Trauma exposure is a universally recognized significant and consequential public health issue, with estimates that two-thirds of the general population have encountered at least one trauma, and that those exposed are disproportionately over-represented among recipients of health and social services.

There is compelling evidence of the negative neurological, biological, psychological and social impacts of trauma exposure, which may be exacerbated or ameliorated , by environmental conditions.

Trauma informed care is advocated as an evidenced-based best practice approach within contemporary health and social services, with evidence supporting the positive impact of such approaches on the service experience, of both recipient and provider, and on treatment outcomes.

While services have understandably embraced trauma informed approaches with many laudable examples of educational, clinical and service initiatives, the degree to which ‘environment’ has been critically appraised an either an enabler of, or impediment to, service experiences that are authentically trauma informed remains uncertain.

This paper will comprise of two components, the first of which will very briefly present an overview of the underpinning principles of trauma informed approaches., and the second being an interactive exploration of application with a purposeful emphasis on the application of principles to practice through readily achievable environmental enhancements.

Lighting plays a critical role in mental healthcare environments, influencing both wellbeing and rehabilitation outcomes. In this presentation, Lee will explore how thoughtfully designed lighting can support circadian rhythms. By linking the latest scientific research with practical design strategies, the session will provide attendees with an in-depth understanding of how light affects human biology and how we can combine this technology with compliant safety principles. Dynamic lighting systems can mimic natural light patterns, with blue-enriched light in the daytime to support wakefulness and blue-depleted light in the evening to encourage restful sleep. These non-visual effects of light, often overlooked in traditional design, can significantly enhance mood and overall wellbeing. Beyond the biological impact, lighting design in mental healthcare must balance aesthetics and safety. Environments should feel calming whilst combining ligature-resistant design principles and impact protection to reduce the risk of harm. Real-world clinical examples demonstrate that well-designed lighting can improve sleep quality, daily cognition, and even positively influence self-perception and motivation. This presentation will also address practical considerations for designers and healthcare providers. Challenges in mental healthcare environments, such as aligning safety with therapeutic goals, will be discussed. Attendees will leave with a comprehensive understanding of how lighting can be used to support mental health and rehabilitation, informed by science and real-world case studies. By aligning lighting with circadian rhythms, facilities can create safer environments.

The design of mental health environments requires careful consideration of safety, wellbeing, operational performance and regulatory compliance. Drawing on a comprehensive whitepaper combining industry surveys, in-depth interviews and over 20 years of specialist experience, this presentation explores the critical role that windows play in supporting both service user safety and therapeutic outcomes.

The research identified four key themes: safety, balancing competing requirements, testing and future developments. While safety remains the primary consideration for clinicians, estates teams and specifiers, the findings also highlight the importance of natural light, ventilation, privacy, dignity and service user control of the environment in creating therapeutic settings that promote recovery.

This presentation examines the challenges of selecting and specifying windows that meet stringent anti-ligature, anti-contraband and security requirements while delivering positive user experiences. It also explores emerging concerns around product testing, the limitations of current standards, and the industry's move towards more robust, standardised and evidence-based assessment methods.

Attendees will gain practical insights into balancing clinical, design, estates and operational priorities, enabling better-informed specification decisions that support safer, more therapeutic and future-ready mental health environments.

Mossley Hill is a new-built, 80-bed in-patient adult acute mental health hospital, located in south Liverpool. The building comprises 4 wards, a S136 suite, an assessment unit, and share therapies provision across. It replaces dated dormitory wards; 3 from an 1980s building which had timetabled garden access, and one from a Victorian Terraced House, both of which were no longer fit for purpose. Nestled in a leafy site in south Liverpool, the hospital features distinctive ward typology to respond to the clinical brief. The design was co-produced with service users and staff, while being mindful of its green, heritage site context. Pioneering measures include multiple gardens per ward to maximise the use of outside space to deliver a calming environment that can be freely accessed; an immersive suite to utilise new technologies for therapies; and technical detailing that supports the Trust’s ‘No Force First’ policy. The building is highly sustainable, with a fully electric energy supply, an extensive photovoltaic array, backed up by excellent U-values in the building fabric. The talk will cover several themes pertinent to mental healthcare design in Ireland: -The design process-how a sense of healing space was delivered and how quality detailing was achieved -How a complex sloping site was addressed in a safe manner for service users - How rising acuities during the project’s development has informed the design - Key project stats for to benchmark -How the funding journey impacted on the project - The project is the fifth latest in a series of new-build projects by Mersey Care, including Aspen Wood, and Hartley Hospital.

This project examines the local implementation of the HSE Mental Health Services: Guideline on the Implementation and Use of the National Ligature Risk Reduction Audit Tool for Approved Centres (2024) within the Department of Psychiatry, Unit 5B, University Hospital Limerick. The initiative was led through a strengthened Ligature Reduction Strategy Group, bringing together the complementary expertise of Maintenance, Health & Safety, Quality, Risk & Patient Safety, the Registered Proprietor, and the ADON/CMN3 of the service. This multidisciplinary structure ensured that environmental, clinical, organisational, and regulatory perspectives were integrated into a unified, evidence driven approach to ligature risk mitigation.
To enhance the robustness of the local assessment, a bespoke audit was commissioned from Tony Crumpton, formerly Head of Safety and Security for a large NHS Mental Health Trust and now Sales Director with the Anti Ligature Shop. His external review provided an independent, specialist evaluation of ligature risk vulnerabilities and validated the centre’s interpretation of the national audit tool.
The implementation process demonstrated the value of collective capability, where diverse professional viewpoints contributed to a balanced, proportionate, and evidence based risk reduction strategy. The project highlights how structured collaboration, supported by national guidance and enriched by specialist external input, can enhance patient safety outcomes.

Healthcare environments influence far more than clinical outcomes. Long before a person meets a healthcare professional, their nervous system has already begun responding to the environment around them. Lighting, noise, wayfinding, waiting areas, privacy and predictability can either support regulation or contribute to stress, overwhelm and disengagement. Drawing on my work as a psychologist, psychotherapist, neurodiversity consultant and founder of the social enterprise TSK Academy, alongside my lived experience as a neurodivergent person and parent of neurodivergent children, this session introduces Regulation by Design—a human-centred approach that explores how healthcare environments can actively promote psychological safety, emotional regulation and equitable access to care. Through real-world examples from healthcare, social care and family life, I will explore how seemingly small environmental decisions can have a profound impact on a person's ability to engage, communicate and feel safe. Rather than viewing the environment as simply the backdrop to care, this presentation encourages delegates to consider it as an active part of the care experience. Attendees will leave with practical, evidence-informed ideas that can be applied across healthcare settings, regardless of budget or scale, while gaining a deeper understanding of how thoughtful design can reduce unnecessary barriers and improve experiences for neurodivergent people and, ultimately, for everyone.

Home should be our safe place, but for many people with sensory differences as a result of neurodiversity, this is not the case. Environmental modification as part of Occupational Therapy intervention provides an improved fit between the person, their environment and the occupations the person wants or needs to participate in within that environment. Drawing on Ayres Sensory Integration theory®, this presentation will outline a range of sensory profiles which can significantly affect how a person experiences everyday environments including home; influencing arousal, emotional regulation, distress, and participation in everyday activities. The presentation will explore how understanding sensory profiles can directly inform environmental design resulting in person-centred changes that can improve safety, participation and agency. The presentation will examine the impact of sensory differences for one individual, showing how sensory experiences contributed to increased dysregulation and safety issues, reduced tolerance of the environment, and restricted purposeful occupational engagement with restricted autonomy. Using the Person-Environment-Occupation-Performance Model, the case study will demonstrate how environmental adaptation can be an efficient and least restrictive means of reducing the impact of sensory challenges. Rather than attempting to change the person, the intervention focused on modifying sensory demands within the environment to create conditions that supported regulation, safety and participation. Particular focus is given to co production with the recipient and the builder, as well as the innovative use of the Disabled Facilities Grant to help fund the adaptation. The presentation will highlight outcomes and will demonstrate how occupational therapy perspectives contribute to design by linking sensory understanding with practical environmental change, offering transferable learning for those seeking to create environments that are enabling.

The Regional Communications group in HSE West Northwest identified the need to develop a project group to address the mental health literacy challenges faced within the Traveller community. This project group aimed to co-produce an initiative to empower the Traveller community to improve their mental health literacy thereby strengthening their ability to navigate and engage with the Mental Health Services.
A Steering Group was set up and all relevant stakeholders including Traveller reps from each Traveller organisation were invited to ensure the Traveller voice was heard. However, no Traveller reps came forward and we had to go back to the drawing board.
The phrase "Nothing About Us Without Us"—often adapted in healthcare as "Nothing About Me Without Me"—originated as a rallying cry in the disability rights movement of the 1980s and 1990s, though its roots trace back to 16th-century Polish politics. Following further engagement with the Travellers and Traveller organisations it was agreed what was really needed was a safe space to discuss mental health challenges within the community whilst also incorporating a solution focused approach. The Connect Café model developed by Mental Health Ireland was used to meet with Travellers to discuss the strengths in their community, the challenges with regards mental health and proposed solutions for change. The sessions were facilitated by HSE staff and Peer educators from the Recovery colleges.

Healthcare staff are among the most exposed workforce groups to high-demand, sensory-intensive environments. Long working hours, open-plan workplaces, unpredictable noise, harsh lighting, and limited restorative spaces compound occupational stress. For neurodivergent staff, these conditions can be profoundly disabling. Everyday sensory inputs: sound, light, colour, and pattern can be overwhelming, leading to discomfort, anxiety, and distress. Yet the design needs of neurodivergent healthcare workers, estimated at 15-20% of staff, remain largely absent from evidence-based design frameworks, workforce wellbeing strategies, and capital project briefs. This presentation addresses the gap between neuroinclusive design intent and the lived reality of neurodivergent staff in Irish healthcare settings. It explores neurodiversity and work from the perspective of a neurodivergent healthcare professional, challenging the notion that neurodiversity is itself a disability, rather than a consequence of insufficient societal awareness and adaptation. Practical design interventions in the clinical environment are proposed to support neurodivergent professionals in flourishing, rather than struggling, at work. Drawing on emerging best practice in inclusive design and the salutogenic model, which frames health as a dynamic, positive state shaped by environmental, social, and personal resources, the presentation examines how the built environment can support or undermine staff wellbeing, cognitive performance, and retention. Key design considerations include acoustic comfort, lighting quality, sensory zoning, wayfinding, access to quiet and decompression spaces, and nature-informed design. The presentation highlights evidence-informed strategies that benefit all staff through a universal design lens, recognising that what supports neurodivergent individuals ultimately works better for everyone.