Andrew Arnold, an award-winning architect, and director at Gilling Dod Architects, explains how – as he puts it – designing ‘productive and appropriate environments’ for service-users with learning disabilities and/or Autism ASD, ‘requires a bit of a reset in terms of design approach’. He illustrates some of the key features and elements he believes are key when designing such spaces optimally with a look at the practice’s recent design of two modern inpatient LD facilities, one complete and the other under construction.
The design, delivery, and procurement of new settings for mental health and wellbeing finds itself at a crossroads. Although huge inroads have been made, the full ambition of the Department of Health & Social Care's Dormitory Eradication scheme is still to be realised, and against a backdrop of scarce central capital, staffing shortages, and crippling backlog maintenance, a new approach to delivering these spaces is starting to emerge. There is undoubtedly a need to bring the national mental health estate up to 21st century standards, but there is also a realisation that pure capacity alone will not deliver the positive clinical outcomes required, especially in a sustainable and person-centred way. As such a more holistic approach is taking shape, with smaller, more focused and neurodiverse- aware inpatient units being designed with a clear emphasis on pathway-specific drivers.
One such example is in Learning Disabilities and Autism-friendly environments. Long the poor relation in terms of investment and focus, these services are now taking on increased prominence and rigour on the NHS national estate as Trusts and other healthcare providers look to update and innovate their settings to better meet this evolved service. As designers this presents intriguing challenges, but the outcomes are not only moving the dial on LD friendly environments, but also prompting a re-think on the wider design approach around settings for mental health and wellbeing.
A learning disability is a disability that affects the acquisition of knowledge and skills, in particular a neurodevelopmental condition affecting intellectual processes, educational attainment, and the acquisition of skills needed for independent living and social functioning. Put more simply, a learning disability is to do with the way someone's brain works. It makes it harder for someone to learn, understand, or do things, is a reduced intellectual ability, and a difficulty with everyday activities — for example household tasks, socialising, or managing money — which affects someone for their whole life. As such, environments to support and provide mental health and wellbeing for people with learning disabilities need to respond directly to individual need, and particular sensory stimuli, with a design approach and characteristics beyond the norm of general mental health inpatient settings.
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