Sensory Integration Education

Adult mental health services are provided across a range of settings: home environments, clinics, community settings, acute mental health settings, nursing homes and residential centres. This can create challenges for SI Practitioners when working with clients in a way that meets their sensory processing needs.

Some environments have very limited opportunities to make alterations to the physical environment due to risk assessment concerns. This presents an opportunity to consider how to create sensory friendly environments for clients while working within varying levels of restriction. There are several spaces which are common to all services, which could contribute considerably to creating and promoting a sensory friendly approach within adult mental health services.

If we consider the properties of a ‘typical’ waiting room, a clients’ introduction to the clinical setting may contribute to their feelings of overwhelm, outside of their mental ill health. It awkwardly presents overwhelming volumes of certain types of sensory information (visual, auditory, olfactory), while limiting access to other forms of sensory stimulation (vestibular, proprioception).

A common concern expressed by clients within my clinical practice is the impact of visual stimulation on their level of arousal within waiting rooms of ‘clinical’ environments (clinics, acute mental health settings, nursing homes). This consists of both the busyness of the environments, as well as the colour and intensity of lighting used in these settings.

Additionally, clients who use vestibular strategies to assist with regulation will typically curb their engagement in these strategies – particularly if the waiting room is busy. Part of this is a desire to adhere to ‘social norms’, but it can also be due to the lack of opportunity presented by the setting.

While there is no ‘one size fits all’ solution, simple strategies can be very effective when welcoming clients into the entry point for services. Installing a dimmer switch, changing the colour of the lightbulb, or having different lighting options available within the waiting room are a useful way to give clients some control of their visual stimulation, which may assist with their modulation of their level of arousal prior to their appointment.

 It is worth considering the cultural environment in which we provide services. Services with a sensory-informed culture can create sensory friendly solutions to environmental challenges, with the aim of promoting client participation and engagement in their appointments.

Where it fits with the risk profile of the client group and the setting, examples of this could include:

·  Inviting clients to walk in designated areas of the building as part of a calming routine prior to their appointment

·  Providing more than one type of chair within waiting spaces – narrower chairs can provide a proprioceptive ‘squeeze’ in some instances. This can assist with regulation while waiting

·  Advising clients that once they have checked in, they are welcome to use headphones and/or sunglasses to limit the intrusion of visual and auditory information while waiting, and identifying appropriate signals to use to advise they are being called into their appointment

·  Inviting clients to influence the music or radio station being played (if applicable)

·  Advising clients they can leave the building / clinic setting, and that they will receive a phone call to return when they are due to be seen for their appointment

·  Ensuring signage is clear and easy to spot, to allow for effective wayfinding

Part of this is promoting practical strategies for being sensory friendly within our teams to begin to problem solve areas where meaningful change can be effected within a short time frame. Having flexibility where possible is important when considering the sensory needs of our clients, as they are typically representative of a range of sensory needs and preferences.

Providing a service within a sensory friendly environment is reliant on involving staff within the process, enabling them to identify areas of difficulty for clients, as well as how these can be resolved from a team perspective. By intentionally embedding the importance of being sensory friendly within the culture of the team, opportunities can be created to make small but effective changes which are designed to ensure clients can be active participants in their own care. 

Written by Leanne Duggan, Occupational Therapist and Advanced SI Practitioner. 

If you are interested learning more about the SI in the Mental Health Setting, try our course Sensory Integration for Mental Health Nurses.  The course provides a detailed introduction to sensory integration issues commonly faced in nursing practice. It also offers advice and strategies for nurses to support their patients and service users using SI approaches as part of their core nursing practice.