A window to the world of mental health

In this article we look at the impact of modern vision panels on mental health facilities, and find out why a lack of standards is frustrating manufacturers

CCTV technology is an effective means of monitoring healthcare buildings, particularly corridors, communal facilities and external areas.

However, in inpatient and consultation rooms, this ‘Big Brother’ effect can cause anxiety, threaten privacy and dignity, and alienate care users.

For this reason vision panels have become increasingly popular over the past 30 years, providing a glazed pane through which patients can see out and healthcare professionals can see in.

These panels are mainly made from striped sliding glass, which can be opened and closed with a key, offer those inside a degree of privacy while enabling staff to observe what is happening.

Within healthcare environments they are regularly found in patient bedrooms and other areas such as X-ray departments, where it is vital to know whether a room is in use and therefore safe to enter.

But an area where they have become particularly popular in recent years is in mental health environments.

Mark Nash, director of operations at Vistamatic, explains: “Mental health is a big market for vision panels and currently there are a lot of infrastructure improvements underway where they are being specified.

Vision panels are designed to enable healthcare staff to monitor patients, while offering a degree or privacy and dignity

Improved design

“These panels allow staff to observe patients without having to enter the room or disturb them. This is good from the patients view as it enhances their privacy and dignity, as well as from a safety point of view for staff.

“In mental health environments there are patients who are particularly volatile and vulnerable and if there was no vision panel a member of staff would have to open the door and enter the room to see what was going on. This could put them at risk.”

Vistamatic was the first company to design, create and patent vision panels back in the 1970s, but over the years the company has adapted the concept to reflect various settings. Based on a triple-glazed system, Vistamatic mental health panels offer a combination of high-integrity glazing while incorporating a stainless steel frame and anti-ligature operating device specifically designed for use in medium and high-secure units.

There is an expectation now that all mental health facilities will use vision panels and we regularly work with trusts to make sure they get the right product for the right purpose

Feedback from clients has also led to further improvements, with the ‘keys’ used to operate the panels now virtually silent.

Nash said: “On some mental health wards each of our panels is operated every 20 to 40 minutes. Over the years the market has been asking for quieter mechanics so that there isn’t a clunk every time a member of staff needs to check on a patient. That way the patient’s sleep is not disturbed and anxiety is kept to a minimum.”

Britplas’s SafeSee door provides an audit trail in case of incident

Other recent changes include the availability of different-size panels, which means specifiers can choose between one large panel or a number of smaller units. Longer, thinner panels, for example, are better for people in wheelchairs.

“Vision panels are cheaper and more reliable than CCTV and also much less intrusive,” said Nash.

But he revealed that a lack of official guidance or specification was a bugbear for manufacturers.

“Often we get estates and facilities managers at hospitals asking for our advice on which panels to use. We are just a glass manufacturer and because there is no specification there is some confusion within the marketplace.”

He added: “We have undertaken a series of lifecycle, destruction and fire tests under the advice and guidance of leading mental health architects and trusts in order to try and achieve some basic standards, but as yet these are not seen as mandatory standards for vision panels to meet. Often, despite being specified in design documents when projects go through value engineering and cost cutting programmes, post-tender these standards are ignored and lesser products - in terms of durability and quality - that don’t achieve these standards are purchased to save money.

A need for standards

“If we could put together set specifications then it would stop the current problem where 20 different trusts are doing 20 different things.”

Standardisation of this type would also help to bring down costs, he added.

Intastop also provides privacy vision panels. Its business development director, Phil Barsby, said: “There is an expectation now that all mental health facilities will use vision panels and we regularly work with trusts to make sure they get the right product for the right purpose.

If we could put together set specifications then it would stop the current problem where 20 different trusts are doing 20 different things

“The biggest change we have seen over the past few years has been ensuring that panels are impact resistant, mainly driven by mental health operators, and that when they are being operated they are silent. There are then a great number of variations in terms of available fixtures and fittings, particularly ironmongery, and most trusts want panels to be anti-ligature when they are being placed in psychiatric units.”

Vision panels incorporating ‘smart glass’ are a relatively new innovation. These use glass which can be switched automatically between opaque and transparent.

Barsby said: “At the moment ‘smart glass’ is still expensive, so we don’t see it used in many developments, but in 10/15 years’ time I expect it will become standard. That is definitely the direction research and development is taking.”

Britplas manufactures the SafeSee Door, which uses swipe cards to ensure operation is silent. These cards also keep an instant record of when the panel is opened, which provides auditable data in the case of an incident. This is particularly useful in mental health environments where patients may be subject to regular checks if they are deemed a suicide risk.

Neil Guest, sales manager, said: “The SafeSee Door is a programmable anti-ligature detection and an unobtrusive, instant anti-barricade system. It allows for staff to spend more time with patients as it reduces the need to complete paperwork after every observation. A note of the time and the member of staff is logged automatically as each observation takes place. In addition, the swift entry into any room facilitated by the new anti-barricade system makes the destruction of doors to gain entry a thing of the past, and it allows us to use stronger materials to construct the door from which will extend its working life.”