Handover | Issue 41 - December 2017

Earlier this year, Te Pou o te Whakaaro Nui (Te Pou) conducted a stocktake to capture a snapshot of sensory modulation work happening nationally amongst the district health boards (DHBs). Te Pou connected with people leading sensory modulation work through support from the directors of mental health nursing (DOMHNs). Sensory modulation facilitators from 19 of the 20 DHBs participated in the stocktake survey. While most of them identified as occupational therapists, nurses were also a key professional group facilitating sensory modulation. This led to a report that identifies aspects of sensory modulation that are working well and areas that need improvement within DHB mental health services. The report is now available on the Te Pou website.

Sensory modulation is an approach that is utilised by mental health and addiction services across New Zealand, in community and inpatient settings. Sensory modulation translates in Māori as whakaāio ā-rongo, meaning ‘returning to an equilibrium through the senses’. This reflects the intention of sensory modulation, which is to utilise sensory tools to support people to calm and self-regulate, increase alertness and energy, and enable participation in everyday life (Sutton & Nicholson, 2011). In addition to this, sensory modulation has strong links to trauma-informed care, and is regarded as a useful tool for reducing the use of seclusion and restraint (Te Pou o te Whakaaro Nui, 2010).

Many services offer sensory rooms and sensory modulation is integrated into aspects of group programmes, whilst other services may utilise mobile sensory carts in the absence of a sensory room. Sensory rooms are calm spaces with soft furnishings that provide the person with opportunities to sample different sensory tools such as weighted blankets, massage chairs and aromatherapy. Some services offer sensory assessment to support the person to identify sensory tools that are useful, and potential triggers in their environment that could cause distress. This can assist staff in providing care that is trauma-informed, by creating new understandings of behaviour and how to respond with sensory strategies to support the person in feeling safe.

Some services have adapted sensory modulation in New Zealand by displaying scenes from local beaches, or having courtyards that provide access to native flora and fauna as calming spaces. Others play soundtracks of birdsong and display Māori artwork.

The importance of culturally sensitive practice when utilising sensory modulation with Māori was highlighted. Some services are incorporating the use of waiata and karakia, and working in consultation with cultural advisors to ensure training provided took into consideration cultural perspectives.

Overall, the survey indicated that sensory modulation is having a positive impact on people accessing services, based on feedback from staff.

Leadership is important in supporting the implementation of sensory modulation. Many services have established visible leadership support and sensory modulation champions. However, sensory modulation is not included in all DHB strategic work plans, and funding for sensory equipment is not always prioritised.

Staff training helps ensure sensory modulation is safe and effective for everyone involved and improves staff motivation and confidence. However, the need for updated resources, dedicated time, and designated trainers is a key challenge for DHB mental health services.

The stocktake report provides recommendations to guide the future work of Te Pou and DHBs. These recommendations highlight the importance of adapting a strategic multi-level and systemic approach towards implementing sensory modulation.

For more information please contact Frances.Russell@tepou.co.nz.

References:

Sutton, D. & Nicholson, E. (2011). Sensory modulation in acute mental health wards: A qualitative study of staff and service user perspectives. Auckland, New Zealand: Te Pou o te Whakaaro Nui.

Te Pou o te Whakaaro Nui. (2010). Impact of sensory modulation in mental health acute wards on reducing the use of seclusion. Auckland: Te Pou o te Whakaaro Nui.