Mind tells employers and NHS: improve environment to improve mental health
Posted Wednesday 4 October 2006
Mental health charity Mind today released two reports, Building solutions, on the impact of the environment on our mental health. Mind warned employers that they lose productivity if office environments aren't up to scratch. Proposed Incapacity Benefit reforms will be hampered by unhealthy workplaces. The condition of mental healthcare environments must be improved, while NHS financial pressures could lead to further deterioration in cleanliness and repair standards.
Building solutions: improving mental healthcare environments
Mental health patients spend 12 times as long in hospital, yet the conditions of their wards are among the worst.
A survey for Mind's Building solutions report found that nearly a third of people (29 per cent) who had recently stayed in mental health wards were dissatisfied with their ward's state of repair, with 28 per cent unhappy about ward cleanliness. This backs up last year's Healthcare Commission finding that standards of cleanliness are markedly poorer in mental health hospitals compared to acute hospitals. (1)
Mental health inpatients often have to spend many weeks in hospital, with average stays of around 58 days, nearly 12 times longer than patients with physical health problems (2). 56 per cent of recent inpatients surveyed rated their ward as unpleasant or very unpleasant. Mind is calling for standards on wards to be improved to ensure that all patients have a therapeutic and stimulating stay. The lack of activities leads to boredom, which causes frustration and slows recovery.
This report continues Mind's work on mental health wards, including Mind's 2004 Ward Watch report, which found that patient safety, morale, and recovery were being undermined by boredom, harassment, and difficulties associated with low staffing levels (3). This summer damning data on sexual assaults in mental healthcare was eventually released by the National Patient Safety Agency (4).
Good ward design can play a crucial role in providing a calm and therapeutic environment, as can proper access to gardens and other green spaces. NHS Estates' own guidelines recommend that patients are given access to an open space to help prevent behaviour problems (5). Yet Mind's research found that access to gardens was being used in some wards as a reward for good behaviour, and denied as a punishment. Punishment should have no place in a hospital.
Mind's key recommendations
- Service-users should be involved in the design of new hospitals
- Wards should be maintained to the highest levels of cleanliness
- All patients should have access to green spaces
- All sleeping accommodation must be single-sex
- Urgent action must be taken to address levels of violence on wards
- Wards and their facilities need to be pleasant and stimulating, with a good range of activities. Mind supports Bright's 'Star Wards' project (6)
Mind Chief Executive, Paul Farmer, said:
"Going into hospital with mental health problems can be very traumatic. We rely on hospitals to help us get well, but at the moment many are not providing a therapeutic environment. We would like to see all mental healthcare environments come up to the standards of the best. On many wards there's simply no alternative to, at best, boredom, at worst, fear. This can and must be addressed as a matter of urgency."
Building solutions: improving office environments
'We mustn't forget health and safety for our minds.'
Getting office environments right is essential if the Government is to be successful in getting incapacity benefit claimants back to work. People with mental health problems account for around 40 per cent of IB claims. Many want to work, but they need a supportive environment, and healthy offices are part of this. Mind surveyed office workers across England and Wales in association with the TUC, to find out how their office environment impacted on their mental wellbeing.
Workplace stress is the second biggest occupational health problem in the UK (reference), and the office environment is a key factor. Nearly 10 per cent of the UK's gross national product is lost each year due to job stress. (7)
- 26 per cent thought conditions in their office had negatively affected their mental health
- 22 per cent of respondents had formally complained about their office environment
- 42 per cent of respondents were dissatisfied with the temperature in their office
- 27 per cent were unhappy with the amount of natural light
- 27 per cent also unhappy with the amount of working space they have
Studies show that workers in less pleasant environments get less work done (8). As building costs are a small proportion of all business costs, especially compared to wages, investment in healthy, enjoyable workplaces reaps rewards for employers as well as employees.
Office environment facts
- Researchers have proved that good daylight in an office leads to better health, increased productivity, and lower absenteeism. Studies have shown that proper daylight reduces headaches, eyestrain, and seasonal affective disorder (9).
- Good design is not just personal taste. Environmental psychologists are finding cross-cultural patterns in buildings that underlie what contributes to positive emotions (10).
- Cramped working conditions are a source of stress, a problem is worse in the public sector than the private or voluntary sector, according to TUC research (11).
- American researchers found that the presence of plants or flowers has a measurable impact on creativity, productivity, and workers' wellbeing (12).
Mind is asking employers to:
- be open to suggestions of change in the office
- listen to employees' views about their environment
- provide sufficient desk space and good ventilation
- consider giving someone the role of 'environment champion'.
Mind chief executive, Paul Farmer, said:
"Dilbert-type cubicles won't cut it in the information economy. To maximise productivity and creativity, it's crucial that staff have inspiring, flexible work environments. What can often be a fairly small investment in improving your workspaces will reap rewards in staff morale and productivity. Everyone thinks of health and safety as a physical thing - we mustn't forget health and safety for our minds."
1) The Healthcare Commission, December 2005, A snapshot of hospital cleanliness in England
All the worst performing hospitals were mental health hospitals. The Healthcare Commission suggested possible reasons for this were a lack of pre/post operative patients with low immunity levels requiring a very high standard of hygiene, but also suggested poor staffing levels and low morale in mental healthcare may contribute. They urged the DH to urgently examine the issue.
2) ONS, Social Trends 36 [PDF]
Table 8.13 on page 122: 2003/4 average acute inpatient stay was 4.9 days; average mental health inpatient stay was 58.3 days.
3) Mind, 2004, Ward Watch
4) National Patient Safety Agency sexual assault data
5) NHS Estates, 1996, Building Note 35
6) Bright's Star Wards project
Star Wards is a user-led project to improve the daily experiences of acute mental health patients.
7) Mind, 2005, Stress and mental health in the workplace
Cost is due to sickness absence, staff turnover, lost productivity, and medical costs.
8) CABE, 2005, The impact of office design on business performance [PDF]
9) Edwards, L. and Torcellini, P., 2002, National Renewable Energy Laboratory, A Literature Review of the Effects of Natural Light on Building Occupants
10) Whole Building Design Guide, Productive
11) TUC, 2004, Biennial survey of safety representatives
12) Flowers and plants
The Impact of Flowers and Plants on Workplace Productivity, Dr Robert Ulrich, 2004, Center for Healthcare Systems and Design, Texas A&M University
Lohr, V.I., C.H. Pearson-Mims, and G.K. Goodwin. 1996. Interior plants may improve worker productivity and reduce stress in a windowless environment. J. of Environmental Horticulture 14(2):97-100.
Building solutions: Improving mental healthcare environments - survey distributed of 199 current or recent inpatients and frequent visitors to mental health wards. Focus groups were also held.
Building solutions: Improving office environments - survey distributed via TUC health and safety representatives. 238 responses received.