Literature demonstrates that patient care outcomes and satisfaction can be significantly influenced by the healthcare environment. This research focuses on the design of mental health wards for adolescent patients and highlights understanding and implementing the viewpoints of adolescent patients in the design of mental health spaces. This study suggested several environmental interventions towards improving the comfort of adolescent patients’ experience: provisions for privacy, spaces for group and independent activities, and environments with positive distraction (nature, art, music).
The purpose of this study is to inform the redesign of adolescent mental health inpatient ward environments based on the evidence elicited from the users’ (the adolescent patients’) perspectives.
Data for the study was collected from a larger consultation project focused on a hospital redesign in New South Wales (NSW), Australia. The pediatric mental health unit of the hospital (focus of this study) is 12-bed facility for children and young adults between 12 and 17 years in need of inpatient treatment.
The research question that guided the study was: “How can the pediatric mental health inpatient environment be designed to improve emotional responses to the space?” The researchers’ goal was to gather evidence that could be used to inform the design of the hospital.
After obtaining the ethical research approval for the study, combined methods of focus groups and interviews were conducted with eight adolescent patients between the ages of 15 and 18. All participants had been admitted to the setting over the previous year (five former inpatients and three current inpatients).
Interviews/focus groups were semi-structured and included questions such as: “(1) Can you please describe what kind of environment you believe supports your well-being? (2) What would it look like? (3) Is there anything lacking on the unit that you believe it would benefit from? (4) In your opinion, what space is available to you on the unit? and (5) Is there anything else about your experience you would like to share with us?”
Data collected through interviews and focus groups was recorded and transcribed. Qualitative content analysis was utilized for coding and identification of key themes and phrases in each transcript. The authors include anonymous quotes from the interviews and focus groups that help to illustrate each theme in the results section.
Therapeutic healthcare spaces dedicated to adolescent patients need to be designed with close attention to the safety and risk mitigation during episodes of mental health distress. While adolescents understood the importance of safety for the environment, they also highlighted that the unit resembled a “jail.” This study emphasizes the importance of user involvement in the design process. The results of this qualitative study suggest several major themes that adolescents proposed for enhancing the mental health wards:
- A need for improved privacy and sense of control over one’s environment (e.g., control of the lighting, temperature, auditory privacy) to reduce the feeling of being in a “jail.”
- Discomfort with surveillance from and location of the working spaces in the mental health ward (e.g., nurse stations, ward layout, waiting area, etc.). The current unit seems to be isolated and secluded from the rest of the hospital. Participants pushed against the “out of sight, out of mind” mentality and criticized the spaces that provided little to no privacy for them through using transparent glass.
- Activities and programming (both indoors and outdoors) that can contribute to maintaining a sense of independence and relieving feelings of boredom.
- Social activities and programs that accommodate interaction with peers and improve sense of self-worth.
- Home-like spaces (colorful, flexible for personalization, flexibility in lighting and acoustics, and welcoming colors and textures).
- Access to environments that provide positive distraction such as nature, music, arts, etc.
The authors recognize that due to the exploratory and descriptive nature of the study, the generalizability of the findings may be limited. The sample size is also small and given the sensitive nature of the adolescent inpatient experience, the participants may not have fully disclosed their feelings and knowledge. The evidence is from an Australian context; future studies can supplement the evidence with adding voices from diverse users across different geographical contexts.