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

Inpatient services are frequently constructed as a topic of concern in research and policy, often in response to service-users’ reports that wards are unsafe, boring, and lacking in amenities (Quirk & Lelliott, 2001). Our research shows that service-users, as well as staff and families, experience inpatient mental health spaces as impermeable, separate and stigmatising, and sometimes uncomfortable, chaotic and unsafe (Fenton et al., 2014; Hickman et al., 2015). Experience-based co-design (EBCD; Bate & Robert, 2007) is a participatory action research approach to service development, which has been used extensively in physical healthcare (Donetto, Tsianakas & Robert, 2014), but is only recently being used to improve mental health services (Larkin, Boden & Newton, 2014). This chapter will draw on EBCD projects from two NHS Mental Health Trusts. These projects brought together service-users, staff and families, alongside Trust management and community staff to co-design improvements to the inpatient wards. Sometimes these improvements were as simple as introducing soft furnishings and better signage, sometimes they were more complex interventions in the culture of the wards, however all the improvements, and perhaps more importantly, the improvement process, allowed service-users and families to feel more welcomed and comforted, and helped staff working in difficult circumstances feel more supported.