1) Following discharge from Orchard House, do you feel that patients have enough support from the Community Mental Health team, in terms of social support for reintegrating back into society?
Yes for those having been discharged, not so great for those with mild symptoms in the community, there are long waiting lists.

2) Are you aware of how the Clairvale Rehabilitation Unit was run prior to its closure? If so, please state whether you feel this was successful and why. If not, what could have been improved.
Vaguely. I think it housed about 8 patients? A friend of mine used to work there, they were always very busy and often could not accommodate referrals. They housed people for various times depending on needs. It needed to be larger.

3) Do you feel that Jersey has suffered since the closure of Clairvale?
Slightly – due to being so small, it hasn’t made a huge difference, but now having no facility at all is quite significant.

4) Do you feel that Jersey needs to invest more money into Mental Health Care?
Yes definitely.

5) Do you feel that a rehabilitative centre, where people with mental health issues could access medical advice, meet people in similar circumstances, improve skills and gain confidence would be beneficial in assisting patients reintegrate back into society?
Yes.

6) What do you think should be included in a rehabilitative centre of this nature?
Group sessions, courses to help people learn skills.

7) Do you feel like a rehabilitative centre could potentially reduce readmissions; if people had a well-being centre to visit, instead of having a nurse visit their homes?
Potentially for people with mild mental health disorders whose main struggle is regaining confidence and not isolating themselves from the community.
 

8) Do you feel that architecture plays an important role in recovery? For example the use of natural light, the integration of nature, panoramic views and sound absorption?
Yes the architecture at Orchard House is horrible and does not assist in the recovery process at all. I believe plenty of natural light is essential.

1) Do you feel that architecture plays an important role in recovery? For example the use of natural light, the integration of nature, panoramic views and sound absorption? 

Yes, the environment makes a big difference. If there is a garden and benches, people will socialise there. If the acoustics are bad inside, people won't be able to communicate and may become agitated. Colours, light and space are all important

2) Are you able to give some examples of how the architectural design does and does not work well in your hospital?

It's a secure unit, so you are able to see most of what goes on due to the open plan design. However, the seclusion is on the bottom floor, meaning you need to restrain people down the stairs on occasions. The acoustics are terrible and often you can't hear people. The clinic is too small on one of the wards, meaning it's hard to move, and they also have 2 flights of stairs so when there are increased observations, you have to keep walking up and down the stairs every 15 minutes!

3) Following discharge from the psychiatric hospital where you work, do you feel that patients have enough support from the Community Mental Health team, in terms of social support for reintegrating back into society?

Yes, they have a Community Mental Health Team and they are eligible for social funding due to being discharged from the Mental Health Act. They may not, however, have all those social networks in place, especially if they've been in hospital a long time. 

4) Are you aware of any rehabilitative community centres in Nottingham which you feel are successful in steadily reintegrating people back in to society?

I don't know of any specifically no, but I worked briefly at Macmillan Close, which was a nurse led rehab uni, which is now closed down. 

5) Do you feel that the NHS needs to invest more money into Mental Health Care? 

Yes, lots of it.

6) Do you feel that a rehabilitative centre, where people with mental health issues could access medical advice, meet people in similar circumstances, improve skills and gain confidence would be beneficial in assisting patients reintegrate back into society?

Yes absolutely, because they would feel supported with a sense of belonging.

7) What do you think should be included in a rehabilitative centre?

A big range of activities, both on and off the unit. Day trips. Support from external support services.

8) Do you feel like a rehabilitative centre could potentially reduce readmissions, if people had a place to go instead of simply having a nurse visit their homes?

Yes potentially, as long as people want to, and whether it is accessible to them. 

1) Do you think that architecture plays an important part in the recovery of your patients?
Yes, the refurbishment 7 years ago has made a huge difference. The spaces are a lot more open and bright allowing for larger classes. The old building was very dark and had small rooms, which didn’t instigate creativity.
 

2) If you were to redesign this site, what would you do?
- A larger lounge/ communal kitchen space.
- Larger garden space
- Better insulation, it gets very cold. Due to the expense of heating we do find that these spaces are often cold and at times we have split sessions into the smaller workshop spaces​

- Different lighting system, the automatic lights we have are not very sensitive
- Different furniture: high raised stools would make this space a lot more comfortable for users

3) Is the location of the site okay?
Yes we’re in a good central location, with a bus stop right outside our front door. The train station is also a 5 minute walk away. The busy road is sometimes a problem in the summer when the windows are open and people are out in the garden, but we do try to plant as many trees around the circumference of the garden to try and tackle this.

1) Have you identified a problem with offenders with mental health problems struggling to fit into society, or is this not a problem?
Yes there is evidently a problem as they continue to repeatedly commit crimes.

2) Do you feel that people with mental health problems have enough support in the community?
No, because we see people suffering with mental health problems coming to court. Some commit crimes to be put in Prison so that they have a bed to go to.

3) Do you feel that Jersey has suffered since the closure of Clairvale?
Yes, Clairvale did a great job.

4) Do you think that the homeless shelters (where people often end up) provide adequate support?
I don’t have much knowledge of the homeless shelter, however I do know that many people are reluctant to go there.

5) Do you feel that Jersey needs to invest more money into Mental Health Care?
Yes, it needs to be taken more seriously.

6) Do you feel that a rehabilitative centre, where people with mental health issues could access medical advice, meet people in similar circumstances, improve skills and gain confidence would be beneficial in assisting patients reintegrate back into society?
Yes, a caring specialist environment where they can have the support they need to hopefully equip them for independent living at a later stage would be great.

7) What do you think should be included in a rehabilitative centre?

An ideal rehabilitative environment should in my opinion be in the country or on the out skirts of town. It should have facilities such as a well equipped kitchen in which people could learn to cook, a laundry room , a gym, a computer room. a games room, lounge for relaxing and one for receiving visitors with for example children's toys. Bedrooms should be modern and spacious. Ideally there should be a garden and vegetable area in which the clients could relax and cultivate crops.

8) Do you feel like a rehabilitative centre could potentially reduce readmissions to Orchard House?
Yes if problems were tackled at an earlier stage.
 

9) Do you feel that architecture plays an important role in recovery?
I consider that architecture does play an important part in rehabilitation as the environment on lives in affects one mood.

Dean Balbes, 56
General Practitioner 
18 December 2015

1) Do you feel that following discharge patients have enough support?
No there is a serious lack of funding.

2) Are you aware of how the Clairvale Rehabilitative Centre was run prior to its closure? If so, please state whether you feel this was successful and why. If not, what could be improved.
No, it closed before I started working in Jersey.

3) Do you feel that Jersey needs to invest more money into Mental Health Care?
Yes.

4) Are you able to give a rough estimate of the proportion of people you see for mental health related problems?
I would say that 20 - 30 % of my consultations are related to mental health. Mainly stress and depression. Mainly age group - 35 - 45.

5) Do you feel that a rehabilitative centre, where people with mental health issues could access medical advice, meet people in similar circumstances, improve skills and gain confidence would be beneficial in assisting patients reintegrate back into society?
Yes that would be a great way of making people feel part of a community.

6) What do you think should be included in a rehabilitative centre?
CPN/Psychiatrists/Psychologists/HCA Mental Health/Family Nursing/? GP's.

7) Do you feel like a rehabilitative centre could potentially reduce admissions, if people had a place to go instead of simply having a nurse visit their homes?
Yes it could help minimise isolation.
 

8) Do you feel that architecture plays an important role in recovery?
Yes a well designed space can help people relax.

1) Do you feel there is enough support in the community for those suffering with mental health problems?
The NHS do a great job considering the resources, in an ideal world there would be a lot more contact.

2) Do you feel that following discharge patients have enough support?
There is enough support in terms of emergency contact, if they were to relapse. However, for minor issues such as self-esteem and confidence and gradually recovery back into old life support is lacking.

3) Are you aware of any rehabilitative centres which you feel are successful in steadily reintegrating people back in to society? If so, please state their names and why you feel they are successful.
It's not an area I'm sufficiently up to date with. But I'm not aware of any.

4) Do you feel that the NHS needs to invest more money into Mental Health Care?
Yes

5) Do you feel that a rehabilitative centre, where people with mental health issues could access medical advice, meet people in similar circumstances, improve skills and gain confidence would be beneficial in assisting patients reintegrate back into society?
Yes a rehab centre of this nature would be great. Residential sections could also work well for those requiring more support.

6) What do you think should be included in a rehabilitative centre?
A range of psychological therapies. On-going group support. Day centre activities so people can drop in for social aspect, as well as therapeutic input.

7) Do you feel like a rehabilitative centre could potentially reduce readmissions, if people had a place to go instead of simply having a nurse visit their homes?
Yes if people didn’t feel so isolated when they were deteriorating perhaps therapy in these environments could assist in intervention.
 

8) Do you feel that architecture plays an important role in recovery?
Yes I do. But I would regard it as significant rather than central.