Architecture for Mental Health

Overview

This interactive workshop constitutes a rare opportunity to reflect on one of healthcare architecture’s greatest challenges.

Buildings for mental health are one of the most important chapters of medical architecture and planning. Psychiatric environments often promote stigma and institutionalization. Community care has set to change that, yet as research demonstrates psychiatric building stock resists to change. Yet, as mental illnesses present low accuracy in diagnosis and treatment, environment becomes of great significance. How do we transform buildings for mental health from spaces of control and exclusion to integrated, psychosocially supportive facilities? 

This unique short course presents the state of the art on psychiatric provision. It breaks silos as it brings together world leading figures on design for mental health, clinicians and people who commission mental health buildings from the UK and the US to discuss openly what we could do differently. It combines academia with practice and real world problems such as the transformation of a metropolitan psychiatric campus. 

The course is run by the Bartlett Real Estate Institute UCL and offers great networking opportunities.

Course content/structure of the day

9.00am - 9.30am: Opening, coffee and networking

9.30am - 10.30am: ‘Introduction on the day and overview of BREI research on psychiatric buildings’ by Dr Evangelia Chrysikou (Lecturer - Program Director MSc Healthcare Facilities, the Bartlett Real Estate Institute UCL)

10.30am - 10.45pm Break

10.45am – 12.00pm ‘How to design mental health facilities?’ by Dr Nikolina Jovanovic (Consultant psychiatrist and architect, Queen Mary University of London)

12.00pm - 13.00pm Lunch break and networking

13.00pm - 14.00pm ‘The St. Pancras redevelopment programme’’ by Malcolm McFrederick (St Pancras Transformation Programme Director, Camden and Islington NHS Foundation Trust)

14.00pm – 14.30pm Break

14.30pm – 16.30pm ‘Diverse Preoccupations. Caring for the Mentally Ill in North America: Implications for Design and Planning’ by Francis Murdock Pitts (Founding partner and President of architecture+)

16.30pm – 17.00pm Key messages – Closure

Main Presentations

Introduction – From marginalization to social valorization: removing the stigma surrounding mental illness via design

Introduction on the day and State of the Art for Psychiatric Provision. The presentation will set the tone of the day and bring up the major questions that will shape mental health provision in the next decade. What are the consequences of one of the largest taboos in healthcare provision affecting so many among us? Is mental healthcare becoming mainstream? What major drivers such as integration of mental health into primary care mean for psychiatric provision? How could technology influence some of the most low-tech areas of healthcare environments? What does the ageing of the population means for mental health provision? How do we balance safety and community care? How can we reduce stigma by design? How can we design therapeutic environments for mental health?

How to design mental health facilities?

Psychiatric facilities are often criticised of being poorly designed which may contribute to violent incidents and patients’ complaints of feeling bored and lacking meaningful interactions with peers and staff. There is lack of understanding how to design environments for staff, patients and visitors to engage in positive social interactions (e.g. conversation, sharing, peer support). This presentation will focus on evidence-based architectural typologies and design solutions that could facilitate helpful social interactions between users of psychiatric facilities.

The St Pancras redevelopment programme

Camden and Islington NHS Foundation Trust is the largest provider of mental health and substance misuse services to people living within the London boroughs of Camden and Islington. The Trust sees 25,000-30,000 people a year and covers diverse boroughs with a BME population of 50%. We provide the full range of services for our adult population including talking therapies, a range of community based services, crisis care, acute in patient care and home treatment. We serve a population that is highly mobile with 30 - 40% of our admissions for people who are previously unknown to our services. The population also has significant need compared with other parts of the country yet our current facilities in the community and particularly on the St Pancras site, are old, lack the required modern therapeutic and safety design, and are unfit for purpose.

The Trust has a history of delivering high levels of innovation and research. Our academics have been at the forefront in developing the evidence base for, amongst others, rehabilitation services, early intervention services, assertive outreach teams, crisis teams, crisis houses, dementia care, and physical health in psychosis.

To deliver the future services that our population requires, the Trust has a comprehensive clinical strategy which focuses on:

• building integrated services and greater capacity in primary care and community settings;
• integrating physical and mental health; 
• increasing access to all services;
• improving lives and wellbeing through wider integration of social and mental health support;
• reducing stigma.

The St Pancras redevelopment programme enables an overarching transformation of the estate to progress effective delivery of our visionary Clinical Strategy along with national and local health strategies. It puts service users at the centre recognising there is a once in a lifetime opportunity to transform services across the two Boroughs, building more visible, more accessible and more integrated services for people locally alongside world class research driving the very best practice. Our vision is to use the St Pancras redevelopment programme as the opportunity to not only meet leading 21st century standards in facilities but to reshape the services themselves delivering high class local, integrated care and world class research.

Diverse Preoccupations  
Caring for the Mentally Ill in North America: Implications for Design and Planning

While the past fifty years have been the occasion for dramatic changes in both the conditions and settings for the care of the mentally ill in North America, the current moment is marked by an unprecedented preoccupation both within society at large and within the architectural profession with the opportunities inherent in new care models and the associated design opportunities.  

This course will survey both the changing conditions in care models, social commitment, and care settings within the recent past with a particular focus on the particular trends that have led to recent changes and some observations about what might be the next movements in care models and design.  

Who is this course for?

The course is for a mix of professionals and students with an interest in environments for mental health and of multiple backgrounds: architects, designers, engineers, facility managers, healthcare planners, healthcare professionals, healthcare managers with an interest on healthcare buildings. Professionals of the care home sector might also find the course interesting as well as people working for capital planning and facilities and estates of the NHS.

Learning outcomes

By the end of this one-day short course, you will:

• have an introduction to therapeutic design
• acquire a broader understanding of how buildings for mental health are expected to influence healthcare delivery
• get a glimpse of the potential of design and architecture but also the challenges /opportunities for healthcare facility designers
• get an overview of the potential of design for mental health and end-user experience 
• have a general overview of healthcare buildings tender and NHS commissioning processes 
• have the opportunity to interact and network with leading professionals, people commissioning projects and academics from multiple-disciplines and gain a multiple perspective on the subject.

Soft outcome: 

• Increase your understanding on working across sectors and collaborating with different disciplines.
• Learn how to interact across sectors and increase your networking skills. 
• As a short course student you won't be formally assessed, but you're expected to fully participate in group work. You'll receive a certificate of attendance on completion of the course. 

Course team

Dr Evangelia Chrysikou DiplArch, MA MARU, PhD – course leader

Evangelia is Lecturer (Assistant Professor) at the Bartlett Real Estate Institute, UCL in London, Program Director of the MSc Healthcare Facilities and medical architect. She rare PhD on mental health facilities from UCL and a former Marie Curie H2020 Fellow. She has been actively involved in policymaking, being Coordinator on D4 Action Group of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) of the European Commission (EC) and consulted, on behalf of the EC, the Hellenic Ministry of Health and the Centre of European Constitutional Law on legislation regarding mental health facilities.  Her work on therapeutic environments has received prestigious international awards (Singapore 2009, Kuala Lumpur 2012, Brisbane 2013, Birmingham 2014, London 2014, Vienna 2017, London 2019). Her research on mental health, ageing, accessibility and mental health, autism, social inclusion, healthcare, welfare and wellness facilities, medical architecture, medical tourism planning spans in several countries of the world (UK, France, Belgium, Greece, Middle East, Japan, New Zealand etc.). Currently, she is the PI at a Butterfield award of the Great Britain Sasakawa Foundation and a CoI at a Marsden Fund from the Royal Society of New Zealand.  Evangelia authored the books ‘Architecture for Psychiatric Environments and Therapeutic Spaces’ & ‘The Social Invisibility of Mental Health Facilities’, a healthcare architecture editor, reviewer, active member of several professional and scientific associations and a TED-MED speaker. She is also Member of the Board at the Scholar’s Association Onassis Foundation.

Malcolm McFrederick

Malcolm has a long history of working in the NHS, charitable and private health sectors. He has an operational background which allows him to function on the design and operation of services for patients, and how best the environment can support the needs of patients and clinicians. He has been a Chief Operating Officer in both physical acute and mental health Trusts in South East England. Prior to working in the NHS he worked in the private sector and was involved in the Princes Royal and Darent Valley Hospital PFI schemes.

Francis Murdoch Pitts, FAIA FACHA OAA

Francis is widely recognized as one of the world’s leading planners and designers of psychiatric facilities and as a leader in the development of an evidence-based design practice culture in North America. 

He has consulted on more than 300 projects involving well over 20,000 mental health beds in clinical settings located in in all parts of the United States and Canada. He has served as President of both the AIA’s Academy of Architecture for Health and the American College of Healthcare Architects. In his leadership positions in both institutions he has advocated the development of practice cultures that evince evidence-based design. He speaks widely and publishes articles on the lessons that can be learned from exemplary hospitals and the application of research evidence to hospital design.

In recognition of his contributions to healthcare design and in particular for his work for the mentally ill, Frank was honored by the Center for Health Design with their 2018 Changemaker Award.

Dr Nikolina Jovanovic, MD, PhD

Nikolina is a psychiatrist and an architect working at Queen Mary University of London. In her work she explores the link between hospital built environment and patient and staff outcomes.

Contact information

Name: Bandana Rehncy
Email: brei.healthcarefacilities@ucl.ac.uk
Telephone: 020 3108 8162

Cost

The standard course fee is £300

Concessions