, exercise, creativity and activities of daily living, foster healing and encourage interaction. Plentiful natural light achieved through large windows and rooflights enhances mood, balancing an individual’s circadian rhythms. Key examples of successful Mental Healthcare architecture are Red Kite View where the building massing meanders through the wooded site, Combe Valley Hospital where large windows flood the building with natural light, and Aspen Wood which embodies LD friendly design in its configuration and arrangement.
Space
The enduring link between nature and human well-being predates modern psychology. We are, after all, a species of the land. From our earliest settlements, connection to the land and nature has shaped our existence, influencing everything from where we live to how we feel. The Victorian’s recognised the healing properties of the landscape, and as we inhabit an ever more urbanised world, the desire and draw towards green space as a source of mental wellbeing, is as strong as ever. A constant and recurring theme in Service User Engagement, and indeed Post Occupancy Evaluation, is the importance of gardens and nature. Being close to, or touched by nature and wildlife, keeps us grounded and reassured. Our modern designs have a green heart space at their core, prioritising and integrating with nature, employing biophilic principles to create environments that nurture both body and mind. Outside space is a source of activity and physical wellbeing as well as a natural canvas for sensory enrichment, aspect and therapy. Our designs blend indoor and outdoor spaces symboitically, fulfilling our innate need for light, air, and stimulation, promoting holistic health and well-being.
Green
“We all want quiet. We all want beauty…..We all need space. Unless we have it, we cannot reach that sense of quiet in which whispers of better things come to us gently.”
Octavia Hill, 1883
A Mental Health bedroom presents the biggest challenge and the biggest opportunity to aid individual wellbeing. Striking the right balance between homeliness and safety is important. The challenge of ever-increasing acuity can be a barrier to this. The bedroom remains an individual’s only personal space during a hospital admittance and can be an important sanctuary. Bedroom comfort can be achieved through good interior design and individual control of their environment. Colour choice is important – soft pastel colours are often popular as they can add warmth without being overbearing. Control can be achieved through simple elements such as anti-ligature curtains. They can typically be washed easier than blinds too. User control of heating and ventilation aids their sense of empowerment and autonomy. Co-producing bedrooms with service users and experts by experience is imperative. Opportunities for personalisation are useful too; be it memory boxes, blackboards, space to display photos or endeavours created in the art room. The en-suite too is frequently overlooked and can often appear sterile. Integrated storage is often dismissed, leading to sanitary bottles scattered across the floor and becoming a trip hazard. These are two elements where we are exploring innovative ways to address this challenge. The principles of the P22/P23 repeatable rooms remain strong. Gilling Dod developed both generations in conjunction with contractors. Some elements we evolve and enhance on live projects. A good example of personal space is exemplified by Combe Valley Hospital, where we designed a half-bay window facing the bed so that a patient can look out onto meadows from their bed.
Personal Gilling Dod’s experience delivering thousands of successful Mental Healthcare bedrooms provide us with a wealth of learning to share for future projects.
Space
Crisis & The spectrum of UK Mental Health services is huge, and although Secure Mental settings occupy a relatively small number in terms of beds, the services, pathways and settings can be some of the most challenging in the NHS. As such, these environments need a particular design approach and not just in terms of safety, security, and robustness. Design and construction in High/Medium/ Low Secure settings is exacting with compliance and guidance to suit. Gilling Dod have delivered successful and sustainable designs across all these levels and developed fully tried and tested components and details to meet these high impact spaces. The real secret to this success however, is not just in the detail. It is an understanding that spaces for mental health and wellbeing, wherever they are, still relate back to person centred design, neurodiversity, and pathway principles. Rising acuity is a key issue in today’s inpatient Mental Health settings. The move away from restrictive practices has meant designs need to deliver more in terms of de-escalation, flexibility and sensory qualities. Seclusion design, although still vital, is becoming part of a more nuanced approach to risk and acuity. Relational and procedure is overtaking the physical, in terms of importance. Pre-emptive measures and settings are helping meet this risking acuity with URC (Urgent Response Centres), S136 suites, Mental Health suites in A&E, Community Walk-in Centres and Early Intervention Schemes, becoming ever more utilised. Ultimately, risk and acuity will always be part of any Mental Health brief, service or environment. However, with a joined up and holistic approach, it need not mean a new generation of prison builds masquerading as Mental Health Units.... far from it.
Acuity
Detail &
Compliance The construction of Mental health settings is often described as a science of millimetres. Inpatient
environments in Mental Health inpatient units are exposed to extreme attack, interrogation and pressure during the course of their occupation and fabric or detail failure can lead to catastrophic system failure, injury or even death. As such, the finite design of key details, specifications and interfaces is a huge part of our focus and knowledge base at Gilling Dod. Designing therapeutic environments can only be successful if they are safe environments. Achieving that balance is one of the hardest challenges in Mental Health design. Our designs are informed by risk and operational understanding, so we know exactly what the environment needs to deliver from the outset. Our Interior Designers work closely with clients and Service users to develop internal environments that deliver this balance. Our Technical teams have an enviable and in-depth knowledge of the HBNs/HTMs, and this is brought to bear as our designs evolve. Add to the mix an active culture of Post Occupancy evaluation, destruction testing and Supply Chain working, fair to say we can deliver fully compliant solutions for the most demanding of Mental health settings. Design co-ordination is another fundamental part of our delivery offer and utilising our BIM level 2 accreditation we pride ourselves in working collaboratively with our design partners and leading the team from the front. This includes detail interface planning, integrated MEP design and Structural synergy in all our designs. Never more prominent than in Fire compartmentation, protection, and certification issues. As signatories for the DMH Informed Choices, a joint venture for testing, we ensure meticulous attention to detail, proven specifications helping design safe and inviting spaces. Only with expert knowledge can therapeutic yet secure environments be designed effectively.
Construction
& Delivery At Gilling Dod, we believe our designs are to be realised and inhabited. We work collaboratively with main contractors, supply chains and manufacturers to help ensure our designs become reality. Buildability, co-ordination, and zero-defect solutions are fundamental in constructing sustainable
Mental Health settings. Over the last 30 years, through roles on progressive procurement platforms such as Procure23, Pagabo and NHS SBS, we have forged strong links with the industry via not only ‘on the job’ delivery but also being part of nationwide ‘Best/Next’ Practice initiatives such as the Mental Health Repeatable Rooms, Modern Methods of Construction expert groups and the New Hospital Programme. Constructing sustainable and successful Mental Health settings is about 5 key areas: Robustness and Testing, Co- ordination and Interface, Tolerances and Detail, Quality, and Application. Throughout our 35 years of delivering acclaimed Mental Health settings, we have amassed a vast proven library of details and specifications which are constantly updated and evolved with each completed project. Workshops with supply chains, refinement and evolution of key components and specifications, on-site support, and commissioning duties. All, are part of our continued role through RIBA 5, right until completion. All this means that Gilling Dod are ideally placed to deliver on design promises and assist construction partners in the most challenging and constrained economic conditions, creating environments that support communities of the future.
NZC & builidngs, is already delivering the next generation of Net Zero Carbon Mental Health Facilties for our clients and communities. Healthcare buildings face unique hurdles due to specialised components from limited manufacturers. This is particualry true in Mental health settings with stringent criteria around robustness and ligature. Additionally, lack of fire certification restricts product use although we are currently working with specialist suppliers to bridge this gap. Modern Methods of Construction are also aiding the drive to Net Zero. Reduced transportation movements, shorter construction programmes and fewer defects all help. Gilling Dod is working alongside PSCP/Contracting partners to develop exemplar off-site standard component systems to help bring efficiencies to Mental Health builidng which draw on shared learnings from the Custodial, Commercial and Residential sectors. Built into designs from concept stage, we take an holistic approach, ensuring no compromise to Patient safety or experience. Decarbonising the built environment, including Mental Health settings, still presents persistent challenges despite strides in the construction industry. The NHS Net Zero Building Standard is pivotal, yet its inconsistency across NHS Trusts challenges progress. While operational carbon reduction has seen advancements through on-site electricity generation via photovoltaic panels and heat pumps, there is much work to be done in regarding embodied carbon. Sustainable, ethical and economic design will be a bedrock of modern Healthcare building moving forward. Gilling Dod embraces this challenge and building on a proven record for BREEAM Excellent rated MH
MMC
Refurb &
Following years of under investment, large parts of the UK Mental Health building estate is not in a fit for purpose condition. The sheer size of the backlog, plus scarcity of capital, availability of land, planning restrictions and time pressures, sometimes means that new build solutions are not always feasible. As such, today’s designers need to work creatively to repurpose and reimagine existing spaces and structures to create modern, compliant, and productive environments for Mental Health and Wellbeing. This challenge can sometime bring about real innovation, with the end products sometimes surpassing the aspiration of new builds, drawing on as they do, established sites, links to local communities and strong cultural connections. By understanding the roots and historic relationships of services and communities, we can apply best practice and evidenced based innovation, to breathe new life into tired buildings, in a truly sustainable way. Imaginative interior design solutions, structural expertise, creative adaptation design, envelope upgrades, retrofit applications of new technology, immersive landscape design, are all elements that help to create truly astounding refurbishment and repurposing projects. Combining wiour deep understanding of the HBN/ HTMs, the only barrier to such potential is our imagination.
Renew
The
Future According to the World Health Organisation, in 2019, 970 million people globally were living with a mental disorder, with anxiety and depression the most common. Globally, mental disorders account for 1 in 6 years lived with disability. People with severe mental health conditions die 10 to 20 years earlier than the general population. And having a mental health condition increases the risk of suicide and experiencing human rights violations. The economic consequences of mental health conditions are also enormous, with productivity losses significantly outstripping the direct costs of care. The need therefore for appropriate and accessible Services and settings to promote, support and nurture Mental Health and Wellbeing is huge. Environments that support Neurodiversity and facilitate productive and sustainable care are at the forefront of our design approach be they relating to modern inpatient wards, Urgent care centres and Crisis hubs, Rehab and CAMHS facilities, specialist Dementia care homes, or bespoke Learning Disability or ASD facilities. At Gilling Dod, we understand no one size fits all and we are actively engaged in research and innovation projects that look to evolve Pathway specific design in the built environment. Inpatient care alone cannot meet this global demand so the need to look at more Pre-emptive, Community based and individual care strategies has come to the fore including new technologies, products and Service models. These too have driven the need for groundbreaking Research and Innovation buildings which are vehicles for cross sector collaboration and development, housing Virtual reality labs to test new treatments and aid AI product development, living lab spaces for immersive therapies and co- production, plus learning hubs and digital resource spaces for knowledge sharing. The next 10 years will see Mental Health and wellbeing coming out of the hospital setting, into our offices, schools, and public buildings, and through accessible tech, into our everyday lives. Gilling Dod is proud to support this care revolution and through informed innovate design, will help shape the healthy communities of tomorrow.
About Gilling Dod merges passion with precision to design spaces that tell stories. From the heart and with vision, our award-winning healthcare and wellness spaces are visually stunning, practical and promote a sense of hope, recovery and well-being. We care about the communities at the core of our projects, and we ensure everyone has a voice. Our co-production approach to design, places patients and staff at the heart of every building we create together. Our mission is to enrich lives through thoughtful and meaningful healthcare architecture. Our values place people at the centre of every decision. We work with integrity and humility to craft spaces with warmth and thought. There’s always a story behind everything we do. A story that demands more than just bricks and mortar. A Mental Health building needs to aid and enhance the recovery journey, not least, because patients are being care for at their most vulnerable Designing across all health specialisms, we bring expertise and lessons learnt to your project, gathered from leading healthcare schemes across the country. Supporting our co-production approach we use the latest technology, incorporating BIM and AI tools, delivering sustainability that goes beyond net zero carbon.
Vision: Delivering excellence through positive and sustainable architecture
Mission: To enrich lives and support
Us
communities through thoughtful and meaningful healthcare architecture
Collaboration Through a co-production ethos, we embrace collaboration by listening and bringing fresh ideas. Creativity Crafting spaces that are drawn with warmth and thought. Excellence We challenge ourselves and succeed through constant improvement and learning.
Integrity We work with empathy and humanity. We do what is right.
Respect We value everyone’s contribution and we are united in diversity.
Inclusive From working openly with clients and stakeholders, to creating a family-friendly workplace for staff, people are the heart of Gilling Dod.
contact@gillingdod www.gillingdod.com
01257 260070 The Cruck Barn Duxbury Park Chorley Lancashire PR7 4AT
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