mental wellbeing clinic design - the soke, london
The ‘Green & Healthy Places’ podcast series explores the role of sustainability, wellbeing and community in office real estate, residential property, hotels and healthcare facilities today.
Episode 27 is with Dr Chi-Chi Obuaya of The Soke in London, UK a private mental health clinic that has re-defined the mental wellbeing clinic for an upmarket clientele, setting a new benchmark in the process.
We discuss the cultural differences between UK and US in openness around mental wellbeing, the impact of Covid on our relationships at home and in the office, mental health champions in the workplace, why having an off-site venue for discussions around mental health is preferable to an in-office solution, designing an interior for mental wellbeing, the parallel with boutique gyms and private clinics in terms of aspirational positioning and how working on your inner game can make you a more effective manager through empathy.
An indoor environment shouldn't reinforce the fact that you feel unwell, that you're a “patient”. We wanted to create a space that really made people feel nourished, and the design features I think tick the boxes in that respect, but also to be aspirational.
Dr Chi-Chi Obuaya
GUEST / DR. CHI-CHI OBUAYA OF THE SOKE, LONDON, UK
HOST / MATT MORLEY
FULL TRANSCRIPT FOLLOWS COURTESY OF OTTER.AI - excuse typos!
Matt Morley
Chi-Chi, welcome to the show. I'd really like to dig into your role as Head of the Clinical Board for The Soke so could you talk to us about what that has involved for you so far and how you see it evolving over time?
Dr Chi-Chi-Obuaya
Really excited to be here, Matt, good to see you again, as well after all these years. I'm a Consultant Psychiatrist here, I trained as a medical doctor specialized in psychiatry, and I focus on adult psychiatry so I see anyone aged 18 and above, with a range of mental health difficulties, including depression, anxiety, problems related to birth, trauma related issues, addictions.
I'm the Clinical Lead at The Soke - a behavioral health center in the heart of London, we're coming up to our one year anniversary. And the whole premise of setting up The Soke was really that within the UK, there are plenty of mental health professionals that people can see. But we found that there's still massive stigma around mental health and accessing care. And we just wanted to ease that process for people by having a really high quality service that has a beautiful environment, encourages people to come forward and supporting that by offering them very good quality care in an environment that is conducive to promoting good mental wellbeing.
Matt Morley
I think that really comes across in terms of the space that you've created, and clearly that's one of the key attributes in the experience on offer. But in terms of the mix of resources on the team, and the range of services that you offer, presumably you each have specialisms, but there seems to be this interesting client service director role that is atypical, or less common let’s say. How is your mental wellbeing team structured?
Dr Chi-Chi-Obuaya
Yes, so our clinical model is a multidisciplinary one, I think we recognize that in private practice, you can certainly access a whole range of mental wellbeing therapists, psychologists, psychiatrists, and it can be quite difficult for people to navigate through the system, and to really understand who they need to see and what skill set that person needs to have.
So most of us have a pretty broad range of people we would see with a vast range of conditions. But within that, there are areas of interest. So for me, I still work within the National Health System. And I see people with ADHD, attention deficit hyperactivity disorder. We have therapists who have a particular interest in supporting people who have, for example, body image issues, who might have disordered eating, but maybe aren't quite meeting the threshold for eating disorder diagnosis.
I'd say generally, one of the themes is that we're trying to be quite proactive and preventative. So a lot of healthcare services are set up to treat illness, and that lends itself to seeing people when they're already really unwell. And there's certainly a role for that. But we're trying not to offer that acute care rather to catch people before they fall into major difficulties.
We have a broad range of child, adolescent and Family Services. So we're working with couples, parents, right across the age span. So really from from birth right through to old age. The multidisciplinary model is key in that we meet on a daily basis as a team, discuss potential referrals, discuss clients who might be seeing a range of us within the team. And it's then bringing our different bits of expertise together to think about how we can holistically support people from a mental wellbeing perspective.
As I said, we're just coming up to our one year anniversary. So there's still plenty of room for growth, and we want to be able to offer a wider range of services, such as nutritional advice. There are a vast array of therapies. So we're really at the starting point, and we want to add to the clinical team there.
Our client services manager is really the go-to person to help people navigate through the team, because it can be quite daunting and the reality is that when people are seeing therapists, they sometimes don't know how to benchmark that, or to get a sense of what progress they're making.
We're data driven, we have outcome measures and we try to be very goal oriented. The Client Services Manager is the person that can think about some of the services we maybe don't provide, but can signpost people externally for that, and where there are challenges where people do feel stuck therapeutically, which happens, it's not a sign of the therapy being of a poor standard, it just happens that sometimes you don't have the right fit with an individual therapist. We're really trying to think holistically, systemically, I think the multidisciplinary aspect is something that has often been missing within private healthcare.
Matt Morley
That really resonates with me having been through a period of about six months of therapy myself and feeling that it was very much as if we were operating in a complete bubble, there was no third party around to bounce ideas off or to sense-check how it was all going. What you've just described having another person, not in the room exactly but right outside would have been so helpful.
Having a beautiful space in which to physically connect with someone in person rather than online would have been good too!
To pick up on something you've alluded to that earlier, the idea that it's prevention rather than cure. And I wondered how you feel as a Londoner, if there is a change, that's already happened, or it's happening around acceptability of discussions around mental health, the idea of not waiting too long before you pick up the phone or walk through your front doors, for example, when you feel that something's reached a point where it's arguably not too late, it's already become critical.
In the US we'd we'd imagine in places like New York, it's far more common that one should engage with these things, almost on a regular basis, not just for six months, but perhaps semi permanently, how do you see culturally where London's at in terms of this dialogue now with around mental health?
UK-US cultural differences in talking about mental wellbeing
Dr Chi-Chi-Obuaya
Yes, great question, we're on the journey, we're certainly not at the level of the US, in terms of it just being really ingrained in the culture and something that wouldn't make you bat an eyelid. If you and I were having a conversation and you said, I've just come from my therapy session, that would just be a perfectly normal thing.
The UK is still quite conservative, and we might feel a bit awkward. If somebody said that in the middle of a conversation, we are getting there, there have been massive public mental health campaigns, trying to de-stigmatize mental health, both within society and I think particularly within the workplace.
the impact of Covid on mental wellbeing
I would say that the the covid 19 pandemic has forced people to have these conversations because guess what, it's affected people in every way you can imagine. And I think it's made the language of mental health difficulties much more accessible to people, because they can understand when you start talking about grief, for example, which in British culture, we're not great at doing. People can understand it, because it's actually affecting people directly, or people that they know, given what's happening.
Work has been disrupted for a lot of people. People have lost jobs. They've been put on furlough schemes. They felt that their jobs are under threat. They've been working from home and that's equalled stress. They've been trying to homeschool children too, that's very difficult. So I think the conditions are ripe for that conversation to move forward. It is moving forward. I'd still say it's a little bit too much towards the the reactive end. I when people are experiencing difficulties, that's when they're accessing help. And our vision is that we'd like to support people who kind of think you know what, I don't see anything wrong with just having some exploratory therapy just to take stock of things. Even if there isn't Externally what we might regard as a major issue. And I think that's where people are in the state. So I think we'll get there. But it's going to be a process.
Matt Morley
You mentioned the the impact of what's happened over the last year and a half on mental health in the workplace, and the impact on corporates, large businesses, and how there is clearly a need for there to be a wider conversation in the office.
How do you as a company or yourself personally engage with the business end of mental health, because it does feel like that suddenly become such a critical piece now within our overall wellbeing strategy in the workplace. What does that look like for The Soke?
Workplace wellbeing and mental health
Dr Chi-Chi-Obuaya
There's no one size fits all solution. I think that's the key thing to understand. And you use the word ‘conversation’’, I think the key aspect is to be a part of that conversation, and see where it goes. The reason I say that is that different sectors, different businesses within those sectors are at very different points in terms of their recognition of the scale of the problem when it comes to mental health challenges, and also what they really want to do about those problems.
To give an example, at the end of the scale is just dipping one's toe into the water. There are lots of mental health campaigns now across the calendar, we have mental health awareness week, which is often a focus for businesses. And those businesses may get in external speakers. And we've been part of those conversations. I think with any of these initiatives across a range of issues around social injustice and lots of challenges around the workplace, that really is the start. However it isn't enough on its own. All that really does is it raises awareness. And it gets people thinking and ultimately businesses need to decide what's best for them, we try to support that process.
At the other end of the scale, we've had really good engagement with companies that massively want to change their culture. And that could look like having mental health, first aid training, having champions across the organization, having a culture of supervision, which creates opportunities for conversations amongst peers and one's colleagues, through which discussions around mental health again, can just naturally flow. So those are some of the workshops that we offer to corporates. And it really just depends on on how much time, effort and resources they want to invest in.
One of the really interesting things has been to observe from the outside what different corporates do. I'd say that things have moved in a healthy direction over the last 5 to 10 years. A lot of corporates felt that the right solution was to bring a lot of these services in house, that might include offering GP services or psychological therapy services in the house. We have a fantastic space here. And what we find is that there can be reticence from employees about accessing services in house among senior leaders, they see it as too much of a reputational risk.
Amongst more junior colleagues, there's often a culture of competitiveness, and they find that they're worried about their job security if they're accessing the mental health suite, on on floor x within the building. So often, these initiatives are well meaning but they don't really quite cut it in terms of people really accessing them. Often people will even in very well resourced organizations seek external help, because they're more comfortable with that. So we want to get to the stage where Businesses really understand that and they're able to engage with us in that fashion, because often the employees want to do that way. It might be convenient for them to access us in this increasingly fluid working environment that people have at a time that suits them in an environment where they're more relaxed, and we've put in some features to really to bolster the client's experience, and that's probably going to work better for them, we feel.
Mental health officers in an ESG strategy
Matt Morley
You mentioned the mental health officer role. And it's come up on my radar, having done some work with a real estate developer in London, on their ESG strategy. - environmental, social and governance. Mental health is now part of that remit. So if you have a pension fund putting money into a project and a real estate developer the annual report on their ESG depends partly on their approach to mental health in the workplace.
I just thought that was an interesting combination, because the role of the mental health officer is purely to identify a problem and then get that person to pick up the phone, send an email, or make contact with a professional, passing on the issue to the experts in other words. Nothing more nothing less.
I remember thinking that makes total sense, not trying to resolve something themselves, but having the right person on the end of the line and just joining the dots so that that person feels comfortable in taking action.
Interior design for mental wellbeing
That leads us then into the idea of having a physical space that is not the office, but you might get there having been recommended via your corporate, your employer, you then rock up to the soak. And from what I've seen online, your private clinic’s interior space just does not look like anything I've seen in terms of mental health clinics, I think on some level rewriting the rulebook of what it should feel like and look like when you when you go for one of these sessions.
For those who haven't seen the website, can you describe the type of environment that you have there? I mean, there seems to be sort of Scandinavian influences, vintage furniture, it's like a it's like an interior design showroom. As much as anything, it looks beautiful!
Dr Chi-Chi-Obuaya
Absolutely, I think you're spot on. And that is all by design. I certainly wish to take absolutely no credit for it. My role is to focus on the clinical work. But our founder, Maryam Meddin, had a vision. We've talked about the fact that we want people to be able to access care in a way that really feels normal. But the problem she identified was that the environment, and we've got some of the best clinicians in the world in London, I think, New York's up there, but London is about as good a place to practice psychiatry, psychology anywhere in the world.
The indoor environment shouldn't reinforce the fact that you feel unwell, that you're a “patient”. As you said, when you go around a lot of hospitals, which have fantastic clinicians, practitioners offering really high quality level of care, the environment just lags behind. We wanted to create a space that really made people feel nourished. And the design features I think, tick the boxes in that respect, but also to be aspirational.
Aspirational boutique gym designs compared with most private mental health clinics
Lots of people go to gyms now, we don't think anything of it, it's a pretty regular thing to do. And you just go maybe in your lunch break, and you go back to work, and it's not a big deal.
Boutique gyms have become a bigger part of our lives. When they first launched, there was something very aspirational about them. And so the aesthetics support about view that you went to a gym and you just had that wow factor. And that's exactly what we're trying to do here. So you come into reception, it doesn't feel clinical, the sofas are really comfortable. You feel relaxed, it's a bit like being in someone's living room, and a nice one at that.
One of the things about seeing a mental health practitioner in London is that people tend to be very busy. So you leave a session and then you're back out onto the main road and you get on with your day. But actually, we wanted to make people feel that they weren't being kicked out of the building, that they had that time to reflect, and just to not feel rushed, particularly when they're talking about some quite challenging issues.
So one of the key design features would be our pods - spaces next to the therapy rooms, where you can just sit back very comfortably, read a book, have some time in a darkened room to reflect on your session, we have some evidence base technology that supports people, one of these is alpha stem, a device that delivers a microcurrent to your ear lobes. It's a small device, you put it on for anywhere between 20 and 60 minutes. And it has evidence for supporting people in improving their sleep, and also in reducing anxiety levels. And it's going to be approved by nice the National Institute for care and excellence in the treatment of generalized anxiety disorder.
We see a lot of young people, and they have parents. And so we're able to give something to the parents when they're hanging around, So that's thinking about the family as a system. And we don't just talk the talk, we're able to do that by by linking the building to the therapy directly.
Matt Morley
That reminds me of some work I did in the past around with a hospitality client, we were looking at the guest journey and identified this pain point when you're checking out of a hotel or resort and you know the holidays over and guess what you get slapped with a huge bill and then you're sort of just spat out onto the street again. So how could we rewrite the script on that to turn it into a moment of delight?
After a therapy session you may well be feeling a little vulnerable. You might not want to go straight out into the into the hustle and bustle of London street again. So creating that third space between the outside world and the therapy room and allowing someone just to chill is very innovative, I think.
Create a wellbeing interior design that appeals to men as well as women
Dr Chi-Chi-Obuaya
If we go back to your example. It's about recognizing who the client is. And we've done some work around that as well. So yes, the environment, broadly speaking, allows people to have a really great experience. But we also need to understand who our customers are. And so we wanted an environment that had these soft features. But to say very bluntly, one that isn't feminine, per se, because we have a lot of male clients, we know that men are not great at talking, generally speaking, there's been a lot of work in the public domain around getting men to talk about their mental health difficulties.
So they're a big target group in terms of this whole de-stigmatization process. Being in central London, we know that a lot of our our male clients are going to come from a corporate background. So we wanted to make sure the optics weren't suggesting that we're some sort of hippy or New Age service. So we wanted soft, but also very professional. And I think we strike the balance just right.
Matt Morley
So if we then follow that thread a little further, what would you say are typically the red flags that take place before someone .looks for help, for example, someone in a corporate environment? What should we be looking out for in terms of cues?
Dr Chi-Chi-Obuaya
I think it's important to recognize that there are a broad range of mental health conditions and one of the traps we sometimes fall into as psychiatrists when we're asked this question, we think about the more severe end.
So I do see people with really severe depression. People who've experienced significant trauma, even people who might have a psychotic illness. And we tend to go for that, but there's so much in the middle that we miss. And I think your question speaks to the person that that might be undergoing significant stress over a period of time. It might be work related, it may have nothing to do with work. And it could be very much to do with their personal circumstances. And so it's a lot more ill defined. And we know that stress affects people in many different ways. But in keeping with the idea that we want to get people, maybe before they present with a severe depression, I think it's understanding some of those themes around stress and how it manifests for people.
So the sorts of concept I'd want to get across would be pretty high level. And we might talk about people who are thriving. And it's just as it sounds, it's when you've got that spring in your step, you're very outward focused, you feel energetic, you're paying pretty good attention, broadly speaking, to exercise, your your nutrition, you're engaged with friends, family colleagues, and you've got a I don't like to talk so much about work life balance, there are people who have very busy jobs and work long hours, but you're paying attention to the things that give them a sense of energy and enjoyment.
I think particularly in the current context, burnout is one of the key aspects people need to be looking out for. And that builds up over a period of time, where there's that loss of attention to the things that give one a sense of rejuvenation, and replenishment.
At the other end of the spectrum, we might think about the concept of languishing. And it's just as it sounds, you know, the energy levels are down, you start to become a bit withdrawn from colleagues, you're just not quite on top of things at work. And one experiences significant stress. And one of the things we're mindful of is that people can experience this cliff edge experience where they're functioning outwardly, for a period of time, but where stress is building up, it can hit you very quickly. And the cliff edge term comes from the fact that you can very quickly go from outwardly functioning to really not functioning very well at all. And that can have significant implications within the workplace. But of course beyond that, as well.
Matt Morley
Is it rather like an athlete having a strength and conditioning coach, they might have another one who's their mental coach? If we assume that a high performing executive or indeed any professional who's trying to be at the top of their game, do you think there's a case to argue for their having someone on their mental health team, such as a life coach?
a word on executive performance
Dr Chi-Chi-Obuaya
Certainly it’s best not to wait until something goes wrong. I’m biased so you may guess that my answer is going to be yes, it will be a great idea. I think it's really important to be very clear about what the role of that individual or team would actually be. There are psychologists who work in corporate organizations, and may be termed ‘performance coaches’ or ‘psychologists’.
We've been quite clear about what our perceived role is, and that's why I said there are different conversations with different corporate clients. What we don't see our role in doing is saying we're going to come in, and by engaging with our intervention, you impact the bottom line. If that happens as a result of optimizing employees wellbeing, reducing sickness rates, people being happy at work and so on , then yes of course, we want that. But that's not a direct goal.
I think if I use the analogy of a sports person, and there have been a lot of sports people coming forward, people who've played at elite level, who talk about the fact that everything was geared towards winning and performance, and it wasn't actually looking at them as individuals. And there could be a lot of resentment that sets in for people who outwardly appear to have these amazing lives living the dream. And it's far from that. And I think that's relevant to the workplace as well.
We're not here to just help the organization, we actually want to focus on the individual. In the same way, with an elite athlete, you want to look at them holistically, and say, how do we support this person not to run faster, or to put in more minutes in whatever team sport they're in. But to really focus on their wellbeing, that will, of course, have the direct knock on effect, that they will be able to focus on the challenge that they have, be it in the sporting arena or in the workplace. So yes, we want to engage in those conversations. But we want to do it with real clarity about what we're actually trying to achieve. And I think businesses need to wake up to that aspect. It may sound counterintuitive but actually, this is the way forward.
mindfulness, empathy and the inner game
Matt Morley
Certainly from my personal experience in doing this work, it became very much complimentary to my mindfulness meditation, which by itself was getting me somewhere, but I felt perhaps not to where I wanted to be. Combining the two was a magic formula for my mental game.
I think the point I'd ask people to consider is that by loving ourselves, we're able to give more love back out to the world. And if you're managing people in an organization, if you're managing a team of 10-20, however many people, empathy is critical.
So much of that can come from being able to love and respect yourself first. And knowing what your own triggers are and why you react in a certain way, or why you struggle to get into someone's head, the way a particular person rubs you up the wrong way, that's a real problem, because they're on your team yet somehow you still have to handle them every day and get the best out of them and nurture them.
It's not about friendship, it's a professional relationship. But still, I think, this type of work that we do on ourselves, has so much benefit, not just for us, the individual. but for those around us. I think for me, that was almost this unexpected benefit, a knock on effect that I felt able to connect more easily and in a more honest way with those around me, and particularly people I was managing at that time.
Dr Chi-Chi-Obuaya
That's the point I was alluding to, when I said at the starting level, it's get a speaker in to give a half hour talk for Mental Health Awareness Week, what you described, actually enables cultural change, but it requires a conversation. We don't just have an off the shelf package for organizations. But what you have articulated there is where we want to get to with organisations, but we fully understand that it requires leadership, it requires a bit of knowledge about the mental health landscape, what different providers can offer.
Where you want to get to as an organization that absolutely is on the money in terms of where we want to go. And in our workshops. That is what we try to do we go through that journey with people in understanding a bit about their own mental well being. And the key word is empathy, and just being able to understand what's going on for other people. But yes, the journey starts from within, absolutely spot on.
Matt Morley
Thank you so much for your time. It's been great Chi-Chi!