It is a pleasure to read John Casson's sensitive contribution (Letters, aj 4.2.99) to the difficult question of interpreting the needs of patients and staff within mental-health units, psychiatric hospitals and day centres.
His experience as a therapist within the nhs gives strength to the qualities that he calls for: high ceilings, a feeling of space, clarity and legibility of layout, recovery space for staff, relaxation space, space for the expression of anger and frustration, intimate and well-planned spaces for creative therapy, and finally the importance of access to nature as a source of 'healing for troubled souls'. So often we propose these qualities without the 'clinical' authority to protect them from the depredations of cost limitations and a narrowly focused definition of the facility.
We have direct experience that architectural space, properly and appropriately conceived, can be an important and cost-effective participant in the overall healing process. The lack of conscious articulation of these qualities hinders their acceptance and relegates them to luxury or unproven elements by the dominant utilitarian culture. The dialogue that John Casson wishes to open urgently requires that theorists of healing environments connect these pragmatic and tangible factors to the prospects for healing and recovery.
The benefits accrue to all who enter and use the environments: patients, their families and friends, the staff and the community as a whole. Reducing fear and confusion and enhancing calm and joy is a motivation that everyone can assist with and endorse.
The establishment of an 'ethics statement' setting out the qualities and principles for each brief is an important first step to establishing the goals he seeks. It would be helpful to collect and publish a number of examples of these and to associate them with the buildings then produced, with an assessment from users and designers of how far they have met these goals. This would be an important contribution to the development of the 'feedback' of knowledge in the design and procurement of mental-health facilities.
Penoyre & Prasad Architects