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FUTURE DIRECTIONS IN
DESIGN FOR MENTAL
HEALTH FACILITIES
July 2014
Contents
Section
01
02
03
04
05
06
Introduction
A brief history of mental health
Current practice
Future directions
Design principles
References
Contact
Michaela Sheahan, Researcher
msheahan@hassellstudio.com
Megan Reading, Principal
mreading@hassellstudio.com
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Melbourne, VIC
Australia 3000
T + 61 3 8102 3000
hassellstudio.com
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HASSELL
2014
01
02
03
04
06
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Future
in design
iv
Community
Recovery Program
Mentaldirections
Health Facilities,
Melbourne, Australia. Imagery
bymental
HASSELL.
for
health facilities
01 Introduction
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2014
02 A brief history
of mental health
The Enlightenment
In reaction to the imprisonment model
that was failing the mentally ill, physicians
began to explore the theory that patients
could recover from mental illness, if
accommodated in benign environments
within smaller facilities that had access to
nature.
From the time of the Enlightenment,
incarceration of the insane was deemed
inappropriate and over one hundred and
fifteen asylums were built in England. 6
Similar institutions were built in North
America, Europe, and Australia7 and it was
during this wave of reform that the grand
Victorian asylums, with symmetrical form
and layout, access to natural light and
ventilation, generous circulation spaces
and sprawling grounds of parks and farms
came to dominate the housing of the
mentally ill. 8,9
Treatment Revolution
During the 1950s, significant new
treatment options were developed that
allowed faster and more effective
treatment of the mentally ill, although this
was countered by a political movement
that believed psychiatry was a tool of
social reform. Electro-convulsive therapy,
and then psychopharmacology, enabled a
post-war therapeutic transformation that
began to dramatically shorten the length
of stay for patients. 6,10
03 Current practice
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04 Future directions
04 Future directions
Technology
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05 Design principles
Light
It is well documented that daylight,
artificial light and sunlight can all provide
significant health benefits for the general
population, as well as mental health
patients in particular.
05 Design principles
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05 Design principles
Security
Good security design allows the freedom
of movement for patients within the limits
of their condition. The more serious the
illness, the more overt will be measures to
ensure patients do not harm themselves.
Design must also consider the protection
of staff, other patients, visitors and
members of the public.
05 Design principles
Observation
Closely related to security is the issue of
observation, which is ideally achieved
through passive surveillance. Innovative
ways to increase the potential for staff to
check on patients can be seen in a
number of new facilities.
Providing secure courtyards is becoming
the standard approach, but there are
other ways of maximising observation
without intruding on the patients. Wide
corridors with regular gathering spaces
enable a low key approach to observation,
and single loaded corridors with
uninterrupted views to external spaces
also allow staff to continue with their
work while keeping an eye on activities
throughout the facility.
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2014
Colour
The colour most beneficial in making
people feel calm is blue. Studies have
shown that brighter colours: (whites, light
grey, and lighter colours) are found to be
less arousing, and less dominant than
darker colours, grey and black.18
However, the calming effect is not the only
benefit of astute colour selection colour
coding the environment can greatly assist
in orientation19 and can be used as part of
the way finding strategy.
05 Design Principles
Group interaction
The value of social interaction for
psychiatric patients is well researched,
and varies according to the type of illness
and the demographic of the patients.
There are two aspects to socialisation
with other patients, and with visitors.
Culture has a large bearing on how people
behave in mental health settings - privacy
with and for family are critical. Social
interaction with family and friends is an
important element in many treatment
programs, and research indicates that
single rooms are significantly better than
multi-bed rooms for accommodating
visitors. Multi-bed rooms may even deter
family presence because they greatly
reduce privacy and restrict visiting
hours16.
While some patients sharing the same
bedroom provide each other with social
support, research shows that the
presence of a roommate is more likely to
be a source of stress rather than support.
10
Conclusion
Mental health facility design is constantly
evolving but the principles outlined here
provide the basis for a humanistic solution
that seeks a calm and healing
environment for the vulnerable in our
society.
06 References
1.
World Health Organisation, 2010. Fact Sheet 220. Mental Health: Strengthening Our Response. Website,
accessed 11 April 2012www.who.int/mediacentre/factsheets/fs220/en/index.html.
2.
Department of Health, 2012a Mental Health Promotion Resources, Victorian Government website,
accessed 16 August 2012. http://www.health.vic.gov.au/mentalhealthpromotion/resources.html
3.
Centre for Mental Health UK, 2012. The Economic Costs of Mental Health problems in 2009/20, Website
accessed 16 August 2012, www.centreformentalhealth.org.uk
4.
Millon, T, 2004. Masters of the Mind: Exploring the Story of Mental Illness from ancient times to the new
millennium. John Wiley and Sons, Inc. New Jersey. Website, accessed 27 April 2012, www.books.google.
com.au/books?id=nfvaX3eyYjEC&printsec=frontcover&redir_esc=y#v=onepage&q&f=false
5.
Bethlem Royal Hospital Archive and Museum Service, 2012. Website, accessed 11 April /2012 at www.
bethlemheritage.org.uk/aboutus.asp
6.
Garton, S. 2009 Seeking Refuge: Why Asylum Facilities Might Still be Relevant for Mental Health Care
Services Today. Health and History, Vol 11, No1. Australian Asylums and Their Histories, pp25-45. Website,
accessed 21 March 2012, www.jstor.org/pstable/20534502
7.
Rutherford, S. 2005. Landscapers for the Mind: English Asylum Designers. Garden History, Vol 33, No1
Summer 2005 pp61-86, Website accessed 21 March 2012, www.jstor.org/stable/25434157
8.
Yanni. C, 2007. The Architecture of Madness, Insane Asylums in the United States, University of
Minnesota Press, Minneapolis
9.
Malcolm, E. 2009. Australian Asylum Architecture through German Eyes: Kew, Melbourne, 1867, Health
and History, Vol 11, No 1. Australian Asylums and their Histories pp46-64 Website, accessed 19 March
2012, www.jstor.org/stable/20534503
10. Laffy, P. 2003 Antipsychiatry in Australia: Sources for a Social and Intellectual History. Health and
History, Vol. 5, No. 2, Histories of Psychiatry after Deinstitutionalisation: Australia and New Zealand
(2003), pp. 17-36, Australian and New Zealand Society of the History of Medicine, Website, accessed 21
March 2012, www.jstor.org/stable/40111451 .
11. Adams, R. 2010. Transforming Australian Cities. City of Melbourne and Victorian Department of Transport.
12. CABE 2009. Future Health: Sustainable Places for Health and Well-being. Website, accessed 14/05/2012,
http://webarchive.nationalarchives.gov.uk/20110118095356/http:/www.cabe.org.uk/health
13 Giles-Corti B, Ryan K, Foster S, 2012, Increasing Density in Australia: Maximising the Health Benefits and
Minimising the Harm, National Heart Foundation of Australia, Melbourne. Website, accessed 14 May,
2012, www.heartfoundation.org.au/density
14. Department of Health, 2012b. Mental Health Act 1986. Victorian Government website, accessed 17 April,
2012. www.health.vic.gov.au/mentalhealth/mh-act/index.htm
15. Malkin, J. 1992. Hospital Interior Architecture: Creating Healing Environments for Special Patient
Populations, New York, John Wiley.
16. Ulrich, R.,Quan, X. Zimring, C., Joseph, A., Choudahry, R., 2004 The Role of the Physical Environment in the
Hospital of the 21st Century: A Once-in-a-Lifetime Opportunity, Center for Health Systems and Design,
College of Architecture, Texas A&M University, and College of Architecture, Georgia Institute of
Technology, Website, accessed 14 June, 2012, www.rwjf.org/pr/product.jsp?id=15836 Note : Several
studies (19.1 to 19.21) referenced in the text are summarised in this comprehensive literature review
paper on healthcare design.
17. Singh, A, Syal, M., Grady, S., Korkmaz,S., 2010 Effects of Green Buildings on Employee Health adn
Productivity, American Journal of Public Health, September 2012, Vol 100, No.9
18. Call, P. And Jantzen, K. 2012. Does Your Color Scheme Really Matter? Facilities designed with an
understanding of color can help patients connect the eyes and mind. Website, accessed 14 June 2012,
www.behavioral.net/article/does-your-color-scheme-really-matter
19. Wildgoose. D., Rae, M., Halliwell., J., Davidson, B. 2005. More Than Fit for Purpose, Mental Health Practice
April 2005 vol 8 no 7, RCN Publishing
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