Mental health hospital inhabitants’ experiences of social spaces v1.0
Research type
Research Study
Full title
Mental health hospital inhabitants’ experiences of social spaces in traditional and contemporary settings.
IRAS ID
324046
Contact name
Donna M Ciarlo
Contact email
Sponsor organisation
London South Bank University
Duration of Study in the UK
0 years, 7 months, 30 days
Research summary
Research Summary
This interdisciplinary research will be undertaken in acute mental health wards of a mental health hospital with ward staff and inpatients. The principal research question is to explore how patients and staff experience and make sense of the social spaces of traditional and contemporary settings. Traditional settings here are defined as dormitory style wards, little outdoor space and require modernisation. Contemporary settings are purpose built, evidence based, and recovery led designed environments.
Whilst designers and clinical practice are making headway to incorporate person-centred approaches into ward design, there is often insufficient depth in the psychological aspects of the social environments and how individuals make sense of inhabiting them. This research aims to develop upon previous research by advancing our understanding of the meaning making practices of inhabitants in the social environments of traditional and contemporary mental health hospital environments. The areas that relate to making sense of such environments are life histories, memories, social interactions, design and features, affectivity, decision making and ward procedures.
The research will consist of two studies undertaken across five male and female acute inpatient wards. The same participants will take part in both studies to later develop individual case studies of experiences in both settings through thorough qualitative and quantitative analysis. During the first study, each participant will take photographs of social environments within the ward which will be used to provide context and discussion points of a one to one semi structured interview. During the second study, each participant will explore three designed contemporary spaces not yet built through a virtual reality head mounted device with integrated eye-tracking. During this time, participants will talk about the places they explore followed by a one to one semi structured interview looking at the features that appeared to capture their attention outlined in eye-tracking heat maps.
Summary of Results
Study title: Patient and staff lived experiences of traditional and contemporary social spaces in acute mental health.
This interdisciplinary research project brings together ideas and methods from different fields such as psychology, mental health, architecture and design, and cognitive science. It was shaped by the Lived Experiences of Distress Research Group (LEOD) and developed in collaboration with the Design In Mental Health Network and a Mental Health NHS Foundation Trust in North West England. Funded by London South Bank University, the research was designed and carried out by Donna Ciarlo (PhD student) alongside her supervision team Prof. Paula Reavey, Dr Elisa Carrus and Dr Claudia Civai (the authors declare that they have no conflicts of interest). It explores the psychological dimensions of social spaces in acute inpatient wards to understand and make sense of how inhabitants interact within both existing and newly developed built environments. Acute wards are collective care spaces, monitored and supported by clinical staff, where individuals with diverse backgrounds and support needs coexist. Social spaces play a crucial role in fostering interaction and aiding recovery. However, despite their therapeutic importance, little research has focused on the lived experiences of patients and staff who physically and relationally share these vital settings. Drawing on mental health and cognitive neuroscience research and expertise, this project captures the emotions, thoughts, bodily sensations, and perceptions of inhabitants as they engage with traditional and contemporary environments.
People with lived experience were actively involved in the project. Public involvement (PPI) included members of LEOD, NHS staff and clinicians, former inpatients from across the UK (including the hospital where the study took place), and people from working-class, Black, ethnic minority, and neurodiverse backgrounds. Three lived experience contributors (two former patients and one NHS expert) helped shape the project at key stages; design, recruitment, testing and will also help with interpreting the findings and disseminating the results.
The first study asked people to take photos of an older hospital environment to reflect their experiences. The second used virtual reality (VR) to simulate a newer ward design, while also tracking eye movements to see what aspects drew attention. Thank you to the eleven inpatients (eight completed both studies) and five staff members (support workers and nurses) who took part.
Participants came from both male and female wards, between the ages of twenty and seventy, from diverse backgrounds and professions. They took photos, explored spaces, and took part in one-to-one interviews. Very few side effects were reported from using VR. The researchers carefully analysed what patients and staff said in interviews to understand how each person experiences the social spaces on the ward. They then considered the similarities and differences across the individual groups and the overall group. They also looked at how people felt about the new (virtual) ward spaces, and what those spaces meant to them.The findings show that while many people responded positively to the newer designs and aspects of the older settings, there were also some tensions. Staff and patients often understood the spaces differently and sometimes design may conflict with lived experiences and future expectations. Importantly, staff are not a single group; they had a wide range of views and experiences. By adopting an ‘ecological’ approach and considering the relations between people and their environment, this research helps deepen our understanding of these unique and complex spaces of care and recovery. The findings could help improve future ward designs, inform staff training, and support better daily practices on the wards. While much research focuses on how people behave in these spaces, this study shows that personal history, relationships, and identity also shape how people understand and interpret these environments.
Following the research, Donna continues to work closely with NHS partners. She uses evidence and insights from the project to help shape policy and practice, particularly around the design and management of social spaces in mental health care.
Key words: Lived experience, acute mental health, ecological, multi-perspective IPA, social spaces
Websites:
LEOD: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fwww.lsbu.ac.uk%252Fresearch%252Fcentres-groups%252Flived-experiences-of-distress-research-group-leod%2FNBTI%2FgZS_AQ%2FAQ%2F91a708a6-302c-4349-a861-d26da664f97c%2F2%2FdhounU43J6&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cdb69a2ea1fb348516cf008ddbf8c6079%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638877331812971867%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=cQ6b5eYgcGOQzFYVBDat8A7oZbe%2FNy%2BSRpdEb09XNdk%3D&reserved=0
Design in Mental Health: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fdimhn.org%252F%2FNBTI%2FgZS_AQ%2FAQ%2F91a708a6-302c-4349-a861-d26da664f97c%2F3%2Fwe5DJs2T0Q&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cdb69a2ea1fb348516cf008ddbf8c6079%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638877331812987423%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=KXthJah%2Fpm7trOa4ec6b7koB%2FGXMo%2FsXx3%2BowNkHK0o%3D&reserved=0
London South Bank University: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fwww.lsbu.ac.uk%252F%2FNBTI%2FgZS_AQ%2FAQ%2F91a708a6-302c-4349-a861-d26da664f97c%2F4%2FL7B4DPsjeu&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cdb69a2ea1fb348516cf008ddbf8c6079%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638877331813001030%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=gV1qKHPQXqbxMLXm4ylRg9Xmb3kuxIrM%2B%2F4wrZZx7w8%3D&reserved=0
Donna Ciarlo: https://gbr01.safelinks.protection.outlook.com/?url=https%3A%2F%2Ftrack.pstmrk.it%2F3ts%2Fresearchportal.lsbu.ac.uk%252Fen%252Fpersons%252Fdonna-ciarlo%2FNBTI%2FgZS_AQ%2FAQ%2F91a708a6-302c-4349-a861-d26da664f97c%2F5%2FyNBbZgBNTD&data=05%7C02%7Cgmeast.rec%40hra.nhs.uk%7Cdb69a2ea1fb348516cf008ddbf8c6079%7C8e1f0acad87d4f20939e36243d574267%7C0%7C0%7C638877331813014250%7CUnknown%7CTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ%3D%3D%7C0%7C%7C%7C&sdata=GldNnPpsAuO%2Fd%2B5gfI%2FyGhvM%2F7aVJqWqEcLJXagCSPc%3D&reserved=0REC name
North West - Greater Manchester East Research Ethics Committee
REC reference
23/NW/0162
Date of REC Opinion
10 Aug 2023
REC opinion
Further Information Favourable Opinion