Great expectations the mental health & dementia facilities magazine MARCH 2024 PROJECTS The latest updates from around the country INFORMED CHOICES New plans from the Design in Mental Health Network ART WORK The positive impact of art in mental health design p5 p10 p14 New bespoke furniture for London’s Great Ormond Street Hospital
mhdf magazine 3 Contents MARCH 2023 Editor Dan Colombini Sales director Julian Walter Production Nicola Cann Design Mary McCarthy Managing Director Toby Filby Publishers Stable Publishing Limited, SBC House, Restmor Way, Wallington, Surrey SM6 7AH, England. t. 020 8288 1080 f. 020 8288 1099 e. [email protected] In this issue: 5 PROJECTS A look at some of the latest updates to projects from around the country 10 INFORMED CHOICES News on new testing standard for ligature reduction and robustness for products in the mental health built environment 14 CASE STUDY Art in Mental Health: Great Ormond Street Hospital London Great Ormond Street Hospital The publishers do not necessarily agree with views expressed by contributors and cannot accept responsibility for claims made by manufacturers and authors, nor do they accept any responsibility for any errors in the subject matter of this publication. Editor’s Note Art and soul Hello and welcome to another edition of MHDF. At a tough time, the mental health sector is rallying. New projects are making progress and the sector continues to battle adversity in tough times on a global scale. As we all know, stigmas, resource shortages, fragmented service delivery models, and lack of research capacity for implementation and policy change contribute to the current mental health treatment shortfall. This makes every day a challenge. But as we shall see in this edition, hope is on the horizon. Our projects pages bring you news of progress around the country, which is encouraging. This month we also have a special feature looking at some niche initiatives in particular, such as the work from Hospital Rooms to improve and deliver engaging art work to brighten up the Springfield Hospital. How wall space looks in these settings can have a significant impact on a service user’s happiness and recovery. Artworks can encourage greater social interaction, further bringing people together and improving care and support. A focus on seemingly smaller details such as this highlights examples of innovation in the sector and the great strides being made in mental health – something that is vital for growth on a wider scale. In addition, we have contributions from our partners in the industry, chiefly the Design in Mental Health Network, who’s work is also at the forefront of industry growth. We hope you enjoy the magazine and we invite you, as always to engage with us further for future editions. We value your feedback. Contact [email protected]
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mhdf magazine 5 PROJECTS Work has completed on a strategically important ward refurbishment project at Freeman Hospital to create an environment for care that is supportive to clinical staff, and reassuringly calm for patients. The transformation was designed by Medical Architecture for The Newcastle upon Tyne Hospitals NHS Foundation Trust, and the works delivered by Robertson Construction North East. The work forms part of the Newcastle Hospitals Internal Improvement Programme, which is a result of the Trust’s estates strategy, developed in partnership with Medical Architecture. As well as the continuation of clinical ward refurbishments, this phase of work includes upgrades to a set of prominent lift lobbies and circulation spaces. CONSISTENT DESIGN Working to a consistent design standard, particular attention is given to design for patients with dementia and frailty, as well as technical standards and guidance compliance, working within the constraints of the existing structure. The aesthetic is light and bright, with good quality and well-coordinated ceilings, lighting fixtures and finishes. Working with the Trust’s dementia team, an artistic approach to wayfinding was developed to aid those with cognitive impairment, with different rooms and spaces identified by their own unique local landmark. Biophilic design STRATEGIC REFURBISHMENT AT FREEMAN HOSPITAL COMPLETE principles were incorporated in the upgraded circulation and lobby spaces to improve the environmental qualities of these high-traffic spaces. Attention to detail was crucial, as space was often limited. This included making sure that furniture was well-planned and considered, to provide optimal facilities for clinicians. Generously sized equipment bays were also provided to ensure that circulation spaces are left clutter free and accessible. IMPROVEMENTS Alex Ferguson, Architect at Medical Architecture, said: “These strategic upgrades will make a big difference to the experience of patients, staff, and visitors, demonstrating that relatively modest but well-planned interventions, can create high-quality spaces that deliver excellent value to the Trust.” Garry Hope, Regional Managing Director at Robertson Construction North East, said: “Continuing our close relationship with the Trust, these improvements were delivered with the end-users in mind to create bespoke spaces that will support the NHS in its delivery of excellence in healthcare.” Russell Jones, Deputy Director Strategy, Planning & Capital Development at The Newcastle upon Tyne Hospitals NHS Foundation Trust, said: “A great deal of engagement, care, and attention to detail was accomplished in developing these design standards and branding for the Trust’s clinical upgrades. It is fantastic to see the results where environments are transformed for the betterment of clinical care, patient experience and staff wellbeing.”
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mhdf magazine 7 PROJECTS Nabeel Javed, Willmott Dixon Interiors; Anthony Percival and David Steeds, both of Coventry and Warwickshire Partnership NHS Trust; and Craig Kitchen, Willmott Dixon Interiors Willmott Dixon Interiors has completed the multi-phased refurbishment of a mental health hospital in Warwick. The national fit-out and refurbishment specialist contractor has handed over the newly upgraded Larches Ward at St. Michael’s Hospital, on behalf of Coventry and Warwickshire Partnership NHS Trust. It is the final phase of a project to upgrade 5,853 sq m across six inpatient wards at the hospital, which began in 2022 with the anti-ligature refurbishment of Rosewood Terrace. The contractor has since upgraded facilities at the hospital’s Hazelwood, Rowan, Ferndale and Willowvale wards, which provide age dependent mental healthcare services. All works were carried out in a live hospital environment and included the installation of new windows and internal doors, and adaptations to power, data and access control services. Willmott Dixon Interiors has also made improvements to lighting, ventilation grilles, radiator covers and sanitaryware. Flooring has been repaired, and all six buildings have been decorated throughout. The contract to refurbish St. Michael’s Hospital was awarded to Willmott Dixon Interiors via the Procurement Hub Major Project Framework and was delivered by a project team including Fulkers Bailey Russell and Design Buro. It generated a social return on investment of almost £200,000 during the project lifecycle - equivalent to more than 19% of the total contract value - and met high sustainability standards with 99% of project waste diverted from landfill. Nabeel Javed, construction manager at Willmott Dixon Interiors, said: “At the heart of this refurbishment is a commitment by Coventry and Warwickshire Partnership NHS Trust to improve patient experience and keep vulnerable people safe from harm. “We’ve worked incredibly closely with the Trust over the last two years to ensure the successful delivery of each phase of the project. Our understanding of mental health estates has enabled us to create a modern environment that will support patient recovery.” Sonya Gardiner, chief operating officer at Coventry and Warwickshire Partnership NHS Trust, said: “Safety and comfort of our patients is paramount, so we understand how important it is to invest in the refurbishment of our hospitals. St Michael’s Hospital is one of our main mental health facilities and these improvements ensure we will continue to provide safe and therapeutic environments to support the recovery of our patients now and into the future.” Andrew Peck at Procurement Hub said: “This project demonstrates the improvement to quality of life for all involved with St Michael’s Hospital. This is a great example of how Procurement Hub, working with Willmott Dixon Interiors, provides great benefits for the public sector. It is also a clear indicator that social value is at the heart of what Procurement Hub and Willmott Dixon Interiors always strive to deliver through this framework.” Willmott Dixon Interiors is currently working with Coventry and Warwickshire Partnership NHS Trust on the delivery of a separate refurbishment project at the Caludon Centre in Coventry. It includes remediation works, the replacement of fire doors and fire compartmentation line surveys. WILLMOTT DIXON completes St. Michael’s Hospital refurb
8 mhdf magazine PROJECTS The new hospital is one of the first multi-level mental health facilities in the north of England KIER SELECTED FOR £60M MENTAL HEALTH HOSPITAL Kier has been appointed by the Sussex Partnership NHS Foundation Trust to deliver a new £60m 54-bed acute inpatient mental health hospital in Bexhill, as part of its Re-designing Inpatient Services in East Sussex (RIS:ES) Programme. This is the first step in the RIS:ES Programme which is aimed at providing all mental health inpatient services across East Sussex on a single site. The 57,393 sq. ft facility will provide high-quality inpatient services for adults and will replace out-dated services currently provided in the Department of Psychiatry at Eastbourne District General Hospital. There will be three 18-bed wards, all with individual bedrooms and en suite bathrooms, surrounded by attractive and therapeutic landscaped green space. The new building will also provide outpatient services as well as training facilities for medical and other related professions. The building will be fully electric and highly insulated, with energy efficient systems being implemented to reduce energy usage and optimise environmental performance. The majority of the roof will include solar panels and a range of electric vehicle charging points will be installed for maintenance teams, staff and visitors. In addition, the car park has ‘rain gardens’ that collect the surface water run-off, filtering it into a storm water attenuation tank before it is discharged directly into the ordinary watercourse. This prevents flooding and minimises impact on buildings and the environment. “We are delighted to be appointed by Sussex Partnership NHS Foundation Trust to deliver this new mental health hospital, which will provide improved and modernised services to the East Sussex region. Cheryl Parsons, regional director for Kier Construction Southern “We look forward to using our wealth of experience and expertise to deliver this first-class health facility sustainably, benefitting the community for years to come.” “This is a major milestone for a programme which has been almost four years in the making. We are now looking forward to working closely with Kier as full construction of the new facilities begins in earnest. Paula Kirkland, RIS:ES programme director added: “When complete, the building will provide the people of East Sussex and beyond with state-of-the-art inpatient services which will offer the highest quality therapeutic care for those with serious mental health conditions.” Kier has been appointed by the Sussex Partnership NHS Foundation Trust
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DHMN INFORMED CHOICES TESTING 10 mhdf magazine Informed Choices, the testing standard developed by Design in Mental Health Network in partnership with Building Research Establishment (BRE), has been eight years in the making, and involved more than 250 consultations with Network members and technical contributors. Since its launch at the Design in Mental Health conference in 2023, the new standard has had a flurry of interest from NHS Trusts, NHS England, and manufacturers and specifiers alike. In the autumn we held two open days at BRE, aimed at an audience of specifiers and NHS colleagues. The open days covered demonstrations of the ligature reduction and robustness testing, and provided a background and introduction to the new standard. As Gary Timmons, head of built environment, BRE, said: “It’s to try to help the industry to make those informed choices so they can make a decision as to what type of door furniture or what kind of curtain rail they should install, to understand the residual risks left in the environment, to help the clinician and everyone create a supportive but also safe environment for anyone that’s living in them.” The tests conducted by BRE are designed to be repeatable and replicable. That is to say that for example, with the robustness, the force of blows is measured, and conducted by machine rather than manually. This means that the test is not dependant on the strength of the individual holding the hammer, but rather can be reproduced under factory conditions. The certificate issued by BRE also includes factory level examination, to ensure that the product tested is not just one from a line that performs to a standard, but that the whole line performs to the same standard. Of particular interest to colleagues at the BRE open day was the ligature reduction testing. Nick Todd, head of capital projects, Iris Care Group, said: “I’ve been following Informed Choices for a number of years, I’ve been around in this industry for approaching 20 years, so I’ve been looking at anti ligature and robustness from right back when we were attempting to do it ourselves with well meaning maintenance teams. I’m enjoying seeing THE CHOICE The Informed Choices concept has been eight years in the making. IS YOURS INFORMED CHOICES NEWS ON NEW TESTING STANDARD FOR LIGATURE REDUCTION AND ROBUSTNESS FOR PRODUCTS IN THE MENTAL HEALTH BUILT ENVIRONMENT
mhdf magazine 11 DHMN INFORMED CHOICES TESTING how things are progressing and getting a proper testing standard so it’s based on science and not subjective opinions. Ligature products have often been badged as anti ligature. Occasionally you see reduced ligature creep in; you need to know what it is that you’re buying and that once you’ve installed it correctly, that it is the product that you needed.” The ligature reduction testing involves testing with graded categories of equipment which is likely to be available to people on wards, and testing with time limited slots of increasing duration. This gives NHS colleagues a good idea as to how long between observations is required to create a ligature, and is more supportive of clinical judgements that can factor in the relational safety aspect of staffing the ward. Colleagues were encouraged to sign the pledge committing to supporting the new standard and requiring their manufacturers to produce evidence of testing when supplying to their trust. To date we have 13 NHS Trusts and specifiers signing the pledge, and on the day we had a new signing, by Damian O Hanlon, Capital Project Manager, Leeds and York Partnership NHS Foundation Trust. On the motivation for signing, Damian said: “It’s important to have standards, because I don’t think the mental health sphere has had a lot of that in the past and it just gives you some kind of certainty that what you are purchasing is fit for purpose. “ Since the open day in the autumn the publication of supplements to HBN 03-01 and 03-02 saw multiple mentions of the Informed Choices standard. The Design in Mental Health Network working group welcomed these developments, with Phil Ross, its chair, responding to the report authors saying: “When DIMHN started the journey seven to eight years ago to create an independent evaluation of products for use in mental health spaces, having the testing scheme referenced within the highly influential guidance documents of HBN 03-01 and 03-02 was a distant (impossible?!) dream, many NHS Trusts read this as their design bible. I have no doubt this will encourage more NHS to adopt, and in turn, more suppliers to conform to a consistent means of discussing all forms of risk and comparing different products.” To find out more about the standard and the impact of the testing, responses and discussion in the light of it, please attend our webinar at 3pm on 18th April. For Eventbrite link Scan QR Code
Bringing People Together BECAUSE GOOD DESIGN CAN HEAL Design in Mental Health is the event that brings together professionals from around the world to learn about, share and challenge what good design in mental health settings looks like. Attendees include architects, designers, clinicians, lived-experience experts, health planners, estates managers and product manufacturers. All those involved in the design and delivery of the mental health built-environment are welcome and encouraged to attend. HEAR FROM AND INTERACT WITH THOUGHT LEADERS, DISRUPTORS, ACADEMICS AND EXPERTS BY EXPERIENCE Selected content from the Conference Programme: DISCOVER AND TEST THE LATEST PRODUCTS AND SOLUTIONS The event includes a major exhibition where you can see, feel and compare innovative products and services from 60+ leading suppliers to the sector, including many NHS approved framework suppliers. An extensive range of solutions under one roof. KEYNOTE Striving to become an Anti-racism Organisation in Mental Health: NHS England’s Patient and Carer Race Equality Framework Dr Jacqui Dyer, Chair of the Advancing Mental Health Equalities Taskforce and the Patient and Carer Race Equality Framework Steering Group, NHS England KEYNOTE Therapeutic and Trauma Informed Approaches to Custodial Design David Gardner, Director, Holmes Miller Architects Rethinking ‘The Therapy Room’: Flexible Spaces for Mental Health Work Dr Paul Hanna, Head of Psychological Insights, Hoare Lea KEYNOTE Art Insists The Walls Be Kind Dolly Sen, Artist and Activist Arts For Arts Sake? Examining the Function of Art in Mental Health Settings: A Review of the Evidence Prof. Paula Reavey, London South Bank University; Michael Leahy, National Institute For Health and Care Research WORKSHOP Redefining Assistive Equipment as Personalized Empowerment Tools Bruno Oro, Iowa State University Crafting for Design in Mental Health: Personalisation, Participation and Production Prof. Steven Brown, Nottingham Trent University Organised by Event Sponsors Supported by
Image credit: Clock View Hospital - Medical Architecture - Jennie Webb Discover more and book your place 4-5 June 2024 Manchester Central www.designinmentalhealth.com
GREAT ORMOND STREET We take a look at the refurbishment work at the famous Great Ormond Street Hospital in London, which saw new bespoke furniture installed, with patient safety at the heart of the project. Medspace Solutions was delighted to be awarded the package to redesign and refurbish the Psychological and Mental Health Services (PAMHS) Department on Level 6 of Great Ormond Street Hospital. Great Ormond Street Hospital is a children’s hospital in London which is run by Great Ormond Street Hospital for Children NHS Foundation Trust. The project was installed on behalf of Logan Construction and contained a large amount of bespoke furniture, HTM63 and HTM71 cabinetry and reception desks. The Medspace team carried out the design work in March and April of 2023, collaborating closely with Day Architectural and artist Giles Round to ensure the successful integration of design and artwork elements. The aim was to create functional, aesthetically pleasing, and therapeutic spaces for mental health services. PATIENT SAFETY Patient safety was a primary consideration on this project, with many fixtures incorporating anti-ligature handles and fittings. The installation needed a balance of strength and safety whilst retaining a welcoming and calming environment. A lot of thought had been put into creating the department, in particular the integrated art was developed with and for the children and young people to create a space that feels more domestic and comfortable. To achieve the artistic vision for this unique project Medspace worked closely with trusted supplier Formica® using their flagship Younique® product. Younique® has allowed Medspace to incorporate patterns directly onto the laminate panels used in the construction of the furniture. This creates a long-lasting hard-wearing surface, resistant to vandalism and colour fade. Another interesting design feature is the backlit cloud panel. Giles Round’s cloud design is featured throughout the department and Medspace incorporated this by fabricating it using translucent Corian® solid surface material. This was then backlit using LEDs creating a soft and relaxing feature in each of the eight bedroom areas. Installation took place between August and October 2023, and our Furniture, Fixtures and Equipment Package included supplying a functional and stylish reception desk and furnishing and designing the laundry room, kitchen, activity room, bedroom, lounge, study, washroom, dirty utility, teen zone and a quiet space. CLEANLINESS During the installation, two things were paramount – maintaining cleanliness in a hospital environment and ensuring no patients or their families were disturbed by the work. Our team worked closely with the hospital to ensure there were no issues during the installation period, and we kept disruption to an absolute minimum for everyone, including the staff. The finished design is a massive improvement for the department, and it is now a much more modern department that is fit for purpose and more pleasant for treating the patients who come in. https://www.medspacesolutions.co.uk/ https://www.gilesround.co.uk/ 14 mhdf magazine
GREAT ORMOND STREET ABOUT THE FACILITY: PSYCHOLOGICAL AND MENTAL HEALTH SERVICES DEPARTMENT The Psychological and Mental Health Services Department at Great Ormond Street Hospital works with children in the hospital and with their families. It houses both outpatient and inpatients services which treat children from the ages of 7-14 for a range of mental health disorders. GREAT ORMOND STREET HOSPITAL Great Ormond Street Hospital is an invaluable resource for children and families and is one of the world’s leading paediatric care and research centres. Demonstrating a steadfast commitment to continuous improvement and providing the highest quality care and support for seriously ill children and their families, the hospital is embarking on a comprehensive four-phase redevelopment program. This ambitious initiative aims to upgrade and rebuild two-thirds of the hospital site over a 20-year timeframe, fostering a state-of-the-art environment that prioritises patient well-being and clinical excellence. mhdf magazine 15 The finished design is a massive improvement for the department, and it is now a much more modern department that is fit for purpose and more pleasant for treating the patients who come in Artist Giles Round Photography Melanie Issaka
ACTIVITY CENTRES 16 mhdf magazine THE ART OF HEALING TRANSFORMING MENTAL HEALTH SPACES WITH HOSPITAL ROOMS How environments look in mental health settings can have a profound effect on the wellbeing and recovery of someone experiencing mental health challenges. Artworks can encourage social interaction, bringing service users, staff and visitors together and offer a sense of belonging through a shared experience. They can also provide an engaging environment that offers respite from the clinical atmosphere often associated with healthcare facilities. Hospital Rooms is a mental health and arts charity which attempts to transform the way these spaces are encountered through the form and content of the artworks they commission. They aim to encourage healing with artworks that inspire, empathise, respect and occasionally challenge. AMBITIOUS PROJECT In 2023, Hospital Rooms embarked on its most ambitious project to date in collaboration with South West London and St George’s Trust at Springfield University Hospital. This endeavour involved producing over 20 artworks across the hospital site, with the goal of redefining the experience of mental health facilities for both staff and service users. The project at Springfield University Hospital pushed the organisation to create its most ambitious artworks yet, working with over 20 artists and on scales they had never been able to realise before, sometimes installing artworks standing on mobile platforms more than 15 metres high, with vastly different media (from gold leaf, to fine art photographic prints, magnetised walls and ceramics). It’s a process that rewards them with new connections, friendships and community. Each artist brings a unique perspective, challenging conventions and fostering creative exploration within the hospital setting. Jasmin Sehra’s artworks, “Keep on Going” and “One Step at a Time,” emerged from workshops led by the British Sikh illustrator and artist, incorporating positive statements created by patients to inspire and empower one another. These murals serve as reminders to persevere through life’s challenges and embrace personal growth. The project ushered in new collaborative ventures with local cultural organisations, including ActionSpace, The Courtauld, National Opera Studio, Share Community, and Studio Voltaire. Between 2021 and 2022, a plethora of workshops engaged both service users and staff across various departments within Springfield University Hospital, spanning inpatient wards, the Recovery College, and The Leon Kossoff Learning Centre at The Courtauld. A cornerstone of all Hospital Rooms endeavours involves partnering with artists who authentically represent the communities utilising mental health services. The initiative at Springfield University Hospital presented an opportunity to commission artworks that not only acknowledged the hospital’s ethnically diverse community but also instilled a Infused with Nigerian parables and patterns, patients delved into their narratives, expressing them through a kaleidoscope of colours, symbols, and motifs
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ACTIVITY CENTRES Sutapa Biswas in the atrium at the hospital 18 mhdf magazine sense of ownership among service users. Collaborating predominantly with ethnically diverse artists, the artworks produced were co-created with service users during these collaborative workshops. The overarching aspiration is for these efforts to catalyse a gradual shift in the entrenched hierarchies prevalent within mental health institutions, empowering those under care while fostering a more inclusive and participatory environment. SPRINGFIELD COMMUNITY This focus on representation further strengthened ties with specific services within the Springfield community. For instance, the partnership with Bluebell Ward, which caters to D/deaf individuals, relied heavily on the expertise of Rubbena Aurangzeb-Tariq, a deaf artist and therapist affiliated with Springfield University Hospital. Similarly, collaboration with Share Community, a day centre and community garden for individuals with learning disabilities, was enriched by the involvement of artist Linda Bell, supported by ActionSpace. Linda’s reputation as a notable figure in the London learning disabled community, along with her inclusive sensory art events, proved to be highly inspiring for participants. The ethos of Hospital Rooms centres on creating environments with and for the individuals who utilise them, emphasising collaboration and co-production. Insights gleaned from discussions and activities conducted in these sessions directly influenced the creation of each artwork installed within the hospital. Artists either integrated content and imagery generated from workshops into their proposals or drew inspiration from interactions with service users to shape the artwork’s final form. CHRONIC HEALTH CONDITIONS Mental health disorders are among the most prevalent and chronic health conditions in the world, yet societal acknowledgment and acceptance of these issues often lag behind. Hospital Rooms seeks to challenge this stigma through a combination of artwork, community engagement, and dialogue, aiming to redefine the landscape of mental health care. In tandem with these initiatives, consultation with a lived experience team (LET) played a pivotal role in guiding the project’s development. Formed in collaboration with Norwich University of the Arts (NUA) and Springfield University Hospital Recovery College, the LET endeavours to bolster the evidence supporting the integration of art in mental health care settings. Through innovative research methodologies such as collage, ‘photovoice,’ and ‘methods on the move’ (e.g., walking, mapping, and sketching), the LET facilitated opportunities for service users to share their experiences and perspectives on participation in the arts, as well as the transformative potential of art in in-patient and recovery spaces. “Hope For A Better Tomorrow - Lucky Charms”, a vibrant creation, blossomed from a series of workshops spearheaded by British Nigerian designer and artist, Yinka Ilori. Yinka orchestrated a chair painting session, beckoning participants to reimagine second-hand chairs using an array of vivid paints, fabrics, and ribbons. Infused with Nigerian parables and patterns, patients delved into their narratives, expressing them through a kaleidoscope of colours, symbols, and motifs. Within the workshops, discussions veered towards the theme of hope, as participants shared sentiments of optimism and confidence in a brighter future beyond the confines of the ward. The mantra, “Hope for a Better Tomorrow,” emerged as a resounding declaration of aspiration within the artwork, serving as a beacon of positivity for all who traverse this space. As we set out the transformative potential of Springfield University Hospital, it’s crucial to outline a path towards uplifting mental health design. Embracing a set of design quality benchmarks, architects can align with NHS guidance to cultivate spaces that nurture both service users and staff. Key elements such as maximising daylight, fostering inside-outside connections, prioritising quietude, and integrating outdoor spaces are foundational. Additionally, the inclusion of gardens, cosy retreats, and diverse activity areas amplifies therapeutic potential while fostering comfort and engagement. By differentiating spaces and infusing them with art, we not only elevate the environment but also convey a message of care and community support. These initiatives, epitomised by the enriching works of Hospital Rooms, stand as a testament to the profound impact thoughtful design can have in instilling hope and resilience within mental health settings
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