Melanie Jordan: A discussion regarding the Enabling Environments project ~ Follow-on from Nick’s and Jenelle’s posts

Campling et al. (2004) argue we are all constructions of our environment and of each other, developing our identities, learning patterns of communicating, and our social responses in the context of our social environment. ‘The quality of our physical environment can be health giving or health destroying’ (Howard 2004:69).

Johnson and Haigh (2011) review the Royal College of Psychiatrists’s latest initiative, the Enabling Environments (EE) project. This novel 21st century approach can be considered a development of the preceding therapeutic environment treatment methodology and the therapeutic community movement; the principles of EE represent an adaption of these values and standards in reference to contemporary society and the current nature of mental health (Johnson and Haigh, 2011). The EE system intentionally identifies features in any given setting that foster a sense of connected belonging for the involved social actors ‘and suggests a process by which these principles can then be customised for specific settings’ (Johnson and Haigh 2011:17).

Two new concepts from the EE initiative are noteworthy here: the psychologically informed environment (PIE) and the psychologically informed planned environment (PIPE). To summarise, both of these approaches strive for greater psychological awareness of a setting, humane and enlightened treatment, enhanced wellbeing for all involved, plus reflective practice and shared action learning in the staff team (Johnson and Haigh, 2011). The PIPE scheme is designed for high security or high risk settings (e.g. Her Majesty’s Prison Service).

It is argued, by Johnson and Haigh (2011), that the EE initiative signals a new approach to social psychiatry and has implications for both public mental health and social policy in the UK: ‘the enabling environment approach is as broad as it is ambitious’ (p. 22).

To relate these debates to my own area of interest (i.e. prison mental health): Johnson and Haigh (2011) detail nine core elements to the provision of EE; four of these are important in relation to the prison setting: ‘a positively enabling environment would be one in which the nature and the quality of relationships between participants or members would be recognised and highly valued … where engagement and purposeful activity is encouraged … where power or authority is clearly accountable and open to discussion … where behaviour, even when potentially disruptive, is seen as meaningful, as a communication to be understood’ (pp. 19–20, ellipses denote removed sections).

These four ideals are poignant as a) the importance of quality relationships between those with differing social roles in the prison setting is not always considered critically, b) the quantity of worthwhile activities provided for prisoners is (in some prisons) arguably diminutive, c) the power relations in a prison (e.g. between wing staff and prisoners) are not often debateable, and d) disruptive behaviour often results in sanctions in the prison environment and perhaps insufficient attention is devoted to understanding underlying causes of socially deviant actions in the setting.

The EE vocabulary of shared values is the basis for the practical application of the approach; this is problematic in the prison setting, as the underlying goals of the NHS and HMPS are somewhat dissimilar (e.g. care versus containment). Thus, to conclude, the EE initiative serves to highlight the worthy prisoner versus patient issue in prison establishments.

Click here to see Nick Manning’s post.

References:

Campling, P., Davies, S., and Farquharson, G. (2004) (Eds) From toxic institutions to therapeutic environments: residential settings in mental health services, London: Gaskell.

Johnson, R. and Haigh, R. (2011) ‘Social psychiatry and social policy for the 21st century: new concepts for new need – the Enabling Environments initiative’, Mental Health and Social Inclusion, vol. 15, no. 1, pp. 17–23.

Howard, T. (2004) ‘The physical environment and use of space’, in P. Campling, S. Davies, and G. Farquharson (2004) (Eds) From toxic institutions to therapeutic environments: residential settings in mental health services, London: Gaskell, pp. 69–78.

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