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Fresh Start

Cleaning as care.

MA 22/23
cleaning, care, mental health, welbeing

Fresh Start is a research and design initiative that aims to bridge the gap in holistic care between mental health and adult social care using a cleaning as care approach. After understanding the cycle in which users are trapped, we discovered that the bidirectional effect environmental care can have over mental health and vice versa can be detrimental to long term healing journeys when tackled only directly through medical services like therapy.  Through our approach of cleaning as care, we can support those who need help on their healing journeys using the vehicle of cleaning in promoting long-term well being. This non-medical, service based intervention will support people focusing on the key pillars of reeducation + messaging, action + support, and community & care.

You can find a short video that summarizes our aim here.


We have partnered with MindKind, a Walsall based organization helping residents with their mental health struggles through community action. Through their expertise we have been able to access social workers and professionals connecting with struggling users everyday, but also we have engaged directly with users in the conceptualization of our intervention.

We have collaborated with NHS Primary Care mental health professionals and independent clinical therapists to evaluate our approach and better understand users in an ethical non-judgemental way. We have also collaborated with independent cleaners to understand the potential in their role as carers.

We have partnered with London Office of Technology an Innovation (LOTI) to spread the word of our work and find local governments to work with in the future. We are in conversation with some London Boroughs to continue work in this area for their local adult social care services.

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The cycle of avoidance

From the analysis of more than 15 case studies and peoples stories we discovered that many people who end up in the situations of environmental distress or so called "self-neglect" are struggling with something we have called the cycle of avoidance. This cycle initiates when someone is in a distressed mental state and so they end up unable to complete care tasks, leading to a distressed environment, what aggravates their current mental state getting stuck in this negative cycle. 

It is important to know, that although they may know they need to clean and are motivated to do so, they just cannot for a number of reasons: the most common being executive dysfunction (a common symptom in some mental health related illnesses) or to feel a small amount of relief from the stress of not cleaning by avoiding the task they cannot complete. 


We know that there is a complex and layered stigma around mental health. Although much progress has been made in this respect, people still struggle to openly discuss their mental health issues. But, when mental health issues begin to have an impact on personal hygiene and the conditions of your surroundings such as your home, a new layer of stigma emerges. People who fall into this cycle develop feelings of deep shame and moral failing around the fact that they cannot complete house care tasks. Because we exist in a society that has placed moral judgments on the cleanliness of our spaces and created a set of standards and expectations around these “simple” routines.

Socially, we have established that there is a “right way” to do these daily care tasks, we are unable to recognize cleaning as a morally neutral set of actions. We have prioritized the standards of what is clean over the functionality of a clean space. Because of this, environmental care becomes an additional issue that we no longer are able to talk about. Patients begin to isolate themselves and hide the issue, no longer leaving their homes because they have neglected their personal hygiene or not allowing friends and family to visit our homes because of the state it is in. The fear of shame makes us remove ourselves from society and makes it that much more difficult to seek help.

How might break the cycle of avoidance using cleaning as care?


When people are able to realize that they need help and want to take their first steps in breaking the cycle, where do they often begin? Therapy. 

Therapy is the first step that people take, or the step everyone tells you to take. But, what happens when you finish your session and your environment still has all of the same triggers? When we consider mental health care, realistically there is only so much help that just a therapist can provide. There is already a heavy burden on mental health professionals and the care system that impacts the quality and duration of assistance, and so much is left for the individual to handle on their own when they are already in a distressed state.

Reductive thinking and siloed care in the mental health space has equated mental health assistance to medical care. It has left related, but non-medical issues like what we have been talking about, often negatively referred to as “self-neglect” relatively unaddressed, decreasing the overall effectiveness of care and hindering mental health healing journeys as a whole. 

fresh start: using cleaning as care

Those who are struggling should not be expected to clean in the same ways as those who are not experiencing these struggles, these people deserve further understanding and support to maintain their environments to compliment their healing journeys. 

If we view cleaning as a form of care, we can support those who need help on their healing journeys using the vehicle of cleaning in promoting long-term well being. Creating a non-medical approach that tackling environmental health directly can have an impact on mental health and holistic wellbeing.

By examining the needs and experiences of our users, we can effectively shape our initiative to facilitate a positive transformation; allowing them to change the relief of not doing a task for the relief of achieving one while being kind to themselves, understanding that care tasks are not connected to morality and what is important is what is functional to them. All of this while promoting and validating help-seeking and feeling cared for as strengths for those in need.


Special thanks to Nike and all the team at Mind Kind for all the help they have provided.

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