Researching the behaviour of mental health patients within hospitals can inform building design so that the number of negative incidents can be significantly reduced, says the architect behind a flagship new unit in south London.
Teva Hesse of international practice, CF Moller, claimed that studying incidents of self harm, abuse and harassment, and considering how the environment could be used to address these, had been found to have a positive impact on the problems.
In one hospital, changes to the environment based on this evidence saw the number of serious incidents on one ward fall from 27 to just two.
While our work is at an early stage, at Springfield we are beginning to look carefully at how we can go well beyond the norm and create environments that are more therapeutic and beneficial
As part of the design of the new Springfield University Hospital in south London, he is now using similar techniques in an effort to map some of the key flashpoints.
“We are looking at a database of incidents from 2004 to 2013,” he told delegates at this week’s IHEEM Conference in Manchester.
“What we have found is that, as you would expect, self-harm tends to occur in bedrooms and bathrooms, while accounts of violence, abuse and harassment, which are the most common incidents reported, almost always happen in corridors and almost always between the hours of 4-6pm.
“It is about designing buildings where there are spaces that allow people to avoid each other. Old single-loaded corridors are almost engines of aggression and some patients are petrified when they have to walk past another person’s bedroom. We need to avoid dead-end corridors and provide patients with a choice of routes to get around.”
Outside space is also vital, as is natural ventilation, daylight, good acoustics and control and choice over individual spaces.
“The minority of patients are involved in the majority of incidents, so staff need somewhere within a building where they can segregate these people,” Hesse said.
“Access to outdoor spaces is also very important. We are looking at new layouts where the nurse base is as central as possible and all the spaces around it are open plan with good visibility into the gardens and wards. Even on tight, constrained sites you can use design to improve circulation so that you can avoid problem behaviour.
“You need a choice of spaces people can go to and, while our work is at an early stage, at Springfield we are beginning to look carefully at how we can go well beyond the norm and create environments that are more therapeutic and beneficial.
“It is about looking at why, when and how incidents occur.”