St. Catherine's Mental Health case study
St. Catherine’s Mental Health Trust, Doncaster, Yorkshire
Rotherham, Doncaster & South Humber NHS Foundation Trust (St Catherine’s) is a mental health Trust in a parkland site on the outskirts of Doncaster, offering a range of treatments for mental health problems. The facility makes good use of the outdoor areas, from the individual gardens which form part of the secure units through to the parkland which is also open to the wider community.
At St. Catherine’s, every part of the site is seen as potentially having therapeutic value – from the extensive parkland down to the smallest garden areas. The Trust has plans to link even more strongly with the surrounding landscape, to the benefit of the wider community.
In terms of works to the parkland areas, the Trust was chosen as a pilot site for the new NHS Forest initiative, and in March 2010 more than one acre of new woodland was planted with the support of the Woodland Trust, who enlisted local volunteers to help with the planting. The new planting helps screen neighbouring development and provide extra privacy for those using the grounds.
The existing ‘red path network’ which patients use to identify safe walking routes round the site has been extended as part of a scheme called Outer Space, encouraging volunteers to get even more involved with the outside space at the hospital, creating new footpaths on site. More seating and paths also encourage community use.
Gardens attached to the secure units are increasingly designed using high quality materials and a high proportion of planting to emphasise seasonal change and appeal to all the senses, and most of the patients, many detained under the Mental Health Act, are now able to have independent access to the outdoors and enjoy the fresh air and sunshine.
In terms of the future, the Trust has a long term strategy to rationalise building usage on the site. This will involve more use of the parkland and some of the key buildings for community-based activities, opening up the south west side of the site to local businesses as well as to the community it serves.
At St. Catherine’s Trust, the grounds have over recent years come to be seen as an integral part of the healthcare environment and capable of delivering significant benefits for the health of not just patients but also staff too. Significant resources in terms of both staff time, particularly with regard to the Environmental Manager, and capital funding have been (and continue to be) invested in improving the hospital grounds. Where opportunities arise to develop partnerships with other agencies such as the Woodland Trust, the Centre for Sustainable Healthcare, and even the Kings Fund (who have recently funded a new garden for the dementia unit), these have been followed up wholeheartedly.
What are the health benefits?
There is a considerable body of evidence now for the benefits to mental health arising from being outdoors in the natural environment. In her paper on Healing Gardens in Hospitals, writer and academic Clare Cooper Marcus states that nature engages attention without demanding any effort, because it has the effect of ‘awakening the senses, calming the senses, reducing stress, and assisting a person to marshal their own healing resources’.
In terms of benefits for physical health, new paths will mean a longer walking route for patients and as a result, an increase in exercise being taken. The paths will also be available for local residents to use,as well as staff on site – there are already small groups of staff who regularly complete circuits of the site at lunchtime.
There is also a growing body of evidence that trees in particular in the urban landscape have a threefold effect on people;
- Psychological - they feel better from just seeing trees.
- Physiological – trees help to clean the air that we breath so reducing many health problems associated with airborne pollution and also provide space for a ‘physical workout’.
- Social health and wellbeing – in studies the most favoured setting for social activity is an open natural environment (Barnhart, S.K., et al 1998).
A manager’s perspective
‘The work we’re doing outdoors at St. Catherine’s is helping the Trust to become better integrated with the local community. With a renewed focus on the grounds we are also creating outdoor spaces that more patients can enjoy, either with walks around the site in the fresh air and sunshine or by simply having an outdoor space with improved visual stimuli. Local residents are also slowly increasing footfall on site coming in for recreation and dog-walking too’. (Environmental Manager, St. Catherine’s).
- Think about the opportunities of the site context – such as the chance here to use a new footpath to connect the proposed housing development next to the site with a nearby local nature reserve;
- Be creative about seeking funding and take advantage of national initiatives – such as the NHS Forest, co-ordinated by the Centre for Sustainable Healthcare;
- Involvement of the local community has been slow to develop due to the stigma associated with the site, a legacy of historic attitudes to mental health, but this should in time improve, bringing two-fold major benefits - integrating the Trust within the local community, and helping reduce this stigma.
Ian Higgins, Environmental Manager, St. Catherine’s.