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Design in mind: eliciting service user and frontline staff perspectives on psychiatric ward design through participatory methods

Originally Published:
Key Point Summary
Key Point Summary Author(s):
Dickey, Andrew
Key Concepts/Context
Previous studies have shown repeatedly that the physical design of psychiatric wards has a significant impact on patient recovery and well-being. It has also been found that staff and patients often express conflicting expectations regarding the design of psychiatric wards. Therefore, it is important to better understand different stakeholder perceptions of the same environment so that the most effective design decisions can be made. One possible way of doing this would be using the “SURE model,” which is a participatory method involving collaborations with service users during all stages of the study.
To use an adapted version of the “SURE model” to gather staff and service user perspectives on psychiatric ward designs.
Data were gathered from four 18-bed adult acute-care wards between 2012 and 2013. A literature review was conducted in order to generate questions for semi-structured interviews with groups of service users and staff members. Participants were also given digital cameras and instructed to take two photographs depicting what they considered to be the best and worst aspects of the ward’s physical environment. Researchers questioned participants regarding the reasoning behind their choices, and participant responses were recorded and analyzed.
Design Implications
Artwork, natural lighting, and access to outdoor space can help reinvigorate the physical appearance of treatment spaces and increase both patient and staff satisfaction. Adequately sized and appropriately sanitized lavatories should be available to prevent dissatisfaction and potential health hazards.
Participants from both groups described the physical appearance of the psych ward as “bland” and “uninspiring,” and noted that artwork could help “brighten up” the atmosphere and improve well-being. Crowded and unhygienic communal bathrooms were also mentioned frequently by both groups as a source of dissatisfaction. Patients voiced their desire for more autonomy and control over windows, heating, and locks, while staff members suggested that more space for leisure activities and privacy would greatly improve life in the ward. Overall, the authors found that there were generally no notable differences in perceptions of the ward’s design between the two groups, even when factoring in age, gender, or legal status.
This study was conducted in one psychiatric ward over the course of one year; hence all data gathered addresses only one particular ward’s design. The length of time each participant had spent at the ward prior to the study was not taken into account; this may have affected participant perceptions of the physical environment.
Design Category
Building location/site optimization|Unit configuration and layout
Outcome Category
Patient health outcomes|Patient satisfaction and comfort|Staff health outcomes|Staff productivity / efficiency|Staff satisfaction
Environmental Condition Category
Attractiveness of physical environment|Patient Satisfaction and Comfort
Key Point Summary Author(s):
Dickey, Andrew
Primary Author
Csipke, E.
Paper Type