PSYCHIATRIC HOSPITAL
AND OFTEN SPACES FOR RESEARCH
A SUCCESSFUL DESIGN FOR A
PSYCHIATRIC HOSPITAL REQUIRES CAREFUL
COORDINATION OF A MULTITUDE OF
FACTORS; THERE IS NO ONE-SIZE-FITS-ALL
SOLUTION. THE FINAL DESIGN WILL BE
UNIQUE TO THE INDIVIDUAL FACILITY AND
ITS STATED GOALS AND PHILOSOPHIES. IN
PARTICULAR, MANY ELEMENTS TYPICALLY
USED IN GENERAL HOSPITALS TO ADDRESS
THE SPECIFIC NEEDS OF PATIENTS AND
STAFF ARE NEEDLESSLY CARRIED OVER
INTO BEHAVIORAL HEALTH FACILITIES, EVEN
THOUGH THE FUNCTIONS THEY ARE
INTENDED TO ADDRESS ARE NOT PRESENT
OR NEEDED IN PSYCHIATRIC UNITS.
RANGE OF PSYCHIATRIC FACILITIES
THE RANGE OF PSYCHIATRIC
FACILITIES INCLUDES PSYCHIATRIC
HOSPITALS, PSYCHIATRIC AND NEURO-
PSYCHIATRIC NURSING UNITS OF GENERAL
HOSPITALS, FACILITIES FOR THE
PSYCHIATRIC MEDICALLY INFIRM,
GEROPSYCHIATRIC UNITS, ALCOHOL AND
DRUG ADDICTION TREATMENT FACILITIES
(BOTH INPATIENT AND OUTPATIENT),
MENTAL HEALTH CLINICS, DAY HOSPITALS,
DAY TREATMENT CENTERS, AND OTHERS.
IN ADDITION TO INPATIENT NURSING
UNITS, PSYCHIATRIC HOSPITALS INCLUDE
THEIR ASSOCIATED DIAGNOSTIC AND
TREATMENT AREAS, AS WELL AS THE
NECESSARY DIETETIC, SUPPLY,
HOUSEKEEPING, AND ADMINISTRATIVE
SPACES COMMON TO ALL HOSPITALS.
THEY DO NOT GENERALLY INCLUDE THE
COMPLEX AND HIGH-TECH DIAGNOSTIC
AND TREATMENT AREAS OF GENERAL
HOSPITALS.
PSYCHIATRIC HOSPITALS MAY
INCLUDE OUTPATIENT PSYCHIATRIC AREAS.
THESE AREAS SHOULD BE LOCATED ON A
DIRECT PATH FROM THE LOBBY, AND
CIRCULATION PATHS OF THE OUTPATIENTS
SHOULD BE SEPARATED FROM THE PATHS
OF THE MORE ACUTELY ILL INPATIENTS.
TEACHING HOSPITALS WILL ALSO INCLUDE
SPACES FOR TRAINING AND EDUCATION,
STUDIES.
THE MENTAL HEALTH CLINIC IS THE
BASIC OUTPATIENT UNIT, PROVIDING AN
INTERFACE BETWEEN INPATIENT CARE AND
THE COMMUNITY. AS SUCH, IT PROVIDES
PREVENTATIVE CARE, PRIMARY CARE, AND
AFTERCARE. THE CLINIC MAY ALSO SERVE
AS A SITE FOR RESEARCH AND FOR
TRAINING OF MENTAL HEALTH
PROFESSIONALS ON ALL ASPECTS OF
OUTPATIENT TREATMENT OF MENTAL
HEALTH PROBLEMS.
A SUBSTANCE ABUSE CLINIC
PROVIDES OUTPATIENT CARE AND
TREATMENT OF ALCOHOL AND/OR DRUG-
DEPENDENT PATIENTS NO LONGER
NEEDING INPATIENT CARE. IN A HOSPITAL,
IT SHOULD BE SO LOCATED THAT ITS
PATIENTS DO NOT NEED TO TRAVEL
THROUGH OTHER PARTS OF THE HOSPITAL.
THE DAY HOSPITAL HAS NO BEDS, BUT
IS TYPICALLY LOCATED WITHIN OR
ADJACENT TO A HOSPITAL. IT OFFERS
TOTAL HOSPITAL PSYCHIATRIC SERVICES
FOR ACUTELY ILL PATIENTS WITHOUT
REMOVING THEM FROM THE FAMILY AND
COMMUNITY.
THE DAY TREATMENT CENTER
PROVIDES A SUPPORTIVE LEARNING
ENVIRONMENT AWAY FROM A HOSPITAL IN
WHICH PATIENTS HAVING CHRONIC
DIFFICULTIES WITH COMMUNITY
ADJUSTMENT AND OTHER PSYCHO-SOCIAL
PROBLEMS MAY RECEIVE HELP. SUCH
PATIENTS HAVE OFTEN HAD LONG PERIODS
OF HOSPITALIZATION, AND NEED
CONTINUING MONITORING OF THEIR
GENERAL HEALTH AND MEDICATION
NEEDS.
THINGS TO BE CONSIDERED BEFORE DESIGN
PSYCHIATRIC SETUP
MENTAL HEALTH FACILITY DESIGN IS
CRUCIAL FOR PATIENT CARE, AFFECTING
SERVICE DELIVERY EFFICIENCY AND
PSYCHOLOGICAL IMPACT ON USERS. IT 2.A HOLISTIC APPROACH
INFLUENCES PATIENTS' BELIEFS,
EXPECTATIONS, AND PERCEPTIONS OF BEHAVIORAL HEALTH CONDITIONS
THEMSELVES, STAFF, AND THE HEALTHCARE HAVE SHIFTED TO A HOLISTIC TREATMENT
SYSTEM. FACILITY DESIGN ALSO APPROACH IN WHICH PATIENTS TAKE
CHARGE OF THEIR HEALING PROCESS
INFLUENCES STAFF BELIEFS, ATTITUDES, AND
THROUGH INDIVIDUAL AND TEAM-BASED
BEHAVIORS, AFFECTING PATIENT
CARE IN A SUPPORTIVE AND NURTURING
INTERACTION AND INTERACTION WITH ENVIRONMENT.
PATIENTS AND THE ENVIRONMENT.
FACILITY DESIGN EMPHASIZES TREATMENT FACILITIES SHOULD BE
DESIGNED TO BE SAFE AND
PATIENT SAFETY, AS HEALING
COMFORTABLE, EMPHASIZING PERSONAL
ENVIRONMENTS CAN BE DESIGNED AS
EMPOWERMENT AND INDIVIDUAL DIGNITY,
SAFE ENVIRONMENTS. A HEALING AND THUS BECOMING A CATALYST FOR
RECOVERY-ORIENTED ENVIRONMENT IMPROVING HEALTH CARE PRACTICES AND
PROMOTES A SENSE OF CALM AND ENABLING PATIENTS TO TAKE CONTROL OF
CONNECTION TO SURROUNDINGS. THEIR OWN HEALING PROCESS.
PATIENT ENGAGEMENT IS ALSO ESSENTIAL
FOR PATIENT SAFETY, AS FEELING 3.SPECIAL CONSIDERATIONS
CONNECTED TO STAFF CAN PREVENT OR
DEESCALATE PERSONAL CRISES. GIVEN THE RANGE OF SPECIALTIES
THEREFORE, ENVIRONMENTAL DESIGN AND AND AGES IN BEHAVIORAL HEALTH, IT IS
CLINICAL PROCESSES SHOULD FACILITATE CRITICAL TO UNDERSTAND THE UNIQUE
REQUIREMENTS FOR EACH TO PROVIDE A
STAFF INTERACTION AND CONNECTION
SUPPORTIVE ENVIRONMENT. WHILE ADULT
WITH PATIENTS, DISCOURAGE ISOLATION
POPULATIONS MAY REQUIRE A HIGHER
OR DETACHMENT.T DEGREE OF SECURITY, DIFFERENT
REQUIREMENTS SHOULD BE TAKEN INTO
1.BEHAVIORAL HEALTH AND ITS INFLUENCE
ACCOUNT WHEN DESIGNING FOR OTHER
ON DESIGN
POPULATIONS.
THE AHA REPORTS THAT MEDICAL AND
BEHAVIORAL HEALTH COMORBIDITIES A GROWING OLDER POPULATION
POINTS TO INCREASING NUMBERS OF
OFTEN COMPLICATE CARE PROTOCOLS,
NEGATIVELY AFFECT PATIENT OUTCOMES SENIORS WITH DEMENTIA AND MENTAL
ILLNESS. OLDER ADULTS OFTEN ARE
AND INCREASE THE COST OF
CARE. SEVERAL FACTORS ARE THOUGHT BROUGHT TO THE ED FOR CARE,
TO CONTRIBUTE TO RECENT INCREASES IN COMPOUNDING OVERCROWDING.
MEDICAL AND BEHAVIORAL HEALTH BECAUSE OF THEIR AGES, THESE PATIENTS
COMORBIDITY, INCLUDING AN AGING HAVE LONGER LENGTHS OF STAY, TYING UP
POPULATION, THE RISING INCIDENCE OF VALUABLE ED SPACE. ADDITIONALLY,
CHRONIC ILLNESS AND GROWING ISSUES MOST EDS ARE NOT EQUIPPED TO ADDRESS
THE SPECIFIC NEEDS OF THE ELDERLY.
WITH SUBSTANCE ABUSE. WHILE PATIENTS
WITH MEDICAL AND BEHAVIORAL HEALTH GERIATRIC PATIENTS, BECAUSE OF THEIR
COMORBIDITIES ARE SEEN IN ALL SETTINGS MEDICAL AND PHYSICAL LIMITATIONS,
ACROSS THE CARE CONTINUUM, THERE IS REQUIRE CORRIDORS WITH HANDRAILS TO
GROWING REALIZATION THAT CURRENT PROMOTE AMBULATION. LIGHTING AND
INPATIENT ROOM DESIGNS OFTEN FAIL TO FLOORING MATERIALS SHOULD BE
MEET THE UNIQUE NEEDS OF THIS DESIGNED TO ADDRESS LIMITATIONS OF
SIGHT AND TO REDUCE FALLS. THE
POPULATION AND THOSE WHO CARE FOR
TRANSITION BETWEEN MATERIALS AND
THEM.
CONTRAST LEVELS OF FLOORING COLOR
ALSO SHOULD BE CONSIDERED.
FACILITIES FOR CHILDREN AND
ADOLESCENTS SHOULD BE DESIGNED TO
ADDRESS THE UNIQUE ASPECTS OF THIS
AGE RANGE. THEIR PHYSICAL NEEDS AND
COGNITIVE ABILITIES CHANGE OVER TIME,
GIVING THEM DIFFERENT PERSPECTIVES ON
THEIR ENVIRONMENT. WHAT APPEALS TO A
YOUNG CHILD MAY NOT BE ENGAGING
FOR AN ADOLESCENT, YET THE
ENVIRONMENT NEEDS TO RESPOND TO ALL.
RESEARCH HAS SHOWN THAT
POSITIVE DISTRACTIONS CAN ENABLE A
CHILD TO BE MORE RECEPTIVE TO
TREATMENT AND TO BE TREATED WITH
FEWER MEDICATIONS. AS MUCH AS
POSSIBLE, THE ENVIRONMENT SHOULD
STRIVE TO PROVIDE A SENSE OF
NORMALCY. THE PATIENT ROOM BECOMES
A PLACE WHERE A CHILD CAN HAVE MORE
CONTROL OVER THE ENVIRONMENT AND
CAN PERSONALIZE HIS OR HER SPACE.
PLAY SPACES ARE IMPORTANT TOOLS TO
REDUCE TENSION AND ANXIETY. THEY CAN
ALLOW FOR LEARNING AND EXPLORATION
BY ENABLING CHILDREN TO ENGAGE WITH
THEIR ENVIRONMENT.
CARING FOR THE MENTAL HEALTH
OF MILITARY PERSONNEL AND VETERANS
CAN BE WIDE-RANGING. THE ISSUES THEY
FACE INCLUDE PTSD, AS WELL AS
TRAUMATIC BRAIN DISORDERS, DRUG
ADDICTION, PAIN MANAGEMENT, SLEEP
DISORDERS AND SUICIDE. THOUGH PTSD
AND TRAUMATIC BRAIN INJURIES
REPRESENT MAJOR MENTAL HEALTH CARE
NEEDS, PSYCHOLOGICAL ISSUES MORE
GENERALLY GO BEYOND THESE SPECIFIC
PROBLEMS.
MANY VETERANS PERCEIVE
CONSTANT THREATS TO THEMSELVES AND
THEIR FAMILIES, THEREBY RESPONDING
DIFFERENTLY TO ENVIRONMENTAL
CONDITIONS. FOR EXAMPLE, OPEN ATRIUM
SPACES MAY BE CONSIDERED
THREATENING TO A VETERAN WITH
COMBAT EXPERIENCE. THE DEPARTMENT
OF VETERANS AFFAIRS HAS EMBRACED A
PLANE TREE MODEL OF CARE THAT
FOCUSES ON CREATING MORE
WELCOMING AND FAMILY-FRIENDLY
ENVIRONMENTS.
4.THERAPEUTIC ENVIRONMENT
THE CHARACTER OF THE IMMEDIATE
SURROUNDINGS CAN HAVE A PROFOUND
AFFECT ON THE PSYCHE OF A PSYCHIATRIC
PATIENT. THE NEW YORK PSYCHIATRIC
INSTITUTE REPORTS A DRAMATIC DROP IN
THE NUMBER OF PATIENTS WHO NEED TO BE
RESTRAINED SINCE OCCUPYING THEIR NEW
FACILITY WITH ITS BRIGHT OPEN SPACES.
EVERY EFFORT SHOULD BE MADE TO
CREATE A THERAPEUTIC ENVIRONMENT BY:
• USING FAMILIAR AND NON-
INSTITUTIONAL MATERIALS WITH CHEERFUL
AND VARIED COLORS AND TEXTURES,
KEEPING IN MIND THAT SOME COLORS
AND PATTERNS ARE INAPPROPRIATE AND
CAN DISORIENT OLDER IMPAIRED PATIENTS,
OR AGITATE PATIENTS AND STAFF. SEE ALSO
VA INTERIOR DESIGN MANUAL.
• ADMITTING AMPLE NATURAL LIGHT
WHEREVER POSSIBLE.
• PROVIDING A WINDOW FOR EVERY
PATIENT BED, AND VIEWS OF THE
OUTDOORS FROM OTHER SPACES
WHEREVER POSSIBLE. VIEWS OF NATURE
CAN BE RESTORATIVE.
• PROVIDING INPATIENTS WITH DIRECT
AND EASY ACCESS TO CONTROLLED
OUTDOOR AREAS
• PROVIDING ADEQUATE SEPARATION
AND SOUND INSULATION TO PREVENT
CONFIDENTIAL BUT LOUD CONVERSATION
FROM TRAVELING BEYOND CONSULTING
OFFICES AND GROUP THERAPY ROOMS.
• GIVING EACH PATIENT AS MUCH
ACOUSTIC PRIVACY AS POSSIBLE—FROM
NOISES OF OTHER PATIENTS, TOILET NOISES,
MECHANICAL NOISES, ETC.
• GIVING EACH PATIENT AS MUCH
VISUAL PRIVACY, AND CONTROL OVER IT,
AS IS CONSISTENT WITH THE NEED FOR
SUPERVISION.
5.DAYLIGHT, ART, COLOR
THE POSITIVE IMPACT OF DAYLIGHT
HAS BEEN SHOWN IN ONE STUDY TO
REDUCE THE LENGTH OF STAY FOR BIPOLAR
PATIENTS
(WWW.NCBI.NLM.NIH.GOV/PUBMED/8882
914). IN THIS STUDY, 174 PATIENTS WITH
CLINICAL DEPRESSION WERE ASSIGNED TO
EITHER SUNLIT OR DIMLY LIT ROOMS.
PATIENTS IN THE SUNNY ROOMS STAYED AN
AVERAGE OF 16.9 DAYS COMPARED WITH
19.5 DAYS FOR THOSE IN THE DIMLY LIT
ROOMS.
THE COALITION FOR HEALTH
ENVIRONMENTS RESEARCH'S REPORT,
"COLOR IN HEALTHCARE ENVIRONMENTS,"
FOUND THAT COLOR DOES NOT HAVE A
DIRECT IMPACT ON HEALTHCARE
ENVIRONMENTS. DESPITE STUDIES
SHOWING A MOOD-COLOR
ASSOCIATION, THERE IS NO EVIDENCE OF
COLORS BEING EMOTIONAL TRIGGERS.
INDIVIDUAL RESPONSES TO COLOR VARY
AND ARE INFLUENCED BY CULTURE AND
PHYSIOLOGICAL MAKEUP. THE TREND IN
BEHAVIORAL HEALTH DESIGN IS TOWARDS
BRIGHTER, MORE OPTIMISTIC COLOR
PALETTES. STUDIES SHOW THAT REALISTIC
ART CAN REDUCE PATIENT ANXIETY AND
AGITATION IN BEHAVIORAL HEALTH
SETTINGS, WITH MEDICATION DISPENSED
SIGNIFICANTLY LOWER ON DAYS WITH
LANDSCAPE IMAGES. THIS COULD LEAD TO
ANNUAL COST SAVINGS OF $4,000 TO
$27,000. UTILIZING NATURE AS A HEALING
DISTRACTION BENEFITS ALL AGES OF
PATIENTS, AND ACCESSIBLE OUTDOOR
SPACES CAN BE CALMING, POSITIVE, AND
THERAPEUTIC.
6.SAFETY AND SECURITY
THE APPROACH TO SAFETY HAS
SHIFTED FROM TRADITIONAL LOCKED-
DOWN UNITS AND ENCLOSED NURSE
STATIONS WHERE PATIENTS SPEND THE
MAJORITY OF THEIR TIME ALONE IN THEIR
ROOMS. THE FOCUS IS NOW ON
PROVIDING COMFORTABLE
ENVIRONMENTS, WITH REDUCTION OF
BARRIERS AND WITH A MORE RESIDENTIAL
CHARACTER. HOWEVER, THE SAFETY OF
PATIENTS AND STAFF IS THE MOST CRITICAL
ASPECT OF DESIGN.
GENERALLY, ZONES OF RISK, IN
WHICH PATIENTS MAY CAUSE HARM TO
THEMSELVES OR OTHERS, IDENTIFY AN
APPROACH TO ADDRESSING SECURITY
NEEDS BASED UPON AREAS OF GREATEST
CONCERN. ZONES OF HIGH RISK ARE
THOSE IN WHICH PATIENTS ARE ALONE AND
UNSUPERVISED, SUCH AS THE PATIENT
ROOM, TOILET ROOM OR SHOWER, OR A
SECLUSION ROOM.
MEDIUM-RISK ZONES INCLUDE THOSE
IN WHICH PATIENTS MAY HAVE SOME
SUPERVISION, ARE IN SMALL GROUPS AND
ARE RARELY ALONE, SUCH AS IN GROUP
ROOMS, DAY ROOMS, LAUNDRY OR THE
DINING ROOM.
LOW-RISK ZONES ARE THOSE IN
WHICH PATIENTS ARE OBSERVED AND
ACCOMPANIED, SUCH AS IN CORRIDORS,
OR WHERE PATIENTS ARE NOT ALLOWED,
SUCH AS STAFF SPACES, CLEAN AND
SOILED ROOMS AND HOUSEKEEPING
ROOMS.
SUICIDES ARE THE GREATEST
CONCERN AND STUDIES RECOMMEND
THAT STAFF HAVE VISUAL ACCESS TO
PATIENTS AT ALL TIMES TO REDUCE SUCH
INCIDENTS. FOR THE DESIGN OF PATIENT
SPACES, THE OBJECTS IN THE ROOM AND
DESIGN FEATURES, SUCH AS DOOR KNOBS,
SHOWER CURTAINS, WINDOW
TREATMENTS, CEILING AND FIXTURES, NEED
TO BE SPECIFIED TO PREVENT SELF-HARM.
THE POTENTIAL SUICIDE OF PATIENTS
IS A SIGNIFICANT CONCERN IN
PSYCHIATRIC FACILITIES, AND DESIGN
SHOULD ADDRESS THIS AND OTHER SAFETY
AND SECURITY ISSUES. TO ADDRESS THIS,
FACILITIES SHOULD USE TAMPER-PROOF
PLUMBING, ELECTRICAL, AND
MECHANICAL DEVICES, BREAKAWAY
SHOWER-RODS AND BARS, AND ELIMINATE
JUMPING OPPORTUNITIES. STAFF SHOULD
CONTROL ENTRANCES AND EXITS, AND
PATIENT BEDROOM DOORS SHOULD BE
OPENED IN CASE OF EMERGENCY. SPECIAL
FEATURES IN SECLUSION ROOMS SHOULD
ELIMINATE SELF-INJURY OPPORTUNITIES,
AND GRAB BARS AND HANDRAILS SHOULD
BE PLACED CAREFULLY.
SPECIFICATIONS FOR LIGHTING
FIXTURES, CEILING SYSTEMS, MIRRORS, AND
HARDWARE SHOULD BE CONSIDERED
CAREFULLY. FURNITURE SHOULD BE SOLID,
SECURELY MOUNTED, OR BUILT-IN, AND
FURNITURE SHOULD NOT BE TURNED INTO
WEAPONS OR USED TO HIDE
CONTRABAND. STUDIES HAVE SHOWN
THAT SINGLE PATIENT ROOMS CAN
ELIMINATE ROOMMATE ISSUES, ENHANCE
PATIENT PRIVACY, AND PROMOTE A
QUIETER ENVIRONMENT, LEADING TO
BETTER SLEEP AND LOWERED LEVELS OF
AGITATION. SOCIAL ASPECTS ARE
PARTICULARLY IMPORTANT FOR
COUNSELING SPACES, AS COMFORT,
RELATIONSHIPS, AND COMMUNICATION
ARE ESSENTIAL FOR IMPROVING
OUTCOMES.
EVIDENCE-BASED DESIGN
RESEARCHER ROGER S. ULRICH IDENTIFIED
VIOLENCE IN PSYCHIATRIC FACILITIES AS A
SIGNIFICANT AREA OF CONCERN THAT
CAN BE IMPACTED THROUGH THE DESIGN
OF THE FACILITY. THE GOAL OF FACILITY
DESIGN SHOULD BE TO REDUCE STRESS
AND AGGRESSION, AS TYPICAL INPATIENT
UNITS ARE NOT DESIGNED FOR CALM OR
PATIENT COPING. A SWEDISH STUDY
FOUND THAT ARCHITECTURAL FEATURES TO
REDUCE STRESS AND AGGRESSION WERE
INCORPORATED INTO A HOSPITAL'S
DESIGN, INDICATING THAT THE
ENVIRONMENT CAN POSITIVELY INFLUENCE
BEHAVIOR.
7.SUSTAINABILITY
PSYCHIATRIC FACILITIES ARE PUBLIC
BUILDINGS THAT MAY HAVE A SIGNIFICANT
IMPACT ON THE ENVIRONMENT AND
ECONOMY OF THE SURROUNDING
COMMUNITY. AS FACILITIES BUILT FOR
"CARING", IT IS APPROPRIATE THAT THIS
CARING APPROACH EXTEND TO THE
LARGER WORLD AS WELL, AND THAT THEY
BE BUILT AND OPERATED "SUSTAINABLY".
8.BUILDING ATTRIBUTES
THE GOAL IS TO ENHANCE STAFF
EFFICIENCY BY MINIMIZING THE DISTANCE
OF NECESSARY TRAVEL BETWEEN
FREQUENTLY USED SPACES.
THE NURSING STATIONS ON
INPATIENT UNITS SHOULD BE DESIGNED TO
MAXIMIZE THE VISIBILITY OF PATIENT AREAS
FOR EASY VISUAL SUPERVISION.
DESIGNING PATIENT FACILITIES
• ENSURE ALL NECESSARY SPACES ARE
INCLUDED, BUT NO REDUNDANT ONES ARE
LEFT.
• PROVIDE A CENTRAL MEETING AREA OR
LIVING ROOM FOR STAFF AND PATIENTS,
AND SMALLER ROOMS FOR PATIENTS TO
VISIT WITH THEIR FAMILIES.
• USE SUPPORT SPACES EFFICIENTLY,
ALLOWING THEM TO BE SHARED BY
ADJACENT FUNCTIONAL AREAS AND
MULTI-PURPOSE SPACES.
• ALLOW PATIENTS TO CONTROL THEIR
IMMEDIATE ENVIRONMENT, SUCH AS
LIGHTING, RADIO, TV, ETC.
• PROVIDE COMPUTER STATIONS FOR
PATIENT USE WHEN PERMITTED.
• DESIGN FEATURES TO ASSIST PATIENT
ORIENTATION, SUCH AS DIRECT AND
OBVIOUS TRAVEL PATHS, KEY LOCATIONS
FOR LOCKERS AND CALENDARS, AND
AVOIDANCE OF GLARE.
• DESIGN A "WAY-FINDING" PROCESS INTO
EVERY PROJECT TO ENCOURAGE PATIENT'S
SENSE OF COMPETITION.
• PROVIDE EXERCISE EQUIPMENT FOR
PATIENT USE WHEN APPROPRIATE.
MANY PATIENTS' MENTAL HEALTH
FACILITIES ARE SHIFTING TOWARDS SINGLE
OCCUPANCY ROOMS, AS THEY OFFER
MORE FLEXIBILITY, PRIVACY, AND REDUCE
DISTURBANCES AND INCIDENTS. SINGLE
OCCUPANCY ROOMS ARE ALSO MORE
PRIVATE AND QUIETER, WHICH MAY BE
BENEFICIAL FOR SOME PATIENTS.

• PROVIDE ACCESS TO KITCHEN FACILITIES ON STAGE AND OFF-STAGE DESIGN

FOR PATIENT PREPARATION OF SNACKS OR
THE “ON-STAGE, OFF-STAGE”
MEALS.
CONCEPT SEPARATES, WHERE POSSIBLE,
9. OPERATIONAL CONSIDERATION PATIENT PATHWAYS (“ON-STAGE”)
THROUGHOUT THE FACILITY FROM
BRING THE SERVICES TO THE PATIENTS AND
MATERIALS MANAGEMENT, FOOD SERVICE
MAXIMIZE THERAPEUTIC OPPORTUNITIES
AND CLEAN MATERIALS DELIVERY WITHIN
THE GENERAL TREND IS FOR PATIENTS THE FACILITY, AS WELL AS STAFF SUPPORT
IN INPATIENT MENTAL HEALTH SETTINGS TO AREAS (“OFFSTAGE”). THIS MINIMIZES
HAVE SHORTER STAYS, WITH THE AIM OF NOISE, DISRUPTION AND DISTRACTIONS IN
MAXIMIZING TREATMENT SERVICES, AREAS ACTIVELY USED BY PATIENTS.
PATIENT ENGAGEMENT, AND
USE OF TECHNOLOGY
INTERDISCIPLINARY CARE PROCESSES BY
PROVIDING ADEQUATE TREATMENT, TECHNOLOGY IN MENTAL HEALTH
THERAPY, AND STAFF SPACE WHILE FACILITIES ENHANCES SECURITY,
MINIMIZING PATIENT AND SERVICE COMMUNICATION, AND PATIENT CARE. IT
PROVIDER MOVEMENT. INCLUDES DOOR CONTROL, INVENTORY
CONTROL, AND FACILITY MONITORING, AS
CREATE NON-INSTITUTIONAL TREATMENT
WELL AS ACCESS TO UPDATED PATIENT
ENVIRONMENT
TREATMENT DOCUMENTATION.
THE PROGRAM AIMS TO CREATE A "TELEMENTAL HEALTH" REFERS TO REMOTE
MORE FAMILY-FRIENDLY, THERAPEUTIC VISUAL/AUDIO COMMUNICATION
ENVIRONMENT TO REINFORCE RECOVERY BETWEEN PATIENTS AND CARE TEAM
FOCUS AND REDUCE INSTITUTIONAL PROFESSIONALS. PERSONAL COMPUTERS
STIGMA ASSOCIATED WITH MENTAL HEALTH WITH CAMERAS ARE USED FOR INDIVIDUAL
TREATMENT. THE INTERIOR AND EXTERIOR CONSULTATIONS. ALL FACILITIES SHOULD
FEATURES OF MENTAL HEALTH FACILITIES HAVE AUDIO- AND VIDEO-
ARE INCREASINGLY HOME-LIKE, WITH CONFERENCING CAPABILITIES FOR
SINGLE-STORY OR VILLAGE-LIKE FACILITIES, INDIVIDUAL AND GROUP USE. COMPUTER
MULTIPLE EXTERIOR CORRIDORS, AND ACCESS IS CRUCIAL FOR RECOVERY AND
NATURAL LIGHT. THE INTERIOR DESIGN REHABILITATION AND SHOULD BE
INCLUDES SAFE, RESIDENTIAL INCLUDED IN PATIENT, RESIDENTIAL, AND
COMPONENTS WITH IMPROVED OUTPATIENT CARE DESIGNS.
AESTHETICS, VENTILATION, AND NOISE
10.DESIGN VIEW
CONTROL. TRADITIONAL CLOSED AREAS
AND PHYSICAL BARRIERS ARE REPLACED Flexibility
WITH OPEN-CONCEPT NURSING STATIONS.
THE DESIGN OF A MENTAL HEALTH
PRIVATE PATIENT ROOMS AND FACILITY NEEDS TO RESPOND TO
BATHROOMS CHANGING WORKLOADS, CARE
OBJECTIVES, AND TECHNOLOGIES, SUCH
AS WIRELESS TECHNOLOGIES FOR STAFF.
Efficiency
SHARED SUPPORT SPACES LIKE
STORAGE AND UTILITY ROOMS CAN
REDUCE SPACE REQUIREMENTS. MINIMIZE
TRAVEL DISTANCES FOR NURSING STAFF TO
USE SUPPORT SPACES AND PATIENT
ROOMS, PLACING FREQUENTLY USED
AREAS CLOSEST TO THE CENTRAL NURSING
AREA
Patient Needs
PATIENT AND RESIDENT DIGNITY,
RESPECT FOR INDIVIDUALITY, AND PRIVACY
SHOULD BE MAINTAINED WITHOUT
COMPROMISING THE OPERATIONAL
REALITIES OF CLOSE OBSERVATION, SAFETY,
AND SECURITY. PATIENT AND RESIDENT
VULNERABILITY TO STRESS FROM NOISE,
LACK OF PRIVACY, POOR OR INADEQUATE
LIGHTING, VENTILATION AND OTHER
CAUSES, AND THE SUBSEQUENT HARMFUL
EFFECT ON WELLBEING, ARE WELL-KNOWN
AND DOCUMENTED. A KEY
ARCHITECTURAL OBJECTIVE SHOULD BE TO
REDUCE EMPHASIS ON THE INSTITUTIONAL
ASPECTS OF CARE AND TO SURROUND THE
PATIENT WITH FURNITURE, FURNISHINGS,
AND FIXTURES THAT ARE APPROPRIATE
FROM A SAFETY STANDPOINT BUT ARE
MORE RESIDENTIAL IN APPEARANCE.
PROPER PLANNING AND DESIGN SHOULD
APPEAL TO THE SPIRIT AND SENSIBILITIES OF
BOTH PATIENTS AND CARE PROVIDERS. A
SPIRIT OF COMMUNITY SHOULD BE
ENCOURAGED. MENTAL HEALTH FACILITIES
SHOULD BE ENVIRONMENTS OF HEALING
THAT ALLOW THE BUILDING ITSELF TO BE
PART OF THE THERAPEUTIC SETTING AND
PROCESS. THE TECHNICAL REQUIREMENTS
TO OPERATE THE BUILDING SHOULD BE
UNOBTRUSIVE AND INTEGRATED IN A
MANNER TO SUPPORT THIS CONCEPT.
Risk Reduction
THE FOLLOWING FACILITY
DETAILING, PLANNING, AND DESIGN
CONCEPTS SHOULD BE INTEGRATED INTO
THE PROJECT TO REDUCE THE FOLLOWING
RISKS IN MENTAL HEALTH FACILITIES:
Elopements:
1. ALLOWING ONE WAY IN AND OUT
OF CONGREGATE AREAS, AS ALLOWED BY
CODE.
2. COURTYARDS INSTEAD OF
FENCED OUTDOOR AREAS.
3. ELECTRONIC DOOR CONTROLS
FOR EMERGENCY EGRESS AS ALLOWED BY
CODE.
4. SIMPLE CIRCULATION WITH NO
BLIND SPOTS.
5. CASUAL OBSERVATION (VISIBILITY
FROM STAFF OFFICES AND WORK AREAS
THAT ARE NOT DIRECTLY RESPONSIBLE FOR
OBSERVING PATIENTS)
Patient Behavioral Incidents
1. VISIBILITY
2. SPECIFY PRODUCTS FOR THE
FACILITY THAT CANNOT BE USED AS A
WEAPON OR USED IN A SUICIDE ATTEMPT.
3. DESIGN APPROPRIATE ABUSE
RESISTANCE IN AREAS WHERE PATIENTS ARE
LEFT ALONE FOR PERIODS OF TIME.
4. INTEGRATE TECHNOLOGY TO
ASSIST IN OBSERVING AND MAINTAINING
SECURITY INAREAS NOT READILY VISIBLE TO
STAFF.
5. EQUIPMENT, CARTS, AND OTHER
SUPPLIES SHOULD BE ADEQUATELY STORED
IN LOCKED ROOMS. ALCOVES SHOULD
NOT BE USED FOR STORING OR PARKING
OF EQUIPMENT, CARTS AND ASSISTIVE
DEVICES IN CORRIDORS AND OTHER
UNSECURED AREAS.
REDUCING PATIENT/STAFF INJURIES:
 1. APPROPRIATE AND WANT THE SAFEST POSSIBLE
ACCOMMODATIONS FOR DISABLED AND ENVIRONMENT FOR THEIR PATIENTS. OTHER
BARIATRIC PATIENTS. ORGANIZATIONS, DESIRING A MORE
HOME-LIKE AMBIENCE, REQUIRE
2. ELIMINATE BALCONIES,
UPGRADED FINISHES THAT APPEAL TO A
OPENINGS, ETC. THAT WOULD ALLOW A
DIFFERENT AESTHETIC. THESE TWO
PATIENT TO JUMP FROM AN ELEVATED
APPROACHES CAN LEAD TO VERY
PLATFORM.
DIFFERENT DESIGN SOLUTIONS. MOST
3. PATIENT ROOMS AND OTHER HOSPITALS FALL SOMEWHERE BETWEEN THE
AREAS WHERE PATIENT IS ALONE HAVE TWO EXTREMES. OTHER BASIC DIFFERENCES
ENOUGH ABUSE RESISTANCE TO ALLOW BETWEEN ORGANIZATIONS THAT CAN
TIME FOR AN APPROPRIATE RESPONSE AFFECT THEIR DESIGN GOALS ARE THEIR
TEAM TO ARRIVE BEFORE A PATIENT HARMS FUNDING SOURCE (PUBLIC OR PRIVATE)
THEMSELVES OR IS ABLE TO EXIT THE SPACE. AND ORGANIZATIONAL STRUCTURE (NOT-
FOR-PROFIT OR FOR-PROFIT). OTHER
REDUCING PATIENT AND STAFF
VARIABLES THAT INFLUENCE KEY
STRESS:
COMPONENTS OF THE FINAL DESIGN ARE
1. NATURAL LIGHT IN STAFF/PATIENT PATIENTS’ AVERAGE LENGTH OF STAY,
AREAS. DIAGNOSES, ACUITY, AGE, AND CO-
EXISTING MEDICAL CONDITIONS AND
2. NOISE CONTROL.
WHETHER THEY ARE VOLUNTARY
3. OPEN LAYOUT, WITH NO ADMISSIONS OR COMMITTED BY THE
UNNECESSARY BARRIERS BETWEEN STAFF COURT.
AND PATIENT.
SUICIDE PREVENTION AND OTHER
4. SPACE FOR BOTH PATIENTS AND PATIENT AND STAFF SAFETY ISSUES IN
STAFF IS DESIGNED SO NEITHER FEELS PSYCHIATRIC TREATMENT UNITS PRESENT A
TRAPPED OR VULNERABLE; UNIQUE SET OF ISSUES FOR THE
OVERCROWDING IS AVOIDED. DESIGNER,WE HAVE CONTINUED TO VISIT
NEWLY CONSTRUCTED FACILITIES THAT
5. ATTRACTIVE VIEWS OF THE
HAVE SERIOUS DESIGN MISTAKES THAT
EXTERIOR.
MUST BE CORRECTED BEFORE PATIENTS
6. USE OF NATURAL MATERIALS, A CAN BE ADMITTED.
SOOTHING COLOR PALETTE AND
UNIQUE IN OUR EXPERIENCE WAS A
RESIDENTIAL CHARACTER IN THE INTERIOR
REQUEST FROM ONE OF THESE VISITS FROM
DESIGN OF THE FACILITY.
THE HOSPITAL’S INSURANCE COMPANY.
7. FAMILIAR AND HEALING WE FOUND IT INTERESTING THAT THE
ENVIRONMENTS. INSURANCE COMPANY RECOGNIZED
THERE WERE PROBLEMS WITH THIS FACILITY
8. PATIENT AND STAFF AREAS THAT
ALTHOUGH THE DESIGN ARCHITECTS WERE
ALLOW FOR RELAXATION AND
CONFIDENT THEIR DESIGN WAS SAFE.
CONTROLLING ONE’S SOCIAL
ENVIRONMENT (E.G., QUIET ROOMS, STAFF OTHER FACILITIES HAVE SPENT
LOUNGES, SECURE OUTDOOR SPACE). SUBSTANTIAL AMOUNTS OF MONEY
REMODELING EXISTING UNITS WITH
Common Mistakes in Designing
CHANGES THAT NOT ONLY DID NOT
Psychiatric Hospitals
RESOLVE PATIENT AND STAFF SAFETY ISSUES,
SOME ORGANIZATIONS STATE THEY BUT IN SOME CASES ACTUALLY MADE THE
HAVE A VERY LOW TOLERANCE FOR RISK UNITS LESS SAFE.
 CONCLUSION
THE SPECIFIC DESIGN CRITERIA AND
REPUBLIC ACT NO. 11036
APPROACHES DESCRIBED IN THIS CHAPTER
EMPHASIZE ESTABLISHING HEALING AND AN ACT ESTABLISHING A NATIONAL
PATIENT-CENTERED ENVIRONMENTS OF
MENTAL HEALTH POLICY FOR THE PURPOSE
CARE, WHILE PROMOTING THE
OF ENHANCING THE DELIVERY OF
FUNCTIONAL AND OPERATIONAL MISSIONS
INTEGRATED MENTAL HEALTH SERVICES,
OF THE FACILITY.
PROMOTING AND PROTECTING THE
PATIENT AND STAFF SAFETY AND RIGHTS OF PERSONS UTILIZING
SECURITY, INCLUDING PHYSICAL SAFETY PSYCHOSOCIAL HEALTH SERVICES,
AND SECURITY REQUIREMENTS, INFECTION APPROPRIATING FUNDS THEREFOR AND
CONTROL, AND FALL PREVENTION, ARE OTHER PURPOSES
ALSO INTEGRAL COMPONENTS OF MENTAL
HEALTH FACILITY DESIGN. HOWEVER, THESE
APPROACHES SHOULD NOT AND NEED
ADMINISTRATIVE ORDER NO. 2012-0012 –
NOT DETRACT FROM THE HEALING
RULES AND REGULATIONS GOVERNING
ENVIRONMENT. SPECIFIC STRATEGIES AND
THE NEW CLASSIFICATION OF HOSPITAL
DESIGN APPROACHES ARE PROVIDED FOR
AND OTHER HEALTH FACILITIES IN THE
PROMOTING SAFETY AND SECURITY IN THE
PHILIPPINES.
ENVIRONMENT OF CARE WITHOUT
COMPROMISING THE HEALING AND
WELCOMING QUALITY OF THE
ADMINISTRATIVE ORDER NO. 2005-0029 –
ENVIRONMENT.
AMENDMENT TO ADMINISTRATIVE ORDER
NO. 147 S. 2004: AMENDING
ADMINISTRATIVE ORDER NO, 70-A SERIES
Vejle Psychiatric Hospital / Arkitema
2002 RE: REVISED RULES AND
Architects
REGULATIONS GOVERNING THE
REGISTRATION, LICENSURE AND
IN FEBRUARY 2017 A NEW
OPERATION OF HOSPITALS AND OTHER
PSYCHIATRIC HOSPITAL OPENED IN THE
HEALTH FACILITIES IN THE PHILIPPINES
DANISH CITY OF VEJLE. SINCE THE
OPENING, THE HOSPITAL HAS REGISTERED A
50 PERCENT DECREASE IN PHYSICAL
ADMINISTRATIVE ORDER NO. 147 S. 2004
RESTRAINT AND IT IS WIDELY
– AMENDING ADMINISTRATIVE ORDER NO.
ACKNOWLEDGED FOR ITS HEALING
70-A, S. 2002 RE: REVISED RULES AND
ARCHITECTURE. THIS WAS UNDERLINED IN
REGULATIONS GOVERNING THE
MID-JUNE WHEN THE HOSPITAL WON THE
REGISTRATION, LICENSURE AND
MENTAL HEALTH DESIGN CATEGORY AT THE
OPERATION OF HOSPITALS AND OTHER
EUROPEAN HEALTHCARE DESIGN AWARDS
HEALTH FACILITIES IN THE PHILIPPINES.
2018 IN COMPETITION WITH MENTAL
HEALTH BUILDINGS FROM ALL OVER THE
WORLD.
PD ACT NO. 856 CODE ON SANITATION OF
THE PHILIPPINES-

(P.D. 1096) 1 NATIONAL BUILDING CODE

OF THE PHILIPPINES
SAMPLE PSYCHIATRIC HOSPITALS IN THE
PHILIPPINES

Southern Philippines Medical Center, National Center for Mental Health,

Davao City Mandaluyong

Divine Mercy Psychiatric Facility, Makati Medical Center, Makati

Mandaluyong City