Patients' Health & Well-Being in Inpatient Mental Health-Care Facilities: A Systematic Review

Abstract

Background: Previous research indicates that the physical environment of healthcare facilities plays an important role in the health, well-being, and recovery outcomes of patients. However, prior works on mental healthcare facilities have incorporated physical environment effects from general healthcare settings and patient groups, which cannot be readily transferred to mental healthcare settings or its patients. There appears to be a specific need for evidence synthesis of physical environmental effects in mental healthcare settings by psychopathology.Purpose: This review evaluates the state (in terms of extent, nature and quality) of the current empirical evidence of physical environmental on mental health, well-being, and recovery outcomes in mental healthcare inpatients by psychopathology.Method: A systematic review (PRISMA guidelines) was performed of studies published in English, German, Dutch, Swedish, and Spanish, of all available years until September 2020, searched in Cochrane, Ovid Index, PsycINFO, PubMed, and Web of Science and identified through extensive hand-picking. Inclusion criteria were: Adult patients being treated for mental ill-health (common mental health and mood disorders, Cochrane frame); inpatient mental health care facilities; specifications of the physical and socio-physical environment (e.g., design features, ambient conditions, privacy); all types of empirical study designs. Quality assessment and data synthesis were undertaken.Results: The search retrieved 1,068 titles of which 26 met the inclusion criteria. Findings suggest that there is only indicative evidence of the impact of the physical healthcare environment on patients' mental health, well-being, and recovery outcomes. There is significant lack of pathology-specific evidence. Methodological shortcomings and empirical scarcity account for the poor evidence.Conclusion: This review highlights the need for more research using advanced study designs.

Ontological insecurity of inattentiveness: Conceptualizing how risk management practices impact on patient recovery when admitted to an acute psychiatric hospital

“…Most noted they were severely ill when admitted to hospital, yet their experiences corresponded to research in which the acuity of illness can fluctuate (Llewellyn‐Beardsley et al., 2019). This temporal state suggests opportunities early on to explain what is happening and involvement in risk management as well as what could improve recovery, yet within tolerance levels to engage which vary from patient to patient and within different times (Weber et al., 2022). The apparent rigour applied to mitigate risks could also be adopted by identifying opportunities to engage.…”

Reimagining Institutionalization and a Continuum of Care for People Experiencing Homelessness and Mental Illness

“…Salutogenic design (eg, space for purposeful activities, nonconfining living spaces, sunlight) is associated with patient well-being and encourages recovery-oriented patient-institution relationships. 7 To help patients achieve meaning and purpose, staff can create daily opportunity for skill building, peer mentoring, and community formation.…”

“…Institutions modeled after traditional prisons and hospitals, which optimize safety by prioritizing isolation and oversight over community building, risk attacking mental illness while neglecting mental health. Alternative models may better facilitate recovery; for example, Worcester Recovery Center and Hospital in Massachusetts imitates a town, with small-group “houses,” “neighborhoods,” and a communal “downtown.” Salutogenic design (eg, space for purposeful activities, nonconfining living spaces, sunlight) is associated with patient well-being and encourages recovery-oriented patient-institution relationships . To help patients achieve meaning and purpose, staff can create daily opportunity for skill building, peer mentoring, and community formation.…”

Impact of the design of adult mental health inpatient facilities on healthcare staff: a mixed methods systematic review

“…However, the applicability of the evidence to mental health inpatient settings remains debatable. This is due to the unique treatment and recovery specifications for mental illness, which require specialised designs to minimise the risk of self-harm and suicide or reduce environmental stimuli 13. Addressing this lack of knowledge is essential given the importance of staff health and well-being and their role in supporting service user satisfaction and the therapeutic process.…”