ARCHITECTURE & DESIGN
Springfield garden and bedroom windows.
against the hard metrics of capacity and cost? Can we continue along the same path when the post-COVID demand for services has risen dramatically, set against a backdrop of increasing staff shortages? Lastly, how do we expect to improve outcomes when the mental healthcare sector employs the same thinking again and again? Because cost pressure will always be
there, the state of mental health provision is caught in a vicious cycle. Robust mental health design/products/construction are a niche market, which considerably reduces competition and drives up costs. As a result, budgets are forever under pressure. To deliver this mental health specification means eliminating ‘nice to haves’ such as gardens, art therapy rooms, beverage bays, exercise rooms, games alcoves, or even small things like bookshelves, ping- pong tables, or window seats, that signal that positive opportunities are present throughout the day. A lack of beneficial and meaningful things to do very possibly results in more incidents and heightened risk. Unsafe, custodial environments lead, in turn, to demands for more staff, higher operating costs, higher capital costs, and so on – as the cycle repeats itself.
An alternative approach – designing around risk There is an alternative way forward that merits discussion and testing. In fact, the first steps along this approach have been taken in the design of the new Springfield University Hospital buildings, Trinity and Shaftesbury, that have recently been delivered for the South West London & St George’s Mental Health NHS Trust. I should
THE NETWORK | NOVEMBER 2023
A Springfield patient bedroom.
start by making clear that the following considerations are offered by the author, who is a designer. I make no pretence of having the insights or training of a mental health clinician, but for the past 12 years, as the Project leader for CF Møller Architects, I have had the benefit of speaking to patients and clinicians in over 650 direct engagement sessions. To go a step further and get a picture of what happens on a ward, I headed a research project that obtained and studied anonymised
incident data of over 20,000 incidents that occurred on inpatient wards from 2007 to 2011. The data included the time, location, and type of incident. When this incident data was plotted on the existing layouts of wards, several conclusions could be drawn between architectural form and the frequency or severity of incidents. This research sought an understanding of what types of layouts could be considered safer than others. A picture emerged, with some
Mental health
specification drives up costs.
Budget pressure leads to elimination of patient and staff amenities.
Is there a way out of this cycle?
Increase of incidents and negative behaviours leading to increased staffing and operational costs.
Minimally compliant but sterile and custodial environments.
The onerous cycle of mental health specification leading to the loss of theraputic benefits which, in turn, necessitates more robust mental health specification.
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copyright Sam Whatman
copyright Mark Hadden
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