Chrysikou, E; (2015) IIll performing buildings for mental health. In: Christer, K, (ed.) Proceedings of the Third European Conference on Design4Health 2015. Sheffield Hallam University: Sheffield, UK.

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Abstract

Psychiatric de-institutionalisation was characterised by the shift to community-based facilities. Yet, institutional remnants still prevailed, even in new structures. The building stock was no exception as it adapts slower than organizations and as architects had limited knowledge on mental health (Brand, 1994; Norman, 2002). The lack of understanding regarding community care, of evidence-based guidelines and of comprehensive briefs resulted in architectural experimentation. New facilities often became smaller-scale total institutions, creating social exclusion inside the community. Occasionally, social problems in new buildings were so severe that those had to be demolished (Elderfield, 2002). The research investigated the spatial mechanisms that created those community-based institutions, even when the best architectural intentions were involved. It also aimed to identify the limitations of generic architectural frameworks for specialised healthcare facilities such as mental health. The research investigated 10 community-based facilities. 2/10 facilities were buildings considered state of the art, by their awards and presentation in the architectural literature. These buildings were compared to the rest according to their degree of institutionalization and user satisfaction. Data were triangulated via architectural auditing of these buildings, the development of a 215 point checklist and interviews of 65 residents and 50 staff. The innovative aspects of the awarded facilities varied from the location to the layout and architectural detailing. The architects’ original aim was to generate ideas and address the complexities of psychiatric environment. Yet, both performed poorly in all aspects of methodology. The research revealed the compromises that the buildings posed to clients’ safety and security, to their competence and to their personalization and choice. It demonstrated the importance of user involvement from planning stage. Additionally, it addressed the complexity of the subject and the need to develop scientific methodologies for design that will provide the necessary knowledge -as opposed to subjective intuition- to architects in order to unfold their creativity.

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