Therapeutic Environments for the Mentally Ill
Evangelia Chrysikou
Thesis - Creative Architecture Research & Design
Synthesis Architects
Greece
(Click to download full paper)
The closure of big psychiatric institutions created a move of clients in various settings in the community, ranging from hospital to home. Scientific knowledge on the design of those environments is still limited and design is often based on anecdotal architectural theories.
The purpose of the study is to explore client focused architecture in the community for clients in the acute stage of their illness and to investigate if design can be therapeutic for them. The thesis revisits and re-evaluates the concept of domesticity that was introduced with normalisation theory, in the context of mental health facility provision.
It is proposing that more “domestic” environments, designed with respect to clients’ needs, could contribute to the therapeutic procedure. The project intends to identify the degree of domesticity of the buildings. The buildings were analysed based on three compartment models: safety/security, competence and personalisation/choice. The study compares the acute mental health unit in the UK and the French “Foyer de Post-cure” as there is a cultural element in the treatment and care of the illness.
The seven year study set out to compare the provision of care in five UK and five French units and involved the participation clients and staff. Three research methods were employed: semi-structured interviews, questionnaires and architectural checking of the building. The organisation and architecture of the buildings is juxtaposed with the client needs as those are perceived by them and the staff working in the units.
The issues taken into consideration regard the size and layout of the unit, its location, connections to other services, its external appearance, decoration, fittings and furniture, availability of interior and exterior space. The study concludes with design guidelines that create therapeutic environments for the facilities, in respect to elimination of stigma, the integration of facilities in the community, through an enhanced public image, yet in environments that are and feel safe and operate in accordance to the therapeutic work taking place there. Moreover, designing with clients needs in mind could provide the desired degree of stimuli and interaction and enhance their participation and consequently increase the benefit from their stay, when at the same time reducing the trauma of dealing with the system.
Keywords: Domesticity, therapeutic design, mental health.
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