THERAPEUTIC DESIGN
Service-users must share their experiences
Dr Robert MacDonald, RIBA, Reader in Architecture at Liverpool John Moores University, and the 2019 winner of the DiMHN Recognition Award, discusses his own episodes of mental illness, and how these, and his work and as an architect, have convinced him that only with considerable input from the buildings’ users – the service-users and staff – can the optimal, most fit-for-purpose, mental health facilities be designed and built. He also passionately argues that we need ‘a radical alternative to the old-fashioned biological disease model of psychiatry; one that offers therapy, rather than medication’.
My experiences of bipolar affective disorder (Manic Depression) started when I was 20, soon after my final university examinations at The Liverpool School of Architecture, when I began to have anxiety attacks. I took myself to Accident & Emergency in the middle of the night with chest and body pains; I really imagined that I was having a heart attack. Later, my GP prescribed Valium and Prozac. This was the start of my mental illness, as other episodes followed. Later, at the age of 46, I experienced a suicidal traumatic episode, and was admitted to an acute ward in North Wales for three months. This was followed by outpatient care in Liverpool, where I attended numerous clinics. During this time I had another manic episode while visiting a clinic. I was section under the Mental Health Act, handcuffed, and escorted by the Police to another secure unit in Liverpool. In both episodes I experienced what I only now understand to be ‘seclusion suites’. I was medicated for my own protection, and left alone on the floor in the suite for 24 hours. I have experienced the whole gamut of prescribed drugs, but with enlightened external support I resisted the threat of ECT. I have continued in employment, while attending annual consultations with
THE NETWORK | JANUARY 2021
Top left: An interpretation of bipolar disorder showing two faces of the same head. Top right: Dr MacDonald with what he dubs ‘A selfie image of the face and brain’ (bottom left of photo), submitted to the Brain Charity Competition 2020. Left: A face looking out through an opening in a brick wall. Right: Natural elements of ‘green’, such as these flowers, are an excellent subject for therapeutic drawing/painting.
my psychiatrist. I am sometimes both euphoric and manic, and I take a special academic and practice interest in therapeutic architectural design for good mental health.
Architecture and mental illness My ‘participation observation’ research project is concerned with mental healthcare settings. When I commenced the research, Markus (1993) said: “The last
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All images in this article were created in a TAG Therapeutic Art Group in a Recovery College of a mental health facility
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