Recent research shows a strong correlation between architectural design and a reduction in aggression and violence in mental health facilities.
The psychological impact of mental health facilities is as important as the direct functional design for facility users, and architectural designs that minimise noise and crowding while enhancing patient freedom and sense of control in calm environments can reduce trauma and therefore aggression.
“Not only does a reduction of trauma in health care facilities improve the lives of staff and patients but it can even lower the cost of care,” said Dr. Roger S. Ulrich, professor of architecture at the Centre of Healthcare Building Research at Chalmers University of Technology in Sweden.
“For patients, the stress of mental illness itself can be intensified by the trauma of being confined for weeks in a locked ward. Some features, like single-patient bedrooms with private toilets, do increase the building cost but that is arguably offset by the reduced trauma for patients and hospital workers.”
Ulrich stresses the importance of understanding that higher construction costs are often cancelled out by the savings in additional medical care or expensive lawsuits that can ensue from violent situations.
At Sydney’s St Vincent’s Private Hospital which opened in March of last year, architect Alan McMahon of Woods Bagot said it is extremely important to create a “home away from home.”
McMahon believes there should be diverse public spaces and says it is crucial to offer options as to how those living in those facilities spend their time.
Kate Harel works at St Vincent’s as the nurse manager of the 20-bed facility and sees the positive effects of architectural design.
“Mental health units were traditionally built for confinement or custodial care,” she said.
“There’s been a lot of emphasis at St Vincent’s on not making it cage-like.”
Many mental health care workers agree that by giving patients a home-like space as opposed to an institution-like space it discourages patients from taking on the role of someone who is ill.
The Department of Veterans Affairs published a mental health facility design guide in 2010. The Veterans Health Administration (VHA) stresses the importance of the design process of mental health facilities, noting that the functionality of the final design and how well the staff adapt to it is significantly impacted by the membership and functioning of the design team.
An interdisciplinary design team is recommended throughout the design process including architects, engineers, interior designers, external consultants and clinical staff who can assist in problem-solving.
Patient input and feedback gained through interviews and focus groups are also recommended.
In Victoria, Dandenong Hospital’s new mental health facility by Whitefield McQueen, Bates Smart and Irwin Alsop Architects was designed to focus on patient well-being through innovative design.
The mental health facility includes:
- A non-institutional design
- All single rooms with ensuites
- Outdoor and activity areas for socialising
- A calm, therapeutic environment
- Supervision without unnecessary intervention
- Blended interior and exterior environments
“Globally, a third of all patients admitted for psychiatric care are involved in violent incidents,” Ulrich says, citing a 2011 analysis by researchers at King’s College in London.
He believes there is no doubt that architecture can and should play a much larger role in patient safety and care with emphasis on the reduction of stress which can lead to aggression and violence.