ESTATE REDEVELOPMENT
Inspiring mental health hubs apply best practice
Evangelia Chrysikou, RIBA, Lecturer at The Bartlett Real Estate Institute at University College London, director of the MSc Healthcare Facilities course there, and a medical architect, and her colleague, Eleftheria Savvopoulou, a registered architect with an MSc in Architectural Project Management, discuss the findings of a research project into good practice in the creation of inspiring, imaginative, community-integrated mental healthcare facilities worldwide. They explain how the findings will inform mental health NHS Trust, the Camden and Islington NHS Foundation Trust’s plans for redevelopment of the historic St Pancras Hospital site in London.
One of the key goals of The Bartlett Real Estate Institute, University College London’s global faculty of the built environment, is to challenge the way we understand and value real estate and buildings. Buildings are many organisations’ most expensive assets to run, as well as their most valuable commodity, the NHS being no exception, but how do these buildings foster or break the cohesion of the communities they host and the communities that surround them? What is the intangible value that a building brings to their community? How do we capture this value? What would that mean for psychiatric buildings? What would it take for a mental health facility to become a place of healing? What should a building for mental healthcare look like to encourage the community to perceive it as a resource, and how best can such a building invite the community in, and become a space in
D: Domestic I: Institutional
D (+) I (–) I (–) Competence D (+)
which the most vulnerable individuals facing mental health issues recover? This research project aimed to inform the pre-brief consultation stage of the St Pancras Hospital building redevelopment, initiated by Camden and Islington NHS Foundation Trust, which had taken the decision to open up this large psychiatric campus to the community it served. The Trust invited us to join it to break the Cinderella-pattern of medical architecture, where the importance and social/clinical value of mental healthcare facilities goes unnoticed, with good aesthetics and a sense of pleasure and comfort often seemingly disregarded, and taking second place to a focus on a robust design. A number of mental healthcare facilities, especially historically, have also been sited in remote locations with limited access to amenities.
Figure 1: The SCP Model as a 3D space where psychiatric facilities can be placed according to their individual characteristics in domestic (+) vs. institutional (–) scale.
Understanding what has been achieved elsewhere In redeveloping the St Pancras Hospital site, it was fundamental for the Camden and Islington NHS Foundation Trust to understand what architecture could do to facilitate a shift from institutional, to inspiring, environments, and also to learn what was happening, and what could be achieved with good mental healthcare facility design, elsewhere. The Trust encouraged us to investigate case studies that have supported concepts where the design parameters are outside the its normal scope and the constraints – for instance regulatory – within which it normally operates. In short, the Trust wanted us to bring to the table of patient and staff consultations ‘blue sky, out-of-the box’ thinking that has been happening in mental healthcare premises across the world.
I (–) SCP Model 10 D (+)
Need for ‘more integrated’ facilities Mental healthcare is a service environment, in which all recipients are highly interconnected. As a result, the actions of one can influence the context of the other, in common with any healthcare environment.1 With mental illness on the rise,2 removing the stigma surrounding mental illness would facilitate earlier diagnosis, and, therefore, more effective treatment for those who need it. More integrated facilities, closer in design and nature to what people perceive as accessible and inviting,3 might support the target of getting those facing mental ill health asking for help earlier. In particular, community mental health hubs should be in a location that helps optimise the health and wellbeing of their members. One key way to achieve this is via their integration with the health and social care system, as well as into the community they serve. Through locating health and social care services in the same physical space, users can more easily access related support, while this also enhances the links between different
OCTOBER 2020 | THE NETWORK
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