The Western Trust is getting set to open a new £10m Mental Health Crisis Unit at Gransha this October. The Trust say the unit will ‘set the benchmark’ for mental health care provision throughout Europe. Journal reporter CLAIRE ALLAN was invited along for a preview of the new facilities.
“No one wants to come into hospital,” Bernard McAnaney, Assistant Director of Adult Mental Health Services with the Western Trust said. “Fewer still want to come into a psychiatric hospital. It can be a very daunting experience at a time when you are very ill and very vulnerable.
“We’re trying to make it as comfortable as possible - while allowing patients to protect their dignity, privacy and to be treated with respect.”
Mr McAnaney made these comments as he showed me round the new female ward at the Mental Health Crisis Unit, a new facility which will replace the old Gransha Hospital in October of this year. He admits the new centre is a world away from the current unit at Gransha - which is “no longer fit for for purpose”.
In place of shared wards, limited shared spaces and tired furnishings comes a calm, relaxing environment where attention has been paid to every detail to try and make a stay in the unit as comfortable and non threatening as possible.
The design features are subtle - corridors have been designed to be wide enough to minimise the chance of anyone bumping into another patient. All handles and features are designed so that no ligatures can be tied anywhere in the building minimising a risk of self harm.
Family rooms are designed to allow a patient to visit with family members without leaving the safety net of their ward and each ward - from the day centre to the intensive care ward, has access to their own garden space - all designed with the needs of service users in mind.
Each patient has access to their own en-suite facilities - something which Mr McAnaney said should come as a “basic right” when you are receiving care in a psychiatric unit. Despite the lack of an observation ward or traditional nurses’ station, each individual patient will be observed as often as needed.
“That may be hourly,” Mr Ananey said. “Sometimes it is every fifteen minutes, sometimes every five. In some cases, if need dictates, a nurse will be no more than an arm’s length from a patient.
While mention of an intensive care ward may sound intimidating - there is nothing of the infamous “padded cell” about the new facility. On each ward there is a “break out” room - where all hard furnishings can be removed if someone is very seriously ill, but the rest of the time this is furnished like any of the other rooms.
The intensive care beds can be annexed away from the rest of the ward if there is a need - but intensive care patients will still have access to their own safe shared spaces and garden area.
“We are aware that if someone is in crisis they are also in a very vulnerable place and may display uninhibited behaviour. This may not be an issue for them at the time - as they are so ill - but during recovery they may become embarrassed by their behaviour so we have to do what we can to protect their dignity at all times.”
The £10 million investment by the Trust is a result of a review of Mental Health Services which began in 2004. Mr McAnaney explained how the Trust’s approach to mental health care has changed radically in the last twenty five years.
“In 1990, 90% of the Trust’s mental health budget was focused towards the inpatient facility at Gransha,” he said. “Now 85% of our budget is directed towards community care - be this assisted living facilities, community mental health teams, day care, mental health teams etc. The vast majority of people with mental health problems live at home in the community, Our services need to be tailored to meet their needs. Essentially our services need to designed in a way to meet their needs as close as possible to where people live.”
The 15% budget which he is says is directed towards the inpatient facilities is of huge importance. The changes in how the Trust approaches mental health care obviously have had certain knock on effects for the inpatient facility. While the new unit at Gransha is hugely impressive, it does mark a 25% reduction in the number of inpatient beds available to service the population of Derry, Strabane and Limavady from current numbers.
In the 1990s, when the idea of a move to a new centre was first muted, there were 64 inpatient beds. Mr McAnaney said at one stage the numbers rolled into the “hundreds”.
He said there are definitely “peaks and troughs” in demand for inpatient beds - and said that there were, inevitably, times when inpatient beds could not be found for those in need. However, he said this was a “rare occurence” and that he was confident the new facilities would more than meet the inpatient demands of the service area.
“It is not always appropriate to treat someone in a mental health crisis as an inpatient,” he added. “That decision is made by those assessing them - on a multi-disciplinary basis - and in conjunction with the patient themselves, if they are able, and their family or support network.”
The new centre at Gransha will provide much more than simply inpatient care. A large portion of the building is dedicated to daycare facilities.
These include group spaces where service users can be taught independent living skills or take part in a host of therapies from art workshops to receiving treatments from complementary therapies. The new building houses office facilities for advocates for both service users and their carers and has dedicated space for team meetings where health professionals - from consultant psychiatrists to staff grade nurses, social workers and beyond - will meet regularly to discuss the treatment plans for each patient.
There is no doubt the new facility is impressive. Architecturally it is stunning - with each corridor flooded with natural light and a great deal of thought put into the impressive gardens.
The centre, Mr McAnaney said, marks a major investment by the Trust in Mental Health services and will me a model of care that others will follow.