All individuals have preferences for certain sensory stimuli and process their sensory environments in individualized ways. Traditionally, understanding sensory processing differences has been a diagnostic and treatment focus for conditions like autism, bipolar disorder, schizophrenia and major depressive disorder. However, understanding one’s sensory processing can be relevant for a broad range of individuals receiving services in a mental health setting.
“As clinicians working in mental health, we need to ensure that the people we’re working with are comfortable in a treatment setting,” says sensory processing and mental health expert Dr Elana Moore, an occupational therapy clinician and lecturer. “If they’re struggling with their sensory processing needs, it can make it really difficult to engage in therapy.”
A mismatch between someone’s sensory preferences and the sensory stimuli around them may impact their response to treatment. For example, harsh lighting, white walls, hard furnishings and unfamiliar noises and scents in hospitals can lead to someone feeling overwhelmed or distracted by their environment which is not conducive to promoting improved mental health.
Understanding and Assessing Sensory Processing
Sensory processing is how we register, discriminate, adapt and respond to sensory input from our bodies and the environment. In general, those with low sensory thresholds are quick to notice sensory stimuli while those with high thresholds may miss certain stimuli altogether. Additionally, some people are more inclined to actively respond to sensory stimuli, while others are more passive.
Moore, who completed her PhD exploring Service Users’ lived experiences of sensory processing, occupation and forensic mental health * with support from the faculty at the University of Plymouth, believes there is an emerging understanding of differences in sensory processing needs in mental health settings. In particular, individuals with mental health difficulties may experience challenges navigating sensory experiences in their environment.
“As the research has grown, we’ve started to realize that understanding sensory preferences is not just relevant for specific populations, but for all individuals,” Moore says. “This is not a new treatment approach but we’re starting to consider it a lot more in mental health services.”
Assessments can help clinicians understand sensory processing and its impact on behavior and, in particular, how it might affect mental health treatment. Moore suggests that one tool she finds useful is the Adolescent/Adult Sensory Profile (A/ASP) as a framework to gauge individual sensory preferences and open conversation with service users about their needs.
Studies show that the way a person processes sensory information can affect their outward behavior. When sensory inputs like strong scents, loud sounds or bright lights and rough textures are overwhelming, it can lead to poor attention and focus, impaired problem solving and decision making, trouble socializing and a host of other responses.
Among those with mental health conditions like schizophrenia, bipolar disorder, major depressive disorder, the A/ASP showed a pattern of greater sensitivity to sensory stimuli, a tendency to avoid sensory sensation and less sensation seeking. Moore notes that this type of information can be used to consider the impact of sensory stimuli in a mental health treatment plan.
“Assessments are important to start helping us to understand sensory processing and what that individual needs,” she says. “Once we start to understand [an individual’s sensory preferences] through assessment and observation, then we can start thinking about what environments are challenging and how we can make changes.”
Adjusting the Environment
A mismatch between sensory preferences and sensory environments can hinder wellbeing. In settings such as in-patient healthcare, mental health and forensic facilities, this mismatch may create challenges that exacerbate existing mental health problems. This underscores the importance of using sensory and environmental assessments in healthcare settings.
“Mental health hospitals are often built in the same way as general health hospitals with a focus on infection control,” says Moore. “The environments are often quite sterile: hard floors, bright lights, no…softness or comforting objects within the environment. So those environments that we bring people into might not be supporting them at their most unwell.”
When used skillfully, sensory strategies can have therapeutic benefits. In particular, the ability to implement environmental adaptations in inpatient settings can help those with sensory processing issues self-regulate and reduce distress and support recovery. Clinicians can also help develop strategies for self-management that could include breathing exercises, planning activities to support sensory needs, such as or wearing headphones in noisy environments to facilitate recovery and participation in everyday activities, Moore says.
Moore worked to adapt a quiet room in a psychiatric hospital by adding carpet, soft lighting, a soothing paint palette and blackout shades that could be drawn for relaxation sessions; patients had access to “comfort items” like a portable radio, blankets and an aromatherapy diffuser based on their sensory preferences, creating a more homely and perhaps nurturing environment.
The room started to get used more often and changes to the sensory environment in the quiet room were linked to improved engagement and mental health on the ward.
“We need to start thinking beyond just the safety aspects of the environment. How can it be inviting and therapeutically conducive to the person in treatment?” Moore says. “If we’re not creating the right environment for somebody in a sensory sense, and they’re struggling, then we’re missing out.”
*Moore expresses gratitude to the service users who participated in interviews sharing their experiences, without whom her research would not have been possible. As well as the support she received from the University of Plymouth.
Dr. Moore is happy to discuss her research and work with those interested in developing their thinking about sensory processing in their mental health clinical practice: [email protected]
