ARCHITECTURE & DESIGN
this can be very empowering, and a boost to their wellbeing and sense of autonomy. We would also suggest colour-coding doorways while paring back any staff areas through the use of plain white, thereby making them less visible, and enabling the environment to be more home-like. Meanwhile, smart use of light can
An artist’s impression of part of the school at the Pears Maudsley Centre for Children & Young People.
An airy and light open plan layout The whole design concept was informed by this, creating an open-plan layout that is airy and light, and has a range of adaptable spaces catering to both quiet and noisy environments (such as a play zone in the main atrium), interlinked with bright and easy-to-navigate hallways. Subtle touches include a reception desk designed to be low enough to stop the feeling of a physical or symbolic barrier between the staff and visitors, while upstairs, inpatient spaces have defined functions – from play and study, to treatment and family time, with sensory cues designed in to signal the purpose and moods of the spaces.
‘Green spine’ runs throughout A ‘green spine’ runs throughout, giving building users access to rooftop gardens and landscaped terraces designed for different types of users – including clinically vulnerable patients, researchers, and staff. Biophilic design and access to outdoor spaces are widely acknowledged to hold substantial benefits for mental health and wellbeing and, as outlined in HBN 03-02: Facilities for child and adolescent mental health Services (CAMHS), ‘The importance of good quality, accessible green space should not be underestimated; it improves both mental and physical health outcomes, not only for young people, but for staff as well’. The HBN also goes on to provide guidance on ways to decrease the use of seclusion by providing designated ‘de-escalation’ rooms instead that can offer a nurturing, calming, and secure environment that is not restrictive or isolating. Biophilic design is a major feature in the
Pears Maudsley Centre interiors too, with a tree motif linking its internal and external spaces (also reiterating the sheltering and protective qualities of a tree canopy), while natural wood or wood-effect materials are used for doors and floors. Seating pods are built in and incorporate bookshelves, offering an opportunity for rest, privacy, and reflection, along the circulation routes. There will also be art displays of works by artists working together with users of the healthcare facility. The majority of the
THE NETWORK | AUGUST 2023
lighting is dimmable to avoid a clinical or harsh feel, while fittings, features, and furnishings, are varied through the spaces, to avoid a feeling of monotony, and create points of interest. All in all, this is a safe, attractive, and engaging environment that encourages healing. Its design can also help to de- stigmatise the idea of accessing mental health services, which is often one of the main reasons that prevents young people from seeking help.
Taking a salutogenic approach to design A salutogenic approach is one that favours health, and is focused on factors that contribute to physical and mental wellbeing, rather than on illness, and this has grown to encompass not only treatment, but also the design of healing spaces that can lower anxiety. This concept has been successfully applied in care home environments, and there is much to learn from that way of thinking when it comes to creating ‘silently supportive’ mental healthcare facilities that provide great care for complex needs. In care homes, due to instances of dementia being highly prevalent in elderly people, there is a good level of understanding of dementia-friendly design. Dementia can cause feelings of confusion or challenges when communicating, which in turn have the potential to exacerbate mental health struggles. The goal of salutogenic design methods is to create environments that make use of sensory information in such a way as to support a person’s feeling of independence and build confidence. How can we accomplish this through design across a variety of mental health settings?
Better wayfinding One way is to improve wayfinding, by redesigning long corridors into smaller clusters with distinct identities, with the knock-on advantage of allowing better visibility for staff to ensure people’s safety – but without a feeling of intrusion for the residents. Once residents can make decisions about how to move around and use the spaces without staff intervention,
regulate the circadian rhythm – with blue light during daylight hours stimulating brain activity, and the light becoming warmer towards evening to aid feelings of calm and restful sleep. The same goes for dimmable, ambient lighting, while other considerations should include the types of blinds used in bedrooms (those that let in a lot of light can also negatively impact sleep).
Berkshire integrated health and care home Arcadis applied all the above principles to the Heathlands Integrated Health and Care Home in Berkshire, where the vision was to design an environment that could help people with dementia feel at home, comfortable, and calm. This includes en-suite bedrooms for the dignity and privacy of residents, fun social spaces, easily accessible and barrier-free gardens for all building users to enjoy, fully glazed balconies for resident gardening, indoor potting sheds, and bowling greens. Our team also designed sensory seating
and consoles to stimulate the senses by incorporating woollen balls and blankets, wooden objects, pinecones or dried flowers, music boxes, bells and fruit, as well as dried leaves in the autumn. All of this serves to evoke certain feelings or memories, sparking conversations, and engendering a sense of connection. We also mounted colour-coordinated memory boxes containing meaningful possessions outside residents’ bedrooms to provide them with personalised spaces and a feeling of ownership. Where possible, routes inside the building were designed in a way that can create sensory experiences; references to plants and animals were also incorporated. The lounges have electric fireplaces for that all-important comforting atmosphere and a natural place to gather or relax, while finishes and colours are designed to provide variety, and be uplifting, without being overwhelming to the senses. The design process for Heathlands involved significant user engagement, as well as close collaboration between local authorities and NHS Trusts, and this is something that we would like to see more of, as it is an effective way to deliver precisely the kinds of facilities that are most needed in different communities, as well as addressing some of the most pressing issues facing our health service and councils.
Healing places – the benefits of an integrated approach Following on from the above, there is also scope for collaboration when it comes to
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