Chrysikou, E; (2017) ECOPSYCHOSOCIAL PARAMETERS AND MENTAL HEALTH: the complexities of the psychiatric ward. In: (Proceedings) 11th INTERNATIONAL SPACE SYNTAX SYMPOSIUM. Instituto Superior Técnico, Departamento de Engenharia Civil, Arquitetura e Georrecursos, Portugal: Portugal.

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Abstract

Mental illness historically has followed an uneven path regarding the social integration and the therapeutic priorities of mentally ill people. This was reflected in the institutions that provided for mental illness, with emphasis shifting between custodial and somatic priorities. Gradually, mainly in North America and most European countries, big institutions have been replaced by networks of smaller facilities, known as community care, which introduced the psychosocial model prior to the pre-existing jurisdictional and medical models of treatment and care. These new environments display great variations in policy, service provision and care regimes, even in the same area. Architectural typologies for psychiatric facilities follow this experimental pattern. That hindered the creation of an established, evidence based methodology for psychiatric spaces. The gap was addressed with a patient-focused model, specifically designed for psychiatric facilities, the SCP model. It used methodologies of social medicine, corresponds to the 3 main care models of psychiatry and has been applied in several European contexts. It aids set a red line for medical planners and designers and the identification of areas for further research. A key area identified by the application of SCP model on awarded psychiatric buildings was the lack of understanding on the influence of ward layout to patient wellbeing. Following that, this research aims to promote our understanding of psychiatric space and help us promote our understanding on the mechanisms of the built environment against total institutions and their institutional practices. The locus comprised 2 acute psychiatric wards in London, belonging to different Mental Health Trusts, all part of the public healthcare sector. Each was evaluated using the SCP model, to identify the relation between policy, care regime and patient-focused built environment. Parallel, a syntactic analysis identified the social logic of the wards’ layout, in terms of hierarchies for the two main user-groups patients and staff, staff’s control of the ward in terms of supervision and patient privacy. The juxtaposition of medical architecture and space syntax provided new insights on how psychiatric space is used, as the analysis of the area surrounding the nursing station indicates. The different approaches regarding the gathering of people outside the nursing station, from institutional (unstructured behaviours or unrest) as interpreted by medical architecture to an expected social interaction to the most integrated point from the syntactic perspective, indicated that there is a new potential from the combination of the two methodologies. From the paper, it occurs that Space syntax could unearth underlying issues of social interaction and then the medical architecture methodologies could interpret these issues in the context of the therapeutic regime. That way, we can reach a better understanding not only of how medical spaces operate but provide new insights on the therapeutic regimes.

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