Using experience-based co-design to improve inpatient mental health spaces

While some inpatient mental health services provide pockets of excellence (NICE, 2012), a major UK government report (Crisp, Smith, & Nicholson, 2016) has recently found many under great pressure. Staff are often demoralised and locked into cycles of crisis management and service users and families may feel disenfranchised and excluded. Dangerous and chaotic wards, diverse case-mixes, the lack of therapeutic input and the excessive focus on community services at the expense of inpatient settings, all threaten the quality of acute care (Lelliot, Bennett, McGeorge, & Turner, 2006). Service users (Mind, 2011), families, (Hickman et al., 2015) and staff (Garcia, Kennet, Quarishi, & Durcan, 2005) all agree that acute mental health care is unsatisfactory, frightening and stigmatising. There is even evidence that being hospitalised for a mental health problem can be, in itself, traumatic (Morrison, Bowe, Larkin, & Nothard, 1999). This may be unsurprising given the coercive and controlling practices that take place there, including detention, seclusion, restraint and being forcibly compelled to undergo pharmacological treatments or electro-convulsive therapy.