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Architecture's impact on mental health

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May I open a dialogue about the architecture of mental health units, psychiatric hospitals and day centres? I have worked as a therapist in the nhs and in Social Services for 15 years. I have worked in, and visited, many buildings dedicated to mental-health work. Some of these have been old (and marvellously adaptable), others have been purpose-built, brand- new units. I write to ask whether architects consider the impact of the buildings they create on the mental health of patients and staff. There are budgetary limitations. There are the instructions of purchasers, managers and planners. But do these people know of the needs of patients and staff? Do architects ask patients and staff what they need? May I humbly suggest the following:

High ceilings are helpful to reduce the feeling of pressure or possible claustrophobia (hence old buildings sometimes are preferable to new)

Rooms need to be large enough to give a feeling of space: tiny interview rooms may even be dangerous pressure-cookers

Observation should be possible: corridors should not twist in ways that mean people cannot be seen: there have been incidents of violence and abuse because of a lack of safe observable space

Staff need a safe, quiet room away from the patients to recover from stressful incidents, preferably with a view and armchairs, not a boxroom

Each psychiatric hospital or mental health unit could have a relaxation room designed to promote relaxation with quiet lighting (perhaps coloured and dimmable), soft surfaces, etc

Each psychiatric hospital or mental health unit could have a room specially designed for the safe expression of anger: the walls soft, able to withstand the punishment such a room would undoubtedly receive as many people with mental health difficulties have pent-up aggression and anger

Creative space for group therapy and arts therapies: often these are not adequately designed into buildings; ect suites may be extensive and an art room small. Group therapy rooms should be large enough to be multi- purpose: often it seems planners only think people will want to sit down in a circle. People with mental health problems need space to pace, move and not feel too shut in.

A garden: nature offers quiet healing to troubled souls. Here the Victorian asylums win over many modern units that have barren car parks around them.

There are many other issues that need to be considered, and others will have important ideas. A friend who is an architect confirmed that in this matter everyone says it is someone else's responsibility, but the buildings, once put up, have their effect on vulnerable patients and staff for years.


Oldham, Lancs

The rumour is that culture secretary Chris Smith doesn't want an architect as chair of the new public body for architecture. A good reason for this presents itself. Any architect who has practised will read the extensive wish-list that constitutes the advertisement as a brief. That is, they will consider, as we are expected to do professionally, whether they can realistically deliver a tangible, measurable result in all of the categories specified, taking into account the money available, resources and time. And they may well conclude that here is one of those clients so detached from the realities of the material world that to work for them would inevitably end in tears.

This would be a pity. The new body springs from a great many people thinking concertedly about real possibilities for making what gets built better. The problem is that this laudable aim might well need a larger-scale strategic change.

There is indeed one strategy which, strange to tell, fulfils every single requirement on that seemingly impossible list. It is to introduce a policy requiring all buildings over a given size to be subject to open competition. Such a competitions policy would:

'raise architectural standards and awareness throughout the country'

'generate public and press interest in the cause of good architecture'

'encourage excellence in high-profile projects' (and low ones too) as they would of necessity be scrupulously reviewed

inevitably 'forge links with government and professional organisations' by engaging them in running competitions

be in, and of, itself 'the most effective educational programme for children and the wider community', by involving them, on a regular basis, in real democratic choices over what is built

make the 'regional architecture centres' a hive of activity by situating competitions and judging there

use 'the body's grant programmes' to get the most effective and visible return on public money for the greatest number.

It worked in Graz, and it can work here. How about it?

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