ESTATE REDEVELOPMENT
a wide variety of forums – each one provided distinct insights into the environmental issues that frame mental healthcare. We gained an appreciation for the very difficult situations of carers, who out of necessity give over their loved ones to the care of an institution. We recognise the constant challenges and pressures faced by staff within these environments. We have benefitted from feedback on our designs gathered in peer reviews, Q & A sessions, open day presentations, discussion groups, facilitated workshops, Virtual Reality sessions, and digital walk- through animations.
How is it possible to summarise this experience and feedback within the scope of this article, and how can we articulate the aversion we felt as architects to the architectural qualities we found on the majority of existing wards: the cold fluorescent lighting, smooth hard finishes that reflected sound, reinforced doors with heavy ironmongery, oddly shaped furniture, and toilet / bathing facilities similar to custodial environments? All these things reinforce the feeling that these institutions are anything but homely. They signal that risk and danger are ever-present. In our study of incidents on mental health wards we found another very important fact: that most service-users are not involved in incidents, do not barricade themselves, or engage in self-harm. We understand the necessity for robust and safe design, but are determined to take as many steps as possible to improve these noisy, stuffy, reverberant, impersonal environments so that they can provide a therapeutic respite, especially at times of acute mental stress.
No choice over leaving
A service-user deserves the same benefits from their environment as anyone else, and perhaps even more so, since the individual under section has no choice of leaving. We found that putting oneself in the role of a service-user is a first step towards creating a more humane architecture. Over several years of engagement, a set of primary design goals repeatedly resurfaced in our consultations; these can be set out as a list, not as a checklist, but as our guiding principles for mental health design work: l Creating a varied environment on the ward that avoids monotony; different decor for areas where service-users live (bedrooms), work (therapy, consultation), and relax (lounge, dining and gardens).
l Free access to gardens and outdoor space for both informal and detained patients.
l As large and varied external garden spaces as possible.
l Good sound insulation, and acoustic dampening of airborne sound.
l Good sightlines and visibility for both staff and service-users.
l Ample daylight and views of the sky. l Plentiful fresh air and natural ventilation. l External views from bedrooms.
18 A ward lounge and garden. OCTOBER 2020 | THE NETWORK A ‘Skype corridor’.
l ‘Avoidability’ – providing a choice of routes to get from A to B.
l Reducing boredom by providing opportunities to engage in beneficial activities.
l Robust and easily maintained. l Safe and secure. l Flexible. l Places where service-users, staff, and carers, feel valued.
Over successive design stages, we have had the benefit of extensive discussions on each of the above points with the Trust, as well as within our studio. Along the way we have incorporated the prescriptive guidance for NHS mental health facilities, with a view to achieving compliance without losing our commitment to creating environments where service-users and staff feel ‘comfortable, valued, and safe’.
Therapeutic garden design Proximity to gardens and nature is essential in creating calming and therapeutic environments in mental health facilities. Views and access to outdoor space contribute to health and wellbeing. Providing awareness of the passing seasons and daily changes in weather and natural light can aid in the regulation of sleeping patterns, and help establish a connection between service-users and the surrounding environment. Service-users should be encouraged to occupy the zone between indoor / outdoor environments via the provision of glazed viewing areas,
corner lookouts, window seats, and large skylights.
The design has developed out of the imperative to incorporate high quality external areas for service-users, staff, and visitors. Outdoor spaces will offer a range of activities, such as gardening, exercise, outdoor dining, gentle walking, resting, and quiet contemplation. In every ward the main garden / courtyard is an extension of the lounge and dining space. Where possible, a second outdoor space is provided to encourage quiet contemplation and rest.
To be a ‘garden’, and not a generic outdoor green space, requires seasonal planting; each outdoor space will have a different character to create a variety of smells, textures, and visual appearances. All outdoor spaces have been designed to be easily observed from the central nursing station / ward base. All gardens allow step- free, direct access for service-users. A covered space at the external threshold is provided for use in inclement weather.
Gardening opportunities for service-users
Gardens are designed with planting beds, so that service-users with the inclination might be able to assist with the upkeep of ward gardens. There are also hard surfaces for games such as ping-pong, or other group activities in the gardens. The intention is to provide opportunities throughout the ward for service-users to engage in individual or shared activities that
©C.F. Møller
©C.F. Møller
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