1

KINJAL SHAH
H AV E N I N T H E M E A D O W S
SCAN THIS QR CODE TO
KNOW MORE ABOUT ME

EMPATHY. STRATEGY. DESIGN

Haven in the meadows | 1
 ACKNOWLEDGEMENT Kirk Hamilton, Ph.D., FAIA, FACHA, FCCM, EDAC
(Committee Chair)
I would like to thank my parents for their unwavering support through out my
architecture education. I am grateful for their sacrifices, so that I could do my post
graduation in United States. While doing this project, I started giving importance
to my own mental health, there was a time where I was struggling to cope up
with loneliness and grief from continous family health issues. But one thing I
learnt is that caring about mental health should be priority. That’s how I came so Zhipeng Lu, Ph.D., LEED AP BD+C
far and found contentment about my achievements. (Committee Member)
I have always been in awe with Prof. Kirk Hamilton’s work, his research work
and professional experience guided me in understanding the plausibility of my
project. I am honored to be your student. I have always been inspired to push
my limits and think out of box through out my grad life because of Prof. Lu. I
have always seen him as a cheerleader and motivator. For Carly, I would say
she has been such a great contributor to this project through her knowledge of
psychology. Though my second year was bit different, but Prof. Ray made sure
Carly McCord, Ph.D.
that our in studio and virtual studios were the most learning experiences. His (Committee Member)
attention to detail and motivation to be “over achievers” always kept us on toes
to be the best.

I would like to thank our alumni Hilary Bales and Tim Rommel for helping me
with the industry knowledge and giving me time throughout the project. Last but
not the least, I couldn’t have enjoyed my graduate life without my friends and
classmates. Ray Holliday, AIA, ASLA, APA, ASID, LI
(Studio Professor)

2 | Haven in the meadows

TABLE OF CONTENTS

01 INTRODUCTION
1.1 ABSTRACT
1.2 PROBLEM STATEMENT 04 INVESTIGATIONS
4.1 HUMAN EXPERIENCE
4.2 CONNECTION TO PLACE

02 OBJECTIVE & PURPOSE

2.1 PROJECT PLAN
2.2 FRAMING THE ISSUES 05 SITE & FACILITY
5.1 SITE
5.2 PROGRAM
5.3 PROCESS WORK
5.4 FINAL DESIGN
5.5 DETAILS

03 COMPLEXITY OF BEHAVIORAL HEALTH

3.1 WHAT IS BEHAVIORAL HEALTH?
3.2 TREATMENT AND WELLNESS 06 CONCLUSION

4 | Haven in the meadows Haven in the meadows | 5

6 | Haven in the meadows Haven in the meadows | 7
 01
PERSONAL SPACE

8 | Haven in the meadows

INTRODUCTION Haven in the meadows | 9
 1.1 ABSTRACT
This project began with an investigation about creating an environment that
facilitate the healing process for mental health patients. The state of mental
hospitals in current scenario lacks the continnum of care. To fill this gap of
care, this project caters to the need of behavioral health facilities from acute
care to residential treatment.

In today’s scenario, the need for mental health services have increased. The
attention to overall health can only be achieved if both physical and mental
health are taken care. There are many counties in United States which lack
basic mental health services. This project is located in Larimer County, Colo-
rado, the county lacked any behavioral health services for its residents. Hence
the need for facility was evident. With this intention, the “Larimer County Com-
munity Master Plan for Behavioral Health: Changing the Paradigm” was cre-
ated to comprehensively evaluate the behavioral health service needs; identify
gaps in the continuum of treatment and support services and outline a Five
Year Strategic Plan to address them.

The project consists of 16- bed unit cluster each for acute mental health pa-
tients, substance use, outpatient facility and residential treatment. The de-
sign is based on principles of biophilic design and salutogenic approach. The
research carried out for this project aims to identify the design guidelines to
explore how architecture can be of aid in relieving psychological disorders by
promoting a eunoia state of mind. The planning process was more focussed
on creating secured and non secured environments without a physical barrier
and facilitating spacial orientation in more natural way.

The investigation ahead will act as toolbox for designing behavioral health fa-
cilities with new outlook. The environment around the facility gives the patient
a sense of coherence and choice control leading to feel more like home. At
the end, the architecture needs to be make a person believe that this mental
and behavioral disorder can be controlled and this place will heal them. Hence
the facility is a “ Haven” for all the patients to give them new life purpose
and the zen to feel “Eunoia”.

10 | Haven in the meadows Haven in the meadows | 11

 1.2 PROBLEM STATEMENT
Stigma associated with mental health is very common. Apprehension of treat-
ment is the fear of mental health services, which avoids patients to take treat-
ment. The fear of stigma is more associated with facility itself, the mental
health hospitals are symbolized more of an incarcenation centers rather than
a healing place. Despite all improvements introduced to mental health facili-
ties, they are still labelled and stigmatised. Mental health facilities are often
associated with a penitentiary, an asylum, or a substitute of a panopticon. The
stereotypical image of a psychiatric hospital is inseparably linked with this
object.

The architecture of psychiatric hospitals is sometimes referred to as the archi-

tecture of madness. That applies to both the architectural form and the quality
of the built environment. Very often, architecture not only fails to guarantee
appropriate conditions of stay, but it is also inadequate for its function. Some
mental health facilities were not adapted to the changing requirements for
healthcare facilities, and in some cases they were not designed to accommo-
date people. That creates inappropriate spatial and functional connections and
results in inability to introduce required changes, provide particular technical
conditions, and create a suitable healing environment for patients.

The task of reducing mental health stigma associated with the place (archi-
tecture) necessitates considering a wide range of diverse issues. To meet
standards of quality for mental health facilities, the space need to ensure the
protection of in-patients’ dignity and privacy while maintaining security, as
well as appropriate humanisation of hospital space with respect for local and
cultural determinants. This allows focusing on the patients and facilitates their
engagement on a personal and social level while appropriate therapy is being
carried out.

The enviroment should be welcoming so that care can be given without any
judgements. Mental health architecture should be neither the architecture
of madness nor the architecture of stigma, but an architecture of therapy,
humanity, empathy and safety.

12 | Haven in the meadows Haven in the meadows | 13

 CHOICES
02
CONTROL

CHOICE OF SOCIAL INTERACTIONS

14 | Haven in the meadows

OBJECTIVE &PURPOSE
Haven in the meadows | 15

2.2 PROJECT PLAN
Purpose & Aim:
The purpose of the project is to examine how design can improve the mental
state of patients or aid the process of healing. The focus will be on how spatial
planning and certain design features can be used to improve the state of well
being.
Facility as a hub for eunoia:
The state of mental wellness just doesn’t come with the temporary care it
needs different levels of care at different stages of mental and behavioral
state. Hence to fulfil all these stages a continuum of care needs to be es-
tablished. This project will cater to all those needs by providing a complete
care from inpatient care to residential supportive treatment along with social
interactive activities.
Users:
The facility will have patients with mental and substance abuse disorders. Its
an adult only behavioral health facility with services ranging from outpatient
detox care and emergency department. The community will use be part of this
facility for group therapy and well-being.
The plan:
A regional health facility which is like a hub for Larimer County ensure seam-
less care coordination and fill in critical gaps in the continuum of care for those
experiencing crisis and substance use disorder issues. A place where educa-
tion, health& wellness and early identification and intervention is encouraged.
Design strategies include outdoor courtyards, views to nature, ample of day-
light, form that creates passive secured barried for spaces that needs security
The program has various common spaces for small and large groups. The
inpatient units have combination single and double occupancy which helps in
staff efficiency and also fulfils the cost restrains for the per bed.
16 | Haven in the meadows
Can architecture
heal?
How can people be bought
together in a pleasant
environment and engage
in beneficial interactions?
What are the relevant
design strategies
employed in creating a
healing environment?
Who is it for?
2.1 FRAMING THE ISSUES
A happy human
Behavioral health issues are complex diseases that require individualized
treatment approaches tailored to the person’s severity of disease and specific
health care needs, just like any other chronic health condition. This requires a
system of care that has a range of levels and types of care available to appro-
priately meet the needs of patients accessing the system. When appropriate
levels of care are not available, individuals often go untreated or receive limit-
ed or fragmented treatment, resulting in the utilization of more costly services
in hospitals, emergency departments, crisis care, and the County jail.
Understanding the need for passive privacy:
Every patient has been diagnosed with mental health disorder or substance Needs passive privacy
abuse. These patients have tendency for harmful behavior like suicide and
self harm. For this purpose, a continous supervision is needed to track their
behavior, this supervision needs to be indirect and open so that patients and
staff are comfortable with each other.
Understanding the need to reduce aggression:
Most patients feel that mental health facility can harm them and hence they
become aggressive. The environment needs to portray calm and positive el-
ements which helps in reducing aggression. Thus, the harmful behavior is
controlled.
Understanding the need for psychological sensories : Needs emotional comfort
The space around them can give behavioral cues, these cues should help
in giving comfort, social choice and control. The environment needs to be
designed to give positive distractions which would help in diverting the mind
from illness to wellness.
Understanding the need for safety :
The harmful behavior can not only affect fellow patients but also to staff. Hence
the environment needs to display safe materials and furniture so that objects
for violence is reduced. The balance between patient and staff common spac-
es should be ligature resistant and free from any display of inappropriate art.
Needs a safe place to heal
Haven in the meadows | 17
 ORGANIZATION
03
CHAOS

SPATIAL ORGANIZATION MERGING WITH HUMAN SENSORIES

COMPLEXITY OF
BEHAVIORAL HEALTH
 3.1 BEHAVIORAL HEALTH vs
MENTAL HEALTH
The term “behavioral health” originated just a few decades ago, but the mean-
ing has changed over time. There are several important differences between
mental and behavioral health.
Mental health is a state of wellbeing in which an individual can cope with
stress and be a productive member of the community. Your biology, habits and
psychological condition all impact and are impacted by your mental health.
Depression, generalized anxiety disorder, bipolar disorder and schizophrenia
are all examples of mental health disorders that are not directly a result of be-
haviors. While some mental health challenges are related to behavioral health,
others are caused by genetics or brain chemistry.
Behavioral health is the way your habits impact your mental and physical
wellbeing. That includes factors like eating and drinking habits, exercise, and
addictive behavior patterns. Substance abuse, eating disorders, gambling and
sex addiction are all examples of behavioral health disorders. These condi-
tions stem from maladaptive behaviors and may require behavioral health
services to overcome.
People who have substance use disorders as well as mental health disorders
are diagnosed as having co-occurring disorders, or dual disorders. This is
also sometimes called a dual diagnosis.
20 | Haven in the meadows
1in 5 adults in America experience a mental illness
1in 3 adults in America suffering from mental illness do
not undergo treatment
Mental illness Addiction
Approximately 10.2 million adults have co-occuring
mental health and addiction disorders
3.2 TREATMENT AND WELLNESS
Psychotherapy
1. Psychotherapy - Its also known as “talk therapy” has to be specially tailored
around the patient’s anxieties in order to be effective. Cognitive Behavioral
therapy (CBT) is a type of psychotherapy that encourage the patients to find
different ways of thinking, behaving, and reacting to anxiety-producing and
fearful situations. CBT is composed of cognitive therapy which is used to
identify the problems and exposure therapy which represents confronting the
fears, CBT is done individually or with a group of people and usually requires
some “homework” to be done.
Support Group
2. Self help or Support Groups - Some people will benefit from these group
meetings as sharing their problems and achievements can be deeply satisfying
. Group meetings, support groups and chat rooms, even talking to trusted
friends can have a beneficial impact on one’s mental health.
3. Dialectal Behavioral Therapy (DBT) - DBT can be adapted for many substance
abuse cases, but mainly focuses on treating severe personality disorders,
such as borderline personality disorder. DBT works to reduce cravings, help Dialectal Behavioral Therapy (DBT)
patients avoid situations or opportunities to relapse, assist in giving up actions
that reinforce substance use, and learn healthy coping skills.
4. Stress Management Techniques (SMT)- SMT and meditation can help
people with anxiety disorders, calm themselves and may enhance the effects
of therapy.
Stress Management Techniques (SMT)
Haven in the meadows | 21
 04
ACCESS TO NATURE

INVESTIGATIONS
 4.1 CASE STUDY
Location : Cincinnati
Area: 93,890 sq.ft
Beds: 64 single inpatient
rooms, 16 bed division
Lindner Center of Hope
Location : Tampere, Finland
Area: 122,917 sq.ft
Beds: 180 single inpatient
rooms, 15 bed division
Tampere Psychiatric Clinic
Location : Vejle, Denmark
Area: 353,473 sq.ft
Beds: 91 single inpatient
rooms, 15 bed division
Vejle Psychiatric Hospital
24 | Haven in the meadows
Form Inspirations Taken:
-Spine connecting wings.
-Connection to nature.
-Downtown/Neighborhood/ Hous-
ing Concept.
-Secured Courtyard between the
building.
-Rooms facing the woodlands.
Form Inspirations Taken:
-Multiple Courtyards with different
uses
-Connection to nature
-Distinct Entries to create sense of
arrival
-Window Style.
-Rooms facing the courtyards.
Form Inspirations Taken:
-Multiple Courtyards
-Square shaped units
-Downtown/Neighborhood/ Hous-
ing Concept.
-Rooms facing the courtyards and
woodlands.
4.2 RESEARCH
Evidence- Based Design:
A deliberate attempt to base the building design decisions on the best available research evidence with the goal of improving outcomes
and of continuing to monitor the success or failure for subsequent decision making.
RESEARCH GOAL 1 RESEARCH GOAL 2 RESEARCH GOAL 3
Improving the patient safety Improving other patient outcomes Improving staff outcomes through
through environmental measures through environmental measures environmental measures
-Reducing Patient injury and co- -Considering Patient’s social -Decreasing staff injuries
morbidity choices -Decreasing the staff stress
-Reducing medical errors -Reducing depression -Improving patient-staff
-Reducing Healthcare- acquired and anxiety communication
infections -Reducing spatial disorientation
-Improving patient privacy
Salutogenesis:
A holistic approach towards healing process in all dimensions of a person – body, mind, social and spirit.To achieve this four factors of
environment are considered:
Internal Environment Behavioral Environment External Environment
Healing intention and personal Healthy lifestyles and integrative Healing spaces with ecological
wholeness are crucial for signifi- care to promote the healing sustainability and resilience for
cant impact on health creation & process supporting the healing process
wellbeing
- Creating an environment where - Creating spaces that match with - Creating an outdoor environment
mind, body and spirit is connected an individuals person choices and which helps in the healing process
to the environment. creates an improved lifestyle. by horticulture therapy or group
therapy
Haven in the meadows | 25
 4.3 CONNECTION TO PLACE 4.4 DESIGN GUIDELINES

To translate the research into a built environment, a visioning process is determined to conclude the design strategies. This visioning
process aims in imagining an environment that could check all the research goals and creates a salutogenic environment.

How do we want the How should patients feel How should staff feel
facility to look and feel? about the facility? about the facility?

- Natural Daylight - Welcoming - Staff respite spaces

- Calming colors - Comfortable and quiet - Safety for harmful behavior of
- Antiligature - One stop all care levels patients
- Modern yet agrarian architecture - Multiple options to select their - Easy to supervise spaces
- Single floor facility immediate environment - Access to Daylight
- Interior courtyards - Space for family and alone time - Close proximity to support spaces
- Recreational spaces

Conceptual ideas to define the well- being of spatial relations

Combination of Social choice Access to nature

Visibility from staff
Double and Single How will we know that
control area to patient room and daylight
this environment will
inpatient rooms
work?
Patient Patient Social Communications with
sleep Falls support patient and staff

Patient Patient Patient Length of

stress satisfaction Privacy stay

Hospital Staff Staff

Medical
acquired stress satisfaction
errors
infections

Staff
Aggression Depression effectiveness

Flexible and Behavior Anti- ligature furniture and Safety for staff and patients
adaptable rooms finishes

Defining the design strategies (blue boxes) in relation to patient/staff outcomes (grey boxes). Understanding the Behavioral Psychology and defining the space relation

26 | Haven in the meadows Haven in the meadows | 27

 05
HOME-LIKE ENVIRONMENT

SITE & FACILITY

 5.1 SITE LOCATION & SITE

ANALYSIS 1

National and local statistics indicate that one in five Americans has a mental
health issue, and depression is the leading cause of disability worldwide. It
is estimated that 41,000 Larimer County residents have a mental illness and
30,000 have a substance abuse disorder (some residents have both conditions).
Larimer County holds one of the highest suicide rates in the country. While the Land use context around the site Satellite site image
County has many solid services, it does not currently have the continuum of
care needed to meet differing severity and scope of needs. It also lacks a
centralized facility where care can be effectively and efficiently managed in
a continuum of care. A 2015 study of Larimer County Jail frequent utilizers
(those booked four or more times in a year) found that 9 in 10 had substance
use problems and half had a mental illness.

Natural surrounding context Site view 1

Transportation Connectivity Site view 2

30 | Haven in the meadows Haven in the meadows | 31

 5.2 PROGRAM 5.3 PROCESS WORK

Diagram showing levels of care

DESIGN OPTION 1 DESIGN OPTION 2 DESIGN OPTION 3

PROS: PROS: PROS:
• Central axis form creates a seperation • The courtards and spine work good for • Dynamic form
between secured and non-secured creating secured corridors. • Housing plan with central supervision of
environments. • V-shaped housing unit gives hill view to nurse station
• The courtyards with the spine facilitates the maximum room
spatial orientation
• Single- story form
CONS: CONS: CONS:
• The rectangular form of housing units creates • Open plan in housing not achieved. • Spatial orientation not formed.
negative spaces for supervision from staff • V-shape creates negative spaces for • All the inpatient room don’t get hill views.
area. supervision from staff area. • Two-storeyed
• All the inpatient room don’t get hill views . • Two-storeyed. • Courtyard not secured well
• Long corridors. • Home-like form not achieved.
• No passive seperation of secured and non-
secured environments.
Diagram showing flow of patient through secured and non-secured environments
MODIFIED FURTHER REJECTED REJECTED
32 | Haven in the meadows Haven in the meadows | 33
A HUB FOR EUNOIA
 PART- DIAGRAMS SITE PLAN

Divide & Add Intersect & Elevate

Divide the mass and add the secured courtyard in between Intersect the mass between the other mass to elevate the entry

Split & Connect Rotate and Merge

Split the housing and connect with transparent spine Rotate the housing blocks and Merge the views in two categories

Downtown Housing Neighborhood

36 | Haven in the meadows Haven in the meadows | 37

 5.4 FINAL DESIGN N

DOWNTOWN
Total NSF NTG Departmental
GF

Sta 1. Care Coordination 940 25% 1175

15 ff/S
En ervic 2. Triage + Secure Entry 4446 30% 2691
try e
3. Administration 1730 25% 2162.5
10 6 4. Food Services 2305 15% 2650.75
9
5. Pharmacy 350 15% 3847.9
11 6. Staff Entry 2070 30% 2691
7 7. Building Support 3346 15% 3847.9

14
NEIGHBOURHOOD
4 Total NSF NTG Departmental
GF
5
8. Community Hall (on mezzanine level) 1510 30% 1963
y 9. Large Group therapy room 510 30% 663
10 Entr
blic 10. Courtyards 2000 30% 2600
Pu
11. Family Visitation 460 30% 598

13 HOUSING
1 Total NSF NTG Departmental
GF

12. Medically Managed Withdrawal Unit 4724 40% 6613.6

10 13. Crisis Stabilization Unit 4724 40% 6613.6
14. Clinically Managed Withdrawal Unit 4724 40% 6613.6
15. Intensive Residential Treatment Unit 4434 40% 6207.6

12

2 Total Departmental Gross Square Feet 52,531.85

Building Gross Factore 15%

Triage Entry Total Building Gross Square Feet 60,411.63

0 10 20 25

38 | Haven in the meadows Haven in the meadows | 39

WELCOMING ENVIRONMENT

Access to spaces for public,
staff and outpatients
DOWNTOWN
De-institutionalized & Orderly & organized Visual and Physical
Homelike environment Environment
1. Entrance lobby 10. Housekeeping
2. Pharmacy 11. Power Room
3. Cafe 12. Water pump room
4. Kitchen 13. Boiler Room
5. Storage 14. Loading/Unloading
6. Soiled 15. Staff locker/change
7. Clean and store 16. Medical gas storage
access to nature
8. Sorting 17. Trash
9. Mechanical Room

POND GARDEN

ST
AF
FE
NT
RY
15

SE
16

RV
IC
EE
17

NT
RY
15
14
9

OR
ID
RR
13

CO
PUBLIC USE 11

D
RE
COURTYARD

CU
SE
UN
10
12
5

6 8

1
GROUP THERAPY

Y
TR
COURTYARD
Waiting area view facing towards group therapy courtyard with ample of daylight

EN
IC
BL
and visual access to nature for calming environment

PU
SECURED ENTRY N

0 10 20 25
42 | Haven in the meadows Haven in the meadows | 43
 NEIGHBOURHOOD

Access to spaces for public, Social Dynamics: Analogy to Everyday Life: Edge Conditions: Visual and Physical
staff and patients from CMW Choice of Large or private Connection to housing Group closer to non secure and access to nature
unit and IRT unit space for family visit transitional housing units

1. Waiting Area
2. Family Visitation Room
3. Large Activity Room

POND GARDEN

GA RDS
3

EN
RD
ND A
PO TOW
2

2
RY
ENT
2 IRT

2 PUBLIC USE
COURTYARD

RY
ENT 1
CMV

R INE
OO N
FL ZZA
ME
TO
GROUP THERAPY
COURTYARD
View of Group therapy courtyard between the downtown and housing units, the
group therapy courtyards are meant for casual counselling between the patient and
care giver. An open outdoor space helps in reducing the anxiety and aggression.
N

0 10 20 25
44 | Haven in the meadows Haven in the meadows | 45
 HOUSING
1. Secured Vestibule 9. Nourishment
2. Single Patient Room 10. Medication
3. Double Patient Room 11. Storage
4. Quiet Room 12. Day Room
13. Exam room/
5. Nurse Station
Counsellingroom
Access to spaces for staff Social Dynamics: Analogy to Everyday Life: Edge Conditions: 6. Small Activity Room
14. Storage
and patients from CMW unit Choice of Single or double Front yard and Backyard Small Alcoves between rooms. 7. Detox Bays – Open and 15. Staff lounge
and IRT unit patient rooms concept, Open plan Choice of informal space – quiet Enclosed
16. Seclusion room
room, seating and activity area. 8. Clean/soiled Utility

2
3
POND GARDEN

2
8
8 13

6 16 12 14 15

9 10

2
3

RY
ENT
IRT
7
PUBLIC USE
2
COURTYARD

3
16

8 Y
TR
3 8 9 EN
2 CMW

4 12 5 1

13 10 3

3 14

3
2
GROUP THERAPY
COURTYARD
View of Group therapy courtyard between the downtown and housing units, the 15
group therapy courtyards are meant for casual counselling between the patient and
care giver. An open outdoor space helps in reducing the anxiety and aggression.
N

0 10 20 25
46 | Haven in the meadows Haven in the meadows | 47
 Physical Activity Room Conference Conference Waiting Area
Room Room

Large Group Therapy Family Family Family Family Family Waiting Area Reception Lobby
Visitation Visitation Visitation Visitation Visitation
Room Room Room Room Room

SECTION
FACADE DESIGN
 Downtown MECHANICAL
ROOM JANITOR

SECURED ENTRY 8

Administrative and Staff support 9

10 7
TOILET TOILET
1. Waiting Area 11
6
2. Administrative office reception
VIEW TO
3. Conference Room HILLS SHRUBS S
Access to spaces for,staff and out- De-institutionalized & 4. Workstations
FOR
PRIVACY
6

11
patients and emergency patients for Homelike environment
GROUP THERAPY
E
5. Clinical Director COURTYARD
4
CSU and MMW 6. Executive Director C
13 13 13

7. Facility Director
8. Medical Director U
9. Storage
R
10. Pantry CSU ENTRY
11. Consult Rooms E

Orderly & organized Visual and Physical

Care Coordination D 3
2
Environment access to nature
12

12. Workstations HORTICULTURE

13.Consult rooms SHRUBS
THERAPY

FOR ENTRY
VIEW TO

Secure Entry
PRIVACY TO UNITS OUTPATIENT 1
HILLS TRIAGE
ENTRY
C
14. Sally Port
O
15. Legal processing 36 35
16.Seclusion Room R 25
5 17. Seclusion Toilet LAWN FOR
PHYSICAL
18. Debug/furnace room ACTIVITY R 29

3 19. Storage
I 23 23
20. Secured Lobby 24 24
30 31
4 21. Transport lounge D
22. Secured Entrance Vestibule 24
VIEW TO
HILLS O 24

2 SHRUBS
HORTICULTURE
27

Triage
FOR
THERAPY
PRIVACY R 24
24
32 32
1
23. Consult/ Hot Office Room 24 33 34
24

24. Exam Room

25. MH observation room ENTRY
TO UNITS
23 23

26. Bull pen space MMW ENTRY 26

27. Nurse Station 29

28. Patient Effects Storage 18 19

29. Toilet 20 21

Patient flow 30. Documentation 17

sequence diagram
31. Medication
32. Clean/soiled Utility 16 15 14 22

1 2 3 4 5 33. Nourishment
Involuntary After legal
34. PPE storage VIEW TO INVOLUNTARY PATIENT ENTRY
Patient is kept Then patient is Once the HILLS
patient in seclusion processing done examined as per diagnosis is 35. Lab
arrives room till the by staff, the their condition in done, patient 36. Reception
through sally point stable patient is kept exam room is tranferred to N
port first and in observation housing unit
screened. room
0 10 20 25
52 | Haven in the meadows Haven in the meadows | 53
 Housing
1. Secured Vestibule GROUP THERAPY
COURTYARD
2. Single Patient Room
3. Double Patient Room
4. Quiet Room 14

5. Nurse Station
VIEW TO 2
Access to spaces for staff and Social Dynamics: Analogy to Everyday Life: 6. Seclusion Room HILLS 3 SHRUBS
FOR
patients from MMW unit and Choice of Single or double Front yard and Backyard 7. Exam Room PRIVACY
S
CSU unit patient rooms, group seating concept. Open plan for better 8. Clean/soiled Utility 3
GROUP THERAPY
11 COURTYARD
options visibility 9. Nourishment E
10. Medication 7
15 3
C
11. Storage 2

12. Day Room U

13. Staff Lounge 4 12 5 1
14. Small Activity Room R
Edge Conditions: Visual and Physical
Small Alcoves between rooms. access to nature 15. Documentation 2 E
Choice of informal space – quiet room, 3
10 9

seating area and activity area. 8 D

HORTICULTURE
6 3 THERAPY
SHRUBS
FOR
Alcove space for VIEW TO
3
PRIVACY
HILLS
single socializing 2

zone outside
room 13 C
Dedicated staff
space away from O
Quiet room with patients for staff LAWN FOR
360 degree view respite PHYSICAL R
ACTIVITY
to hills
R
Flexible and
13
adaptable rooms I
Curved edges with views to hills 2 D
to smoothen the and courtyard VIEW TO
HILLS
3
SHRUBS HORTICULTURE
walls and calmer FOR
PRIVACY
THERAPY O
aesthetics 6
3

R
10
Breaking the 3 8 9

stereotypical sally 2

Bigger windows port entrances

for more daylight with wide space 4
12
5 1 MMW ENTRY

in room around and

ample of daylight
& nature 2

15 3
7

3 11
Choice of small Open floor plan
activity space for allows more
people with acute visibility from VIEW TO 2
3

mental issues nurse station to HILLS

rooms and milieu 14

spaces N

0 10 20 25
54 | Haven in the meadows Haven in the meadows | 55
Quiet Day Room Secured Glass Corridor Exam Room Triage Bull Pen
Room Entry Space

SECTION
MILIEAU SPACE
 INPATIENT ROOM DESIGN

Double inpatient room view

Single inpatient room view

60 | Haven in the meadows Haven in the meadows | 61

MILIEAU SPACE
THERAPEUTIC LANDSCAPE
A TRANQUIL END TO THE JOURNEY.....
 5.5 DETAILS WALL DETAIL

Zinc roof
cladding
Roof Level
35' - 0"

PRODUCED BY AN AUTODESK STUDENT VERSION

PRODUCED BY AN AUTODESK STUDENT VERSION
Douglas Fir
beam system

Combination of
Douglas fir col-
umns 4”x6” and Level 2
15' - 0"
12” dia columns
for larger span
support
14
13
11
10
9 11'
8

B
6'-11"
7
6
5
4 1'
3 4'-1"
2
7"
1
Level 1
Walls made of 06' - 0"
limestone and
Level 0
wooden panel 3'-8"

0' -0"
cladding

BUILDING ENVELOPE AND STRUCTURE

68 | Haven in the meadows Haven in the meadows | 69
 DETAIL STAIRCASE DETAIL
Zinc roof panel PRODUCED BY AN AUTODESK STUDENT VERSION

Snap-clad clip with

fasteners
5/8” plywood
In order to maintain the sloping roofs in central axis mass, Displacement sheathing M.S Pipe section
handrail
2” retainer strip
Ventilation is used to have all the mechanical ventilation from plinth and Douglas fir beam
ground. DV provides better acoustics and better air quality than mixed- Roof Level
35' - 0"
M.S Pipe section

flow systems. Mixed-flow systems tend to be louder because of the higher Fascia guardrail
4"

PRODUCED BY AN AUTODESK STUDENT VERSION

PRODUCED BY AN AUTODESK STUDENT VERSION
velocity required from diffusers. Lower supply velocity at diffusers means Metal gutter strap

14
Metal gutter
lower pressure drop, smaller fans, and less energy consumption. Fan
3'-2"

PRODUCED BY AN AUTODESK STUDENT VERSION

Railing screwed

PRODUCED BY AN AUTODESK STUDENT VERSION

horsepower reductions can be attributed to less air movement. to slab

13
Timber connector
DV can use fewer diffusers and less ductwork. DV introduces supply air
Metal frame nailed
at the playing/teaching floor, improving indoor air quality by reducing
Level 2

11
15' - 0"

to connector 2” thk
Skit -proof tile
accumulation of CO2, odor, and indoor contaminants. DV has a higher Double pane glazing
14
13
11
10
9 11'

ventilation effectiveness than mixed-flow systems.If 100% outdoor air and

8
7

10
6
6'-11"
5
4 1'
3 4'-1"

exhaust is used, the heat gain due to the lights and roof can be eliminated
2
7"
1
Level 1

DETAIL AT ‘A’
06' - 0"

Plaster
from building cooling loads.
3'-8" Level 0

9
0' -0"

RCC Slab
1
Double pane glazing PRODUCED BY AN AUTODESK STUDENT VERSION
KEY SECTION 8 PART SECTION
PRODUCED BY AN AUTODESK STUDENT VERSION
PRODUCED BY AN AUTODESK STUDENT VERSION

7
6
Tile floor skirting

6'-11"
5
PRODUCED BY AN AUTODESK STUDENT VERSION

RCC Slab 14
Rigid insulation
13 14
M.S Pipe section
handrail
4 1'

PRODUCED BY AN AUTODESK STUDENT VERSION

11

PRODUCED BY AN AUTODESK STUDENT VERSION

3
13 15

4'-1"

PRODUCED BY AN AUTODESK STUDENT VERSION

PRODUCED BY AN AUTODESK STUDENT VERSION
12 16
M.S Pipe section
Screwed metal frame 11
guardrail

10
17

2
to rigid insulation with
10
silicon membrane 18

Source: www.bsria .com

7"
support 9 19

DETAIL AT ‘B’
8 20

9 1 1

18'-6"
7 21 2” thk

8
6
Skit -proof tile
5
4'-1"
3
7
RCC Slab 4

Screwed metal frame 3

1'
to rigid insulation with 2
6
2

silicon membrane 1
7"

1'
support
6'-11" UP 1/2” nosing 1
5
Rigid insulation
4'-1"
8'-10"

3'-5"

4 1'
RCC bund wall 3'-4" Stringer

Plaster
Steel edging

HVAC return duct open- 14 3 4'-1"

ing out from plinth

13 STAIRCASE PLAN
PRODUCED BY AN AUTODESK STUDENT VERSION
PART SECTION 2
PRODUCED BY AN AUTODESK STUDENT VERSION

7"
70 | Haven in the meadows
DETAIL AT ‘C’
11 1 Haven in the meadows | 71
 RODUCED
PRODUCEDBY
STUDENTVERSIO
VERSI
Zinc Roof Panel
WALL DETAIL
AUTODESKSTUDENT
Douglas fir beam

BYAN
Snap - clad clip
with fasteners A

ANAUTODESK
5/8” plywood

AUTODESKSTUDENT
sheathing
ANAUTODESK

Fascia nailer

PRODUCED BY AN AUTODESK STUDENT VERSION

Metal gutter

STUDENT VERSION
Metal gutter
Wooden Rafter

STUDENT
70"
BYAN

160"
70"

PRODUCED
VERSION

160"
Wooden battens
BY

Wooden decking
PRODUCED
PRODUCED

VERSION
L -angle to hold

VERSION
the layers
PRODUCED BY AN AUTODESK STUDENT

DETAIL AT ‘A’

BY AN AUTODESK STUDENT VERSION

Double-pane fixed
glass window
Metal frame
Granite sill
Metal lath fastened
through insulation

BY AN AUTODESK
Gypsum board

70"

160"
Rigid insulation

Wooden Sheathing
B

50"
50"
Water-proofing

70"
membrane

160"
Limestone cladding

DETAIL AT ‘B’
Limestone cladding
Skirting
Wooden flooring

Metal Fastener

50"
RCC Slab

PRODUCED
Cardboard box for
earth insulation
Metal angle clip
C
Brick Cladding
RCC Bund Wall
Support

50"
Steel edging
Water-proofing
membrane

DETAIL AT ‘C’
72 | Haven in the meadows Haven in the meadows | 73
 06
A PLACE TO FEEL NORMAL

CONCLUSION
This project de-stigmatizes the way we look at
mental health care, a place where all the levels of
care given and designing the spaces not just focuses
on all the users.  The concept of patient-centered
care has taught us, such as incorporating natural
light, ensuring views of nature, providing access to
the outdoors, offering a choice of one activity room or
another, and offering a choice of where to sit in public
rooms, such as by a window or in a quiet alcove.
When people have a choice of where to be, they
are less likely to become dangerous to themselves
or others. The design strategies act as a toolbox for
future projects and it will change the state of facility
across the world. At the end, this project solves the
question-

“How can architecture for behavioral health

envisioned in future?”
How do you feel about this?
 GLOSSARY
1. Addiction or Substance Use Disorder – a primary,
chronic disease of brain reward, motivation, memory,
and related circuitry. Dysfunction in these circuits
leads to characteristic biological, psychological, social,
and spiritual manifestations. This is reflected in an
individual pathologically pursuing reward and/or relief
by substance use and other behaviors.
2. Behavioral Health – includes not only ways of
promoting well-being by preventing or intervening
in mental illness such as depression or anxiety, but also
has as an aim preventing or intervening in alcohol/
substance abuse or other addictions.
3. Continuum of Care (Levels) – a system that guides
and tracks patients over time through a comprehensive
array of health services spanning all levels and intensity
of care.
4. Co-Occurring Disorder (Dual Diagnosis or Co-existing)
– refers to an individual who has a co-existing mental
illness and a substance-use disorder, or another
combination of disorders (such as mental disorders
and intellectual disability).
5. Crisis Stabilization Unit (CSU) – within a behavioral
health facility, a level of care and services provided
for individuals to receive crisis stabilization services
in a safe, structured setting.
6. Clinically-Monitored Withdrawal Management (CMWM)
-This unit provides short-term (3-5 days total) care for
patients who mostly require supervision while detoxing.
This unit complies with the ASAM criteria 3.2WM.
This unit has fewer bedrooms but includes smaller
spaces for detox similar to a “Sobering Unit.”
7. Eunoia - It means “well mind” or “beautiful thinking”.
It is a rarely used medical term referring to a state of
normal mental health.
8. Intensive Residential Treatment (IRT)- This unit provides
up to 30 days total inpatient care for patients with
mental health diagnoses. This unit complies with the
ASAM criteria 3.5 and is intended to be “soft locked”.
If a patient has dual diagnoses (mental health and
substance abuse disorder), they may stay in the IRT up to
90 days.
9.Medically-Monitored Withdrawal Management
(MMWM)- This unit provides short-term (less than 5 days
total) inpatient care for patients requiring medical
assistance in their detox efforts (that is, using drugs to
aid in detox with a severe alcohol, benzodiazapine, or
heroin/other opiates addiction).
10. Mental Health – It includes our emotional,
psychological, and social well-being. It affects how we
think, feel, and act. It also helps determine how we
handle stress, relate to others, and make choices
11. Triage – The process of determining the priority of
patients’ treatments based on the severity of their
conditions.1
12. Wellness – The quality or state of being healthy in
body and mind, especially as the result of deliberate
effort.
REFERENCES
[1] Shepley, M.M., & Pasha, S. (2017). Design for Mental
and Behavioral Health (1st ed.). Routledge. https://doi.
org/10.4324/9781315646916
[2] Sachs NA, Shepley MM, Peditto K, Hankinson
MT, Smith K, Giebink B, Thompson T. Evaluation of a
Mental and Behavioral Health Patient Room Mockup
at a VA Facility. HERD. 2020 Apr;13(2):46-67. doi:
10.1177/1937586719856349. Epub 2019 Jul 15. PMID:
31304785.
[3] Sakallaris, B. R., MacAllister, L., Voss, M., Smith, K., &
Jonas, W. B. (2015). Optimal healing environments. Global
advances in health and medicine,  4(3), 40–45. https://
doi.org/10.7453/gahmj.2015.043
[4] How Kiyoshi Izumi Built the Psych Ward of the Future
by Dropping Acid. (n.d.). Retrieved September 21, 2020,
from https://www.vice.com/en_us/article/ypp8ax/how-
kiyoshi-izumi-built-the-psych-ward-of-the-future-by-
dropping-acid-5886b6e98308bb45d5e26ae6
[5] Mazuch, R. (2017). Salutogenic and Biophilic Design
as Therapeutic Approaches to Sustainable Architecture.
Architectural Design, 87(2), 42-47. doi:10.1002/ad.2151
[6] Ulrich, Roger. (2008). Biophilic theory and research for
healthcare design. Biophilic Design: The Theory, Science,
and Practice of Bringing Buildings to Life. 87-106.
[7] Mazzi, A. (2020). Toward a Unified Language (and
Application) of Salutogenic Design: An Opinion Paper.
HERD: Health Environments Research & Design Journal.
https://doi.org/10.1177/1937586720967347
[8] Ulrich, Roger. (1984). View Through a Window May
Influence Recovery from Surgery. Science (New York,
N.Y.). 224. 420-1. 10.1126/science.6143402.
[9] Marcus, C. C., & Sachs, N. A. (2014). Therapeutic
landscapes: An evidence-based approach to designing
healing gardens and restorative outdoor spaces.
[10] Shepley, M. M., Pasha, S., Ferguson, P., Huffcut, J. C.,
Kiyokawa, G., & Martere, J. (2013). Design
research and behavioral health facilities. The Center
for Health Design.
[11] Shepley, M. M., Watson, A., Pitts, F., Garrity, A.,
Spelman, E., Fronsman, A., & Kelkar, J. (2017). Mental
and behavioral health settings: Importance and
effectiveness of environmental qualities and features as
perceived by staff. Journal of Environmental Psychology,
50, 37–50
[12] Ulrich, R. S., Bogren, L., Gardiner, S. K., & Lundin, S.
(2018). Psychiatric ward design can reduce aggressive
behavior. Journal of Environmental Psychology, 57, 53–
66. doi:10.1016/j.jenvp.2018.05.002
[13] Behavioral Health Services (Behavioral Health).
(1970, May 01). Retrieved from https://www.larimer.org/
behavioralhealth
82 | Haven in the meadows