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YESTERDAY, DESIGN GUIDELINES for those providing accommodation for people living with persistent mental health conditions, was launched by the Housing Agency and the HSE.

The 121-page book – thought to be the first of its kind worldwide – makes recommendations for those with “severe and enduring” conditions so that they can live independently.

These aren’t necessarily complicated or costly measures – but involve everyday solutions such as including key hooks so that the person can find their keys easily, automated systems and simplifying everyday tasks.

Occupational therapist Áine O’Reilly and assistant director of nursing Emer Whelan, both of the HSE, have spent the past four years compiling the report.

They looked at the various difficulties facing people – such as cognitive difficulties and memory problems. They looked at everything from the location of the home, the structure of the building, the garden, and even the colours used in rooms.

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“Many of the problems faced by people with mental health difficulties are problems that we all dealt with, but are magnified because of other factors,” says Áine O’Reilly. “Forgetting something can be particularly distressing for people with mental health conditions because of other cognitive difficulties.”

In one case we looked at, a woman had an oven with ‘touch’ buttons – but she had a tremor. Now for anyone else, we would find a way around this, but for this woman it was distressing [and can lead to people not using their appliances].

“These guidelines are all about problem-solving,” continues Emer Whelen. “We compiled them by going from room to room, system to system and solving various problems like these.”

“The guidelines might seem like ‘common sense’, but only if you already know it,” says Emer. “As individual problems, they might seem like simplistic solutions, but as a combination they make a difference.”

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What this method of problem solving resulted in is a list of guidelines which are simple but important. Here are some of the main points:

• Maximizing daylight and reducing noise – which can exacerbate mental health issues if not designed into homes
• Including natural elements such as plants and views of the natural environment from windows – this can reduce stress and diminish cognitive fatigue
• Low maintenance accommodation and gardens – which reduces the need for additional support
• Monitored smoke, gas, heat, CO2 detector alarms (also controls with audio and touch based clues for ease of use) – for safety reasons
• Use of appliances that are undemanding and straightforward to operate, e.g. one action to turn on and off
• Ensuring homes are located in diverse, active communities close to essential amenities and support services.

Architect Isoilde Dillon, who also worked on the report, says that it stands out because it not only makes recommendations, but gives a rationale for every piece of advice.

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History of care

John O’Connor, CEO of the Housing Agency, says that the guidelines are important to fix Ireland’s track record of institutional care abuse and move ahead.

“This housing design guide is the first of its kind anywhere in the world. Drawing on best practice and the experience of mental health experts and others we hope that this guide will make it easier for those living with enduring mental health conditions to live independently in our communities.”

When asked if this logic will be applied to hospital-builds, he says that the guidelines only relate to housing, but that it does contain universal advice in terms of the benefit of natural lighting and difficulties faced by individuals.

“Up to now, housing was built quickly and effectively – these guidelines put the user at the centre of the design, and builds the house around them.”

The guidelines, described as “user-friendly” and “a menu of information” are intended from anyone who knows, works or lives with someone suffering from chronic or enduring mental health conditions; from health care professionals, to architects, to families, to the individuals themselves.

Although the guidelines don’t prevent mental health conditions from forming, the authors are quick to note that this is the first edition of its kind, and hope that others will look at various aspects of the report in more depth.

“This is the start of a conversation,” says Emer Whelan.

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