The phrases ‘challenging behaviour’ or ‘challenging environments’ are very familiar to anyone working in the field of mental health or learning disability care, or as suppliers of specialist products to this field. However, although at first glance it may appear that challenging behaviours are a very straightforward thing to define, in practice there is quite a lot of complexity when it comes to separating the genuinely challenging behaviours that may require professional intervention, from routine behavioural issues.
In this series of 2 blogs, we’re taking a look at the role of furniture in managing challenging behaviours. Let’s begin by defining our terms: According to the NHS Social Care and Support guide (www.nhs.uk/conditions/social-care-and-support-guide/practical-tips-if-you-care-for-someone/how-to-deal-with-challenging-behaviour-in-adults/) challenging behaviours can be broken down into 4 main types:
Now let’s take each one of these challenging behaviour types and look at ways in which furniture manufacture and design can influence the negative outcomes that may result from these behaviours.
In caring for individuals with more severe mental health conditions, consideration must always be paid to the possibility that those individuals, often under conditions of intense distress, may carry out violent or aggressive acts towards their carers or other service users. When it comes to designing furniture for mental health environments then, it is very important to consider the likelihood of parts of the furniture being ‘weaponized’ in the event that the furniture is broken or disassembled by a service user.
Obviously, the ideal situation is for the furniture not to be disassembled in the first place, so to achieve this the use of special components such as steel dowels, reinforced joints, back blocks, and strengthening bars (for more details see page 5. of our brochure Download Here) are all necessary to minimize the likelihood of disassembly.
Careful selection of materials can also play a role here – use of solid plastic or solid foam to minimize the number of ‘separable’ components is often a preferred strategy, although plastic in particular is no guarantee of security given that it can be shattered and turned into shards. In summary, it is vital to choose specialist furniture for challenging environments to ameliorate aggression, as standard furniture offerings are far too vulnerable to destruction and weaponization.
The second type of challenging behaviour that can be a feature of both mental health and learning difficulty care environments is self-harm. Self-harm as a term covers a broad range of behaviours, from the relatively mild such as hair pulling, or punching oneself through to more serious acts up to and including suicide attempts.
For this more severe end of the self-harm spectrum, the key development in challenging environments furniture over recent years has been the focus on anti-ligature features, which significantly reduce the likelihood of self-strangulation through removing as many points as possible from furniture and other fittings which could be used to tie off a ligature.
A good example of Anti-Ligature products from the Tough Furniture range is our Anti Ligature Television cabinets (ALTVs), which feature sloped profiles to increase the difficulty of tying-off, as well as inset strip hinges instead of traditional cantilever Butt hinges which also offer a reduced ligature profile.
Likewise, all of the wardrobes in our Tough Plus range feature inset doors, which reduce the ‘sticking out’ area that could be used for ligature purposes, as well as strip hinges. Furthermore, following historic reports of low-quality, standard wardrobes having their backs pushed or kicked out for use as a ligature point, all Tough Plus units are reinforced with special back blocks to mitigate or eliminate the risk of the back’s removal.
In conclusion, as with aggression the same basic principle applies to self-harm: when selecting the right furniture for mental health care homes it is vital to choose specialist products such as those in the Tough Plus range from Tough Furniture.