HEALTH INPATIENT UNIT

ADULT MENTAL
PLANNING AND DESIGN

assessment, admission
The Adult Acute Mental
Health Inpatient Unit provides suitable
envirnment
accommodation in a safe and therapeutic
and inpatient
for adult mental health patients and statt.

This section is applicable to:

units;
of
-

A stand-alone Adult Acute Mental

Health Inpatient Unit o r group
A dedicated Adult Acute Mental
Health Inpatient Unit within a general
hospital annexe to an Acute
Bedrooms as an
A number of dedicated Patient
Inpatient Unit.

The Operational Policy shall determine the size and function of theAdult Acute
Mental Health Inpatient Unit. An Adult Acute Mental Health Inpatient Unit
shall comply with the requirements outlined for Inpatient Accommodation,
but with the noted modifications or additions in this section.

1. Planning

I.I Planning Models

Some patients may at times exhibit disturbed or high risk behaviour.

Appropriate planning and use of materials (for example safety glass and low
maintenance/resilient surface) can achieve an environment where all
patients
can co-exist with minimal disruption to each other. The building should be
able to accommodate patients of all levels of disturbance without
the characteristics of a jail.
taking on

Externally the principal concept of planning should be to

integrate the new
facility with its surrounds, and with the other
spaces must take into account the
buildings. Planning of external
requirement for
garden associated with the High Dependency area, andprovision
of a secure

for general use.

an
open garden area
The area should be based on 10m2 per person.
 The design of external
spaces, as for the
nature, rather than formal or building, should be domestic in
monumental. They should have the
features following
-The building should consciously have a front and a back;
It should provide
opportunities tor privacy, recreation and self
-

It should provide expression;

opportunities for movement/ambulation both indoors and
outdoors with unobtrusive environmental boundaries
and with
safety provisions; appropriate
Single rooms are recommended.

Rooms may be grouped

into clusters that can be defined for distinct
patient
groups; each cluster of rooms should include a recreational space to allow
for patient therapy and flexibility for variety of
a
patient categories.
Additional considerations include:
Hexibility of space usage through consideration of a range of patient needs
for personal and shared space;
- Clearly defined patient residential areas readily identifiable by patients who

may be disoriented or disturbed;

An effective balance between opportunities for patients' privacy and the
need for staff to observe patient behaviours.

1.2 Functional Areas

Unit will consist of a number of

The Adult Acute Mental Health Inpatient
areas or zones as
follows:
functional
Clerical area;
-

Main Entry/Reception /
- Assessment/Procedural area;
and management area;
Staff Offices/Administrative
Staff Amenities area;
outdoor areas;
Inpatient Area including
secured courtyard.
-
Secure Area including

AREAS
ADMINISTRATION
AND OFFICE

227
 to the
located in, or directly adjacent
Office should be
The Unit Manager's Station. I here should be the capacity
the Staff
area and in particular, office areas. There may be a
Datient administrative and
access to
patient's and the Staff
to control
areas
between interview
communication system
requirement for Secure
a
assistance. There should be provision for a

signal the need for

Station to to house
audio-visual equipment.
Group/View Room
Store as part of the

ADMISSIONS AREA
Admission Office, general purpose
Area will comprise an
The Admissions allied
Room and will be used by nursing,
Room and Examination
Interview Examination and
staff to intervievw
relatives/patients.
medical
health and these a r e a s . Duress
alarms are
will be carried out in
consultation of patients
areas.
in all these
required
from Waiting Area. Noise
Admissions Area should be directly screened
The reduced to a
area should be
between these r o o m s and waiting
transmission
conversations are not
overheard.
minimum so that

DAY ROOMS
for quiet activities
shall be provided, one
At least two separate social spaces
activities.
and one appropriate for noisy

DRUG DISPENSING/STORAGE

Distribution Station shall include

extra provision for security
The Drug
against unauthorised access.

ECT FACILITIES
undertaken in the
ECT (Electroconvulsive Therapy) procedures should be
Day Procedures Unit, ECT Suite or Operating Unit.

EN-SUITEs
Each bed room in the open unit is to have its own en-suite. There
are a

number of contigurations inboard, outboard and between rooms. I he latter

option is preferred as it maximises bed room use and patient observation.

228
The inboard op option provides
caution for the privacy and
a narrow
following
reasons: dignity but
should be used
-

passage may be created with

at the
may limit observat
blind spots may be
through the door visionentrance to the bed room
that
eated inside the bed panel;
-
staff attending any emergencies in the
room,facilitate
room must
enter in
barricading,
The door to en-suites should single file.
when open or open a way to
in
With inboard avoid
creating a blind spot
-

ensuites
a m door to be tied enable the en-suite door and bed
ta be lockable
together to create a barricade.
by staff when needed and En-suite doors are
have a privacy latch
opened by staff in an
emergency. that can be

ENTRY AREAS
The Entrance provides direct access to the Unit for
for admission arriving either with patients referred
relatives,
police via
ambulance and or
alternative access to the Unit for
patients ariving via the Emergency Unit of
the main hospital. Provision should be made for a
gun safe that allows Police
to deposit firearms when they are in
attendance at the Inpatient Unit.

The Emergency Entrance should be capable of direct approach by ambulance

police vehicles and should have sufficient shelter to allow transfer of patients
in shelter from the elements. The Entrance should have an airlock capable of
accepting an ambulance trolley with ease.

There should be provision for an intercom between the Emergency Entrance

and the Staff Station. The Entrance Area zone of the building should attempt
to break down the "threshold" feeling of many institutional buildings, while

maintaining a sense of direction to the approach.

GROUP THERAPY AREA

be combined with the quiet
pace for group therapy shall be provided.This may minimum
added and
additional 0.7m/patient is
a
Day Room provided that an activities.
is available for therapy
room area of 2 Im2, enclosed for privacy,

229
 DEPENDENCY/SECLUSIONIINTENSIVE CARRE
lockable and
HIGH must be
SECUREAREA Care bed
rooms

to blockade
patient attempt
Dependency/lntensive

The High corridor

should a
from the positioned to
ensure
opened panel,
able to be D o o r s require
a viewing
an a r m
the r o o m . cannot put
themselves in removed, a patient
broken o r
be
the glass
that should lock.
the door
and operate
through
low dependency
accessible to both the
bed rooms may be Dependency/Intensive

High Dependency
sections of the Unit.
The High
dependency Room.
and high access to a
Seclusion

will require
Care Areas
remainder of
from the
of secure separation
should be capable female patients.
for male and
zones
These areas
There should
be defined
the Unit.
should back
client and staff safety purposes,
for
Dependency Unit, of the interior
of the High
The High easy Visibility
Staff Station to
ensure
Patients
onto the emergency.
in times of patient
Dependency
Unit and rapid response

to a secured
courtyard.
access

in this area will require

INPATIENTAREAS

- Single-Bed Rooms:
adds to the perception of
with high ceilings
external outlook coupled should be
An treatment. There
c o n t r i b u t i o n to
and is a positive doors and the
ight and space any
created by open
particularly
spots" in the should be able to be
rooms
no "blind
from the outside. Doors
rooms should be key-lockable blockade him/herself
in
to
from the corridor
should patient attempt
a
will
opened unit bed rooms and
are optional in open
the Door viewing panels
room.
light Over
on
Policy. Low wattage night
the Unit's Operational of
be dependent observations

for use by staff when carrying

out night time
the bed space rooms is required
Acoustic treatment to bed
should be considered.
patients rooms. Whilst
transference of noise
between adjoining bed
minimise
to consideration should
be preferred for ambiance,
domestic-style beds may to low
health and safety issues of
staff attending
be given to occupational
height beds

230
- Two-Bed Rooms:
Two-bed rooms may bei included in the
General Inpatient Zone providing an
tion for sharing, or
proviae accommodation of mother and child. They
a
hawever, be restrictive, resuiting in the
can

der to
disruptive movement of patients
to other rooms in
accommodate new admissions and
not recommended.
are
generally

OCCUPATIONAL THERAPY AREA

Fach Adult Acute Mental health
Inpatient Unit shall cotain 1.5m2. of separate
cnace per patient tor Occupational I herapy with a minimum total area of 20m
The space shall include provisions for:
-Hand-washing
Workbenches;
- Storage:

- Displays.

Occupational I herapy Areas may serve more than one Inpatient Unit.

1.3 Functional Relationships

The Adult Acute Mental health Inpatient Unit should be located with ready

Emergency Unit, Main Entry and service and support

areas
access to the
Linen Handling, Waste
including Catering Unit, Cleaning/ Housekeeping,
Management and Supply Unit.

2. Design

2.1 Environmental Considerations

ACOUSTICS
Acoustic treatment should be applied to the following areas
dining and activities
areas;

-Day Areas such as patient living,dependency.intensive care and seclusion rooms

-

Patient Bed Rooms including high

231
 Consulting Rooms;
Admission Areas.

nooms, return air grilles should be acoustically treated

In acoustically treated
to avoid transter of conversations to adjacent areas. Door grilles to these

areas should be avoided.

WINDOWS AND GLAZING

Wherever possible, the use of natural light is to be maximised. For glazing,
the impact resistance of the glass from toughest at lower level to
graduate
weakest at high level. In areas where damage to glass may be expected, avoid
pane sizes. Smaller panes are inherently stronger for a given thickness
larger
than larger panes. Where toughened glass is used it should be treated with
a protective film to ensure glas is held together when broken. Laminated/
toughened glasS of various thicknesses should be installed dependent
patient injury building damage. All windows and
upon the likelihood of
or

observation panels shall be glazed with safety glass. Polycarbonate is not

recommended due to surface scratching which will reduce visibility over time.
Where windows are openable, effective security teatures such as narrow
windows that will not allow patient escape, shall be provided. Locks, under
the control of staff, shall be fitted.

2.2 Space Standards and Components

SIZE OF UNIT
The schedule of accommodation has been developed for typical 20- and 30-

Bed Adult Acute Mental Health Inpatient Units.

according to the
For alternative configurations, allocate space for key areas

following guide:
Lounge/dining/activity areas -

Secure Observation 7.5m per person;

Lounge/dining/activity areas General 5.5m per person;
Secure 1Om per person;
Outdoor areas (courtyards and terraces)
-

Outdoor areas (courtyards and terraces) General 5m per person;

-
-
 - Courtyard nd Terrace -

Consultation rooms I minimum area

per 5beds -20m
ion/assessment ooms -2
Examinatio

per unit.
2.3 Safety and
Security
ity within the
facility and the
patier tant
movement
requires careful surrounding outdoor area,
deo surveillanc
nce and
motion consideration
sensors.
and related
may include use of
to
communty and domestic service The
security
deliveries should also beof access for staff,
The design should assist statf to considered.
natients by allowing or carry out their duties
restricting access to areas
safely and to supervise
consistent with patient needs/skills. in a manner
which is
Staff should be
movements and activities as able to
naturally as possible, whenever view patient
necessary.
Controlled and/or concealed access will be
of functional areas. required as an option in a number
Functionally the only difference between
closed (locked) area in their design should be an
open and a
the provision controls
of
over the flow to, from and
throughout the
facility. Such controls should be
as unobtrusive as
possible. A communication system which enables staff to
signal for assistance from other staff should be included.

2.4 Finishes

The aesthetics are to be warm and user-friendly wherever possible.

2.5 Fixtures and Fittings

Generally, all fixings should
Fixtures and fittings should be safe and durable.
be heavy duty, concealed, and where exposed, tamperproof.

curtain tracks, bathroom fittings,

should be plastic
Fittings, including hooks,
strain of not more than 5kgs.
where possible, and have a breaking

233
 a n d Desig
Unit P l a n n i n g
Health
Inpatient
Mental
Adult

o r to inflict
used either as a weapon
avoid the potential to be
Fittings should should be rigidly fixed to
m i r r o r s and signage
Paintings,
personal damage.
fixings.
walls with tamperproof and
o r other appropriate impact-resistant
Mirrors shall be of safetyY glass to prevent
shall be fully glued to a backing
shatterproof
construction. They
loose fragments of broken glass.
availability of
avoided in patient
curtains should be
blinds, Venetian blinds and
Holland potential for
tracks, pelmets and other fittings that provide
areas. Curtain that the
avoided o r designed so
themselves should be
patients to hang
potential is removed.

2.6 Building Services

sink wastes which may be easily

Avoid exposed services,
for example,

damaged.
vents
detectors and air-conditioning
smoke detectors, thermal
Light fittings, Seclusion Rooms, should be
vandal-
to higher dependent areas, particularly
a patient's weight.
proof and incapable of supporting

3. Functional Relationship Diagram

Functional Relationship Diagram (Facing
Adult Mental Health Inpatient Unit

Image).
 Inpatient Beds Inpatient Beds

Secure Courtyard Secure Courtyard

Lounge/ Lounge/
Dining Dining/
Activity Activity

Generalare High Dependency

Inpatient Beds
npatient Beds

Staff Station
CIRCULATION
C I R C U L A T I O N

Support

General Care
Support
High Dependeney
lnpatient Beds
Inpatient Beds

Support
Therapy Areas

Seclusion
Secure Courtyard
Waiting Areas
Reception

Direct Access for Police

From Main Entry Assisted Admissions
Admissions Emergency

Back-to-Back Unit as Required

235
 T

TI

236

Architects:
weinbrenner.single.arabzadeh,
architektenwerkgemeinschaft
Location: Stuttgart, Germany
Site area:
10,130m2
Construction area:
6.000m2
Project year: 2011
Photographs
Courtesy of architect
e Plan
Centre for Mental Health
in Stuttgart
Two compact buildings with inner mental health. The chosen form fulfills the
Courtyards complement the existing Ccomplex functional requirements through
building and realign the site to the north the double-station with the sharing of
and the east. Ihe narrowness of the site iS Common areas.
compensated by the adjacent open fields
with panoramic view and landscape in the All double-stations function independently
north and the east. and can also be conducted as closed
stations as needed with the user-friendly
The selected arrangement of the two and well-oriented accessibility of the
building structures allows a "free flow" of circulation systems.
the landscape. One can sense the exist1ng
topography through thee entrance hall with The exterior of the hospital should match
the natural terrain from the south to the with the existing site on the one hand and on
north. The division of the building mass the other hand it should be distinguishable
leads to a centrepiece that is based on the as an individual and separate building. The
centre houses 242
existing structure. beds, a school for patients,
a 24-bed
outpatient clinic at the department
wo angularly arranged cubic compact of child and adolescent psychiatry and 20
structures form the new centre for places in the rehabilitation centre.
237
3
 b u i l d i n g

of
view
Tior
courtyard
t lrendering
u n t n e r

and
detal

le

Section

239
A
 LE

tTiLIUI. hL
:1eliflI.TILT.TETF
e

Floor Plan
 area
station
ft staft s Working
of
eriorview
d room

LE

EEI

EELLJIHAD
PIPTITITTTE

Floor Plan
WW
 OO
N

O
O

O
iO
O O
O
O
O
o o O-

e o &oo
o

O Site Plan

Wier 2
a volume that
The intention is to realise
Stichting Altrecht has commissioned VMX limit
is compact as possible, in order to
design the accommodation for
as
Architects to woodland.
on the surrounding
impact
24 delinquent, lightly mentally handicapped been resolved as an
behavioural In this way, it has
with heavy adjacent
persons extruded four-storey baton, lying
disturbances (sglvg+). The project is a part
road.
institutions that wil and parallel to the
of a series of five similar
locations throughout circulation
be built in separate On the two upper floors
under a
years,
the country in the coming runs centrally along its length, allowing
scheme headed "De Borg". accommodation to be arranged along
the
Architects:* lower floor, a public
VMX Architects outer walls. On the
the wooded grounds leads to the=
Wier2 is to be built on route through the building
Location: Dolder. The project
of Altrecht in Den and on the firs
Den Dolder Germany accommodation
covered main entrance,
a quiet the volume
ramp passes through
create
aims to floor, a
Building area: with a close
relation
inhabitants inte
for this target group, for the
3.600m2 An existing providing access
nature. either side of th
to the surrounding two secured gardens
Project year: "Boerhaave" has already
2010 therapy complex, likewise makes
use building.
been built nearby and
Photographs: of the harmonious setting
Courtesy of VMX Architects
zilding hides The patients' rooms are situated in four aggressive behaviour. The façades of the
landscapes living units on the first and second floor building will be covered with sprayed
detail
with a view to the forest. The ground floor concrete, which will provide the durable
contains spaces, the
office sous-terrain finish. It will furthermore facilitate the
therapy rooms and a gym. chiselled shape, whilst creating a solid,
homogeneous volume which will have the
An important requirement from the client appearance, with time, of a mossy rock
was that damage-resistant materials must ying in the forest.
be used, given the patients sometimes
 State Reference Centre
for the Mental Care

The urban conditions of the site

are at the
day centre, and a research area with
origin of the proposal of an autonomous labs
classrooms, administration and auditorium.
system tilted towards the strict north
orientation, the protection against noise The recovery of the "mat
and direct views. The
compactness of the mechanism
building
allows embracing the
building gets smoothed with its porosity, complexity of the assistance and education
luminosity and interior fluidity, and also
programme in
with its relation with the
a
self-dependent organism
"chitects: surrounding and to respond to the topographic and
in Architects
garden that becomes a second ground floor urban requirements. Its entailment to a
thanks to the manipulation of the levels.
cation: rigorous constructive system, made out
The institutional and reference character of white concrete 2.40-metre modules,
encia, Spain of the centre is underlined
Iding area: by the precision controls the cost and contributes to the
of the structural system, metric
62m2 (60cm institutional character of the centre. As
for pavements, concrete forms, wood in the mat
ject year: building, its compactness is
panels...) and the limited use of materials. attenuated by the interior spatiality, the
shaping of the voids, and in this case
tographs: by
The building has apart from the own the presence of nature and the conviviality
eg0o Opazo services, a care area for 20 persons and between the common and exterior spaces.

251
Elevations and Sections