ESTATE REDEVELOPMENT
More specifically, research conducted highlighted recommendations in relation to: l Engaging different groups (such as staff, service-users, family members, and the local community).
l ‘Provision’ – referring, inter alia, to recreation therapies, primary care integration, physical activity, and technology.
l Location, and issues of accessibility, proximity to public transport, and catchment area.
l ‘Exterior’, focusing on issues such as outdoor sitting areas, green space therapeutic interventions, a welcoming façade, openness to the local neighbourhood, and ways to reduce stigma.
l Layout choices, such as gender-safe design, an accessible and safe environment, and looking into choices to reduce violence within the facilities.
l Interior design – from storage areas to adolescent-focused design, to natural elements, and consideration for both staff and users.
l Attention to detail – such as colours used, furniture selection, art, and adjustable heating and lighting.
l Design for older people, taking into account their perceptions and physiology, and how design choices could create a less stressful
environment for them to live in and use. Conclusions
This research project successfully gathered patient-focused, ‘out-of-the-box’ global examples of psychiatric built environments that demonstrate challenging aesthetics and design innovation. This reminds us that psychiatric buildings can be embedded within the urban fabric and be bright, local, and open, and at the same time ‘posh’ and sophisticated. This was very much the case, for example, at the Skrbovinca Care gift shop in Slovenia (see Fig 2). They could even be dynamic and float, as with the Adamant Day centre/boat in France. Examples showed that with imagination and design flair/innovation, mental healthcare facilities could motivate service- users to support their peers using objects, such as the Youth Prevention and Recovery Care Bendigo in Australia, and the ‘Welcome’ ‘goodie bags’ presented by service-users there being discharged to newcomers. Taking ‘out-of-the box’ thinking even further, they could be red and provocative, and use their facade to project the intensity of the provided therapies, as in the case of the Young Disabled Modules and Workshop Pavilions in Spain. They can also bring the community into the building, with graphics, installations, and images of terraces, city scenes, and landscape.
A dialogue initiated
In most cases, psychiatric buildings tend to go unnoticed, demonstrating clear signs of vandalism, and being located far from the
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urban grid of the community they serve, leading to added inconvenience for the service-users, staff, and visitors, wanting to access them.9 Through the matrix of recommendations for the design of community mental health facilities, the researchers initiated a dialogue among all the parties involved, and clearly demonstrated to service-users and staff that their needs and views matter on the design of such buildings really matter. The research also generated a valuable tool for everyone involved in the design and management of psychiatric facilities that could help, long-term, to minimise the stigma surrounding mental ill health in the wider community. By treating design and place-making as therapeutic tool, we could challenge the way people view mental health buildings, and create the means to disrupt a traditionally segregated architectural dialogue.
References 1 Plsek P. An organisation is not a machine! Principles for managing complex adaptive systems. Materials prepared for leadership for health improvement programme. York, 2006.
2 World Health Organization. The World Health Report. Mental Health: New Understanding, New Hope. Geneva, 2001.
Evangelia Chrysikou
Dr Evangelia Chrysikou, RIBA, is Lecturer at The Bartlett Real Estate Institute UCL, Director of the MSc Healthcare Facilities course, and a medical architect. She is Vice-President of the Urban Health Section of EUPHA. She holds a rare PhD on mental health facilities from UCL, and a Curie H2020 Individual Fellowship. She has been actively involved in policy, being the Coordinator on the D4 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) of the European Commission. Dr Chrysikou has received several international awards for her healthcare architecture and research. She has authored national guidelines for mental health facilities in the community for Greece on behalf of the European Union, and the books, Architecture for psychiatric environments and therapeutic spaces, and The social invisibility of mental health facilities.
Eleftheria Savvopoulou
Eleftheria Savvopoulou is a registered architect (Technical Chamber of Greece), holding an MSc in Architectural Project Management from the University of Edinburgh. She has been involved in the UCL European Commitment on Active and Healthy Ageing (AHA) under the title ‘Inclusive Urban and Rural Communities’, and as research assistant and project coordinator to a number of research schemes under the supervision of Dr Chrysikou, such as the UCL Cities Partnerships Programme in Rome, and the UCL Grand Challenges Small Grant 2016-17 for the proposal, ‘The social invisibility of mental health facilities’. She has also worked as research assistant with UCL consultancy projects such as ‘Guidance Notes on offices: Safe return to work during COVID-19’, and ‘Implementing research and best practice for the development of mental health hubs in the community’, for Camden and Islington NHS Foundation Trust.
OCTOBER 2020 | THE NETWORK
3 Chrysikou E. Architecture for psychiatric environments and therapeutic spaces. Amsterdam: IOS Press. December 2014. ISBN 978-1-61499-459-6
4 Lum J, Ying A. Community Hubs: Right care, right place, right time. Canada: Canadian research network for care in the community, 2014.
5 Thornicroft G, Deb T, Henderson C. Community mental health care worldwide: current status and further developments. World Psychiatry 2016; 15 (3): 276–86
6 Francis S, Glanville R, Noble A, Scher P. 50 years of ideas in healthcare buildings. London: The Nuffield Trust, 1999. ISBN 1902089200.
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7 Chrysikou E, Savvopoulou E, McLennan P, Higgs P. The Bartlett Real Estate Institute. Implementing research and best practice for the development of mental health hubs in the community. Report delivered to Camden and Islington NHS Foundation Trust [
https://tinyurl.com/y5pawjdx].
8 Chrysikou E. The SCP model: A three- dimensional methodology for understanding, profiling and evaluating mental healthcare architecture. In: Yoxall A, Christer K eds. Proceedings of the 2nd European Conference on Design. Sheffield: Sheffield Hallam University, 2014: 66-76. ISBN: 978-1-84387-373-0
9 Chrysikou E. The social invisibility of mental health facilities. London: UCL, 2017.
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