Openmind 137, January/February 2006
Everything needs to know its purpose. A parsnip functions differently to a rose; an aircraft performs its stuff in the skies unlike a bicycle.
In order to operate effectively, psychiatric wards need to know what they are and what they aspire to be. Should they be a home-from-home, all Habitat with a touch of John Lewis? Or should they embrace their hospital surroundings and attempt 100 per cent wipe-down surfaces and rooms with big signs for 'Treatment' or 'Medication'? And what about the custodial implications of psychiatric wards. Should they be equipped with the very latest in high-tech security?
Psychiatric wards perform several functions and there are design implications for each:
The Royal College of Psychiatrist's Not just bricks and mortar (1) stated that the "standards of accommodation should bear comparison with a comfortable modern hospital". It also used the imaginatively described concept of internal 'landscaping' - and this was in the days before Laurence Llewelyn-Bowen was making kitchen tables out of dead computers!
Certainly, when I was in hospital, what the ward looked like felt as important as its layout. When I arrived at the ward, furious and scared, the one thing I was on hyper alert for was dirt.This was not out of any psychiatric, hygienic or aesthetic concern, but because I regarded the ward's state of cleanliness as a proxy indicator for how safe it was. Fortunately, this ward, at St Ann's Hospital, north London, was spotless. And it did indeed turn out that the ward was run efficiently and caringly, and had a great cleaner. I was much less bothered during my stay about other aspects of the ward's appearance, such as the faded pictures of obscure plants and the absence of scatter cushions.
As with all aspects of mental health services, the earlier that service users can be involved in planning the design of acute wards, the more successful those wards are likely to turn out. Planning teams will need to reflect wards' functions, so should include not only architects but also hotel managers, catering staff, nurses, service users, occupational therapists (the doyens of design for daily living) and, of course, interior designers - whether TV celebs or not!
(1) Royal College of Psychiatrists (1998) Not just bricks and mortar: Report of the working group on the size, staffing, structure, siting and security of new acute adult psychiatric inpatient units.
See http://www.rcpsych.ac.uk/publications/collegereports/cr/cr62.aspx