A PROPOSED MENTAL WELLNESS FACILITY IN CEBU CITY: A

BIOPHILIC DESIGN EXPERIENCE

_________________________________________

An Undergraduate Thesis

Presented to the School of Architecture, Fine Arts and Design

of the University of San Carlos

_________________________________________

In Partial Fulfillment

of the Requirements for the Degree

Bachelor of Science in Architecture

_______________________________________

INAJADA, ANGEL ERNESTINE S.

JULY 2018
 Table of Contents
Chapter One: Introduction ...................................................................................... 1

1.1 Rationale of the Study .......................................................................................... 2

1.2 Statement of the Problem ..................................................................................... 4

1.3 Significance of the Study ..................................................................................... 5

1.4 Scope and Limitation ........................................................................................... 6

1.5 Theoretical Background ....................................................................................... 7

1.6 Conceptual Framework ........................................................................................ 8

1.7 Definition of Terms .............................................................................................. 9

Chapter Two: Review of Related Literature ................................................... 10

2.1 Review of Related Literature ............................................................................. 10

2.1.1 Mental Health ................................................................................................... 10

2.1.2 Mental Health Issues in the Philippines and in Cebu ....................................... 17

2.1.3 Addressing Mental Health ................................................................................ 19

2.1.4 Conventional Treatment ................................................................................... 20

2.1.5 Complementary Treatments ............................................................................. 22

2.1.6 Biophilic Design ............................................................................................... 30

2.2 Review of Related Structures ............................................................................. 38

2.2.1 Wellnessland Wholeness Center ...................................................................... 38

 2.2.2. The Farm at San Benito ................................................................................... 39

2.2.3 Sodra Alvsborg Hospital – Psychiatric Department ......................................... 40

2.2.4 Khoo Teck Puat Hospital .................................................................................. 40

2.2.5 Ostra Hospital ................................................................................................... 41

Chapter Three: Research Methodology ............................................................ 42

3.1 Research Framework .......................................................................................... 43

3.2 Research Environment ....................................................................................... 44

3.3 Research Respondents ........................................................................................ 44

3.4Research Instruments .......................................................................................... 45

3.5 Gathering of Data ............................................................................................... 45

3.6 Treatment of Data............................................................................................... 46

Chapter Four: Data and Analysis ........................................................................ 48

4.1 Client .................................................................................................................. 48

4.1.1 Vision and Mission ........................................................................................... 48

4.2 Users ................................................................................................................... 49

4.3 Related Laws and Design Standards .................................................................. 50

4.3.1 Time Saver Standards for Building Types ....................................................... 50

4.3.2 1996 Revised Zoning Ordinance of the City of of Cebu .................................. 53

4.3.3 RA 1378 Revised National Plumbing Code of the Philippines ........................ 54

4.3.4 National Building Code of the Philippines ....................................................... 55

 4.3.5 Accessibility Law ............................................................................................. 61

4.3.6 National Fire Code............................................................................................ 64

4.4 Site Selection and Site Analysis .................................................................... 65

4.4.1 Site Selection .................................................................................................... 65

4.4.2. Multicriteria Analysis ...................................................................................... 70

4.4.3. Macro Site Analysis......................................................................................... 72

4.4.4. Micro Site Analysis ......................................................................................... 81

4.5 Space Programming ...................................................................................... 90

4.5.1. Space Proximity Matrix ................................................................................... 91

4.5.2. Bubble Diagrams ............................................................................................. 93

4.5.3 Space Programing Sheets ................................................................................. 98

Chapter Five: Findings, Conclusions and Recommendations ................. 120

5.1 Architectural Program ...................................................................................... 120

5.1.2 Tabulation and Sizing of Spaces .................................................................... 122

5.2 Conclusions ...................................................................................................... 124

5.3 Recommendations ............................................................................................ 129

References ...................................................................................................................... 130

Appendices ..................................................................................................................... 133

 Table of Figures
Figure 1: Conceptual Framework .................................................................................. 8

Figure 2: Reception Area of Wellnessland Wholeness Center .................................... 38

Figure 3: Meditation Garden of Wellnessland Wholeness Center............................... 38

Figure 4: The Farm at San Benito ................................................................................ 39

Figure 5: Sodra Alvsborg Hospital .............................................................................. 40

Figure 6: Khoo Teck Puat Hospital ............................................................................. 40

Figure 7: Ostra Hospital ............................................................................................... 41

Figure 8: Research Framework .................................................................................... 43

Figure 9: Map of Cebu Province .................................................................................. 44

Figure 10: Site A .......................................................................................................... 69

Figure 11: Site B .......................................................................................................... 69

Figure 12: Site C .......................................................................................................... 69

Figure 13: Cebu City Zoning Map ............................................................................... 72

Figure 14: Slope Map................................................................................................... 73

Figure 15: Land Forms Map ........................................................................................ 74

Figure 16: Road Network Map .................................................................................... 75

Figure 17: Transit Map ................................................................................................ 76

Figure 18: Movement Network .................................................................................... 77

Figure 19: Major Establishments within a 500 m radius ............................................. 78

Figure 20: Average Temperature and Precipitation ..................................................... 79

Figure 21: Sunny, Cloudy and Precipitation Days....................................................... 80

Figure 22: The Site....................................................................................................... 81

Figure 23: View of site from Molave St. ..................................................................... 81

Figure 24: View of site from Molave St. ..................................................................... 81

Figure 25: Lot Plan ...................................................................................................... 82

Figure 26: Sun Path Diagram ....................................................................................... 83

Figure 27: Wind Rose Diagram ................................................................................... 84

Figure 28: Land Adjacency Map ................................................................................. 85

Figure 29: Movement Network .................................................................................... 85

Figure 30: Contour Map............................................................................................... 86

Figure 31: Longitudinal Section .................................................................................. 86

Figure 32: Latitudinal Section ..................................................................................... 86

Figure 33: Existing Vegetation .................................................................................... 87

Figure 35: Acacia and Bamboo trees in the site .......................................................... 87

Figure 34: Mahogany tree in the site ........................................................................... 87

Figure 36: Molave tree in the site ................................................................................ 87

Figure 37: Overlay Map ............................................................................................... 88

Figure 38: Major Zones Bubble Diagram .................................................................... 93

Figure 39: Administrative Area Bubble Diagram ........................................................ 94

Figure 40: Mental Health Clinic Bubble Diagram ....................................................... 95

Figure 41: Wellness Center Bubble Diagram .............................................................. 96

Figure 43: Operations and Maintenance Zone Bubble Diagram ................................. 97

Figure 42: Human Resource Zone Bubble Diagram.................................................... 97

Figure 44: Experience of Biophilic Design ............................................................... 121

 List of Tables

Table 1: List of Users ................................................................................................... 49

Table 2: Minimum Required Number of Restroom Plumbing Fixtures ...................... 54

Table 3: Minimum Required Setbacks ........................................................................ 56

Table 4: Multicriteria Analysis .................................................................................... 71

Table 5: Lot Description .............................................................................................. 82

Table 6: SWOT Analysis ............................................................................................. 89

Table 7: List and Sizing of Spaces ............................................................................. 123

 Chapter One
Introduction

Mental health is no different than physical health: every person has it, and we all

need to take care of it. In the recent years, there has been a strong advocacy for mental

health awareness and taking care of our mental health. In the modern world where we

live in, there could be several causes that could lead to mental health issues such as stress

from school/work, relationship problems, trauma and etc. These mental health issues

include anxiety, depression, stress, mood disorder, and addiction disorder (Benjamin

Sadock, 2015). The body, being one functioning mechanism, works as one - an ailment of

the mental health could affect the whole system (Greenberg, 2012). In addressing mental

health, it is important to consider aspects of the physical, emotional and spiritual

wellbeing as a whole. While medication and psychotherapy are modern practices in

psychiatric care, complementary therapies alongside treatments given by the doctors

allow patients to take on wellness practices while being educated on what natural

methods they can practice (Inger Burnett-Zeigler, 2016). These complementary therapies

can also be used as treatment not only for mental health, but for promoting wellness in

general.

Providing a facility that accommodates to the need of both conventional

psychiatric care and complementary approaches goes beyond merely the allocation of

spaces. The built environment and its effects on human health and psychology should be

considered in order to provide for optimum care. In this proposal, this will be achieved

through an architecture that applies Biophilic Design.

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1.1 Rationale of the Study

Most of us in an urban setting live fast-paced lives. We have become a goal-driven

nation, living in a pressure-filled world, that to be able to live up to the collective

demands of our work, study and relationships, we sacrifice even our health. As a result,

we are often left overwhelmed, pressured and stressed. It is true that we are constantly

evolving and that our environment has drastically changed but with this, mental health

has become one of the least priorities. Mental health is not a matter that involves only

people with diagnosed mental health conditions. Mental health is the state of well-being

in which an individual realizes his or her potential, can cope with the normal stresses of

life, can work fruitfully and productively and is able to contribute to the community

(WHO, 2014). It is more than just the absence of disorders or disabilities.

The Philippines, despite being known to many as one of the happiest countries in

the world, it is both surprising and ironic to know that the country has the highest number

of depressed people in Southeast Asia according to the National Statistics Office last

2016. The same report ranked mental illnesses third in the most common forms of

disability in the country, after visual and hearing disabilities. Last 2015, the Global

Burden of Disease Study reported that 3.3 million Filipinos suffer from depressive

disorders. Alarmingly, Cebu has the highest number of suicide cases in the country, said

Dr. Renato Obra, psychiatric chief of VSMMC. Vicente Sotto Memorial Medical Center

treats someone who attempted suicide almost every day, said Dr. Obra. What‟s even

worse is that these are only reported cases of people suffering from severe cases of

mental illnesses. The stigma and the lack of knowledge regarding the issue lead to the

underreporting of such cases.

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 Last 2017, the House of Representatives approved House Bill No. 6452 otherwise

known as the “Comprehensive Mental Health Act of 2017” which seeks to establish a

mental health policy to enhance the delivery of mental health services in our country,

receiving an overwhelming unanimous approval from 223 lawmakers in the hopes of

giving the best mental health care to all Filipinos.

Section 2 of the bill states that mental health services shall make available best

possible measures to prevent mental disorders and promote mental well-being. It also

states that mental health services shall promote the basic right to health of Filipinos with

due attention to psychological well-being. Section 6 states that every person with a

mental illness shall have access to treatment which holistically addresses the care through

a multidisciplinary care plan approach.

There is a need to be able to promote and practice mental health care that is not

only meant to treat an illness but prevent and promote as well. Our mental health is

interconnected to all our systems. The problem of the mind is a problem of the body

physically, spiritually, emotionally and socially, said Dr. Glenda Basubas, who has been

a practicing psychiatrist for more than 20 years. Because of this interrelation, psychiatric

care is optimized through an integration of both medication and mind-body treatments in

a setting that promotes healing. This is made possible through Biophilic Design.

Biophilia or the inclination of humans to nature is the sole concept applied in the design

of the proposal because of the healing benefits that one receives from the natural

environment which resonates with mental health care.

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1.2 Statement of the Problem

The practice of good mental health shouldn‟t be synonymous to merely treating

mental health disorders. As the interrelation of the mind, body and spirit are vital,

addressing mental health should take on a broader approach. Increasingly, mental health

care has aimed at wellness and prevention at primary settings (Lake, 2017).

Conventional care in psychiatry includes medication and psychotherapy which both have

proven its efficacy over the years. However, accumulating research findings also provide

evidence in both the safety and efficacy of selected complementary treatments for mental

health disorders such as mind-body approaches, lifestyle modifications, selected natural

products, and etc. (Lake, 2017). A study conducted by the Academy of Psychosomatic

Medicine showed that 43% of mental health patients also are using complementary

therapies as supplements to conventional treatment (Alexander Bystrisky, 2014).

Integrating both conventional and complementary care therefore takes on an approach

that allows improvements in mental, physical, emotional, cognitive, social and spiritual

wellbeing. In addressing this need, the environment plays a vital role. As humans benefit

from contact with nature, the facility should be able to consciously integrate nature in the

design. Creating a setting that incorporates this concept to the built environment is called

“Biophilic Design”.

1.2.3 Main Objective

The main problem of the study is to be able to provide the best architectural solution

for a mental health facility that promotes mental wellness through integration of

conventional psychiatric care and complementary treatments, applying the principles

of Biophilic Design.

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The Researcher aims to achieve the following sub-objectives:

1. Provide needed spaces in a mental wellness facility that offers outpatient care

services and wellness treatments in addressing mental health.

2. Apply Biophilic Design principles for optimum mental health.

3. Provide a design that follows technical and planning standards, as well as existing

laws that need to be implemented so the design proposal may be deemed highly

effective and functional.

1.3 Significance of the Study

The researcher believes that the study would be able to help ample entities and

personalities. The following groups enumerated below would notably benefit from the

study:

The general populace of Cebu, wherein a wellness facility is readily available and

accessible, allowing them to safely enjoy a variety of activities and treatments all for the

promotion of optimum mental health even without a diagnosis.

Patients diagnosed with mild to moderate forms of mental disorders that are

recommended with an outpatient level of care, wherein the proposal will provide for both

conventional and complementary treatments.

Mental health advocates, that the facility provides spaces for lectures and

educational activities- promoting mental awareness and in the long term, remove the

stigma of mental illnesses in Cebu.

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 For other researchers, that this would be a reference guide in further research and

development in the creation of a mental wellness facility.

1.4 Scope and Limitation

The proposal focuses on designing and providing spaces for treating and

practicing good mental health through conventional outpatient psychiatric care and

selected complementary treatments. The study also focuses on Biophilic Design as the

approach for creating an environment conducive of healing for all its users. Taken

account in the study are site selection and analysis, architectural programming and

architectural drawings that take into consideration city ordinances, building codes, and

standards for the facility as well as presentations of utilities such as plumbing, electrical,

structural and mechanical.

Quantitative data available only pertained to severe cases of mental health

disorders reported. Because of the type of populace which the facility may offer services

to which are the healthy populace, those of risk for mental health issues, and those

diagnosed and evaluated for outpatient level of care, quantitative data available only

served as a reference in describing the mental health condition in Cebu.

The level of care the proposal offers limits to outpatient services only. As

recommended by psychiatrists, different levels of mental health disorders need different

levels of care. Those needing hospitalization may not fit for a facility that offers

outpatient services. Mental disorder at this level has gotten severe that patients become

functionally impaired or are dangerous to other patients or users of the facility.

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1.5 Theoretical Background

In healthcare settings, it is the latest innovations in technology that receive the

much attention. At most times, spaces are designed to accommodate such machines and

hi-tech treatments. While these are significant factors, other highly beneficial aspects are

overlooked. The relationship between the built environment and its effects on the users,

going beyond the treatments one is receiving, should be considered as well. In the 1980s,

E.O. Wilson, an American biologist proposed that as humans evolved, we have become

soft-wired to prefer the natural environment over built ones. In his words “we have an

innate and genetically determined affinity with the natural world”. Architecturally, this

instinct is addressed through Biophilic Design.

Biophilic Design, as defined by Dr. Stephen R. Kellert, is an innovative approach

that emphasizes the need for upholding, improving and reestablishing the beneficial

experience of nature. In healthcare settings particularly, patients and medical staff receive

substantial healing benefits when they are exposed to environments that incorporate

principles of Biophilia in the architecture and in the interiors. Biophilic design allows for

a more holistic setting that benefits both primary and secondary users of the proposal.

Stemming from the concept of “biophilia” which refers to the human natural inclination

to nature, Biophilic Design seeks to incorporate nature directly / indirectly to the built

environment. This design approach is to be used in the proposal in order to provide the

users a therapeutic environment that promotes healing.

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 1.6 Conceptual Framework

Lack of mental health awareness

and good practice

Mental health promotion Prevention of mental Case identification and

and awareness health issues and severe healing
disorders

Mind – body treatments

Education and Treatment Medication
Lifestyle modifications wellness practices
Psychotherapy
Patient education and
counseling

Wellness Center Mental Health

Clinic

Biophilic Design

Direct Experience of Indirect Experience of Experience of Space

Nature Nature and Place

Wellness of a person‟s
mental state

Figure 1: Conceptual Framework

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 As shown in Figure 1, the study begins with identifying that there is a lack of

mental health awareness and good practice in our society – particularly in Cebu City

which is the site of the proposal. From this, needed solutions to this problem are

introduced such as promotion and awareness, prevention and case identification. In order

for these to achieved, necessary activities are to be done which are educational and

wellness practices for both diagnosed and undiagnosed populace, as well as treatment for

diagnosed ones. These two main activities are broken down into more specific actions

and treatments. A wellness center and a mental health clinic make up the built

environment that provides for these necessary activities. Encapsulating these two is the

proposal of a Mental Wellness Facility. As the goal of the designer is not only to provide

spaces but consider the effect of the environment to the users of the structure as well,

Biophilic Design was the design approach opted as it resonates with the goal of the

designer. Biophilic Design attributes are broken into three: Direct Experience of Nature,

Indirect Experience of Nature and the Experience of Space. Applying these to the

proposal will eventually lead to what the designer ultimately aims for the users of the

proposal which is the total wellness of a person‟s mental state.

1.7 Definition of Terms

Biophilia –theory supporting the design approach of the proposal, started by EO Wilson

that recognizes the human innate inclination to nature

Biophilic Design – is the concept of Biophilia translated architecturally and is also the

approach taken by the designer for the proposal

Experience – refers to either direct experience to nature, indirect experience to nature or

the nature of the space

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 Chapter Two
This chapter summarizes published works and research in the area of the study. This

chapter also discusses major topics, along with their sub-topics which is then contextualized in

relation to the proposal. Related structures such as wellness centers and psychiatric facilities are

also shown in this chapter.

2.1 Review of Related Literature

2.1.1 Mental Health

The World Health Organization defines mental health as the “state of well-being in

which the individual realizes his or her own abilities, can cope with the normal stresses of

life, can work productively and fruitfully, and is able to make a contribution to his or her

own community”. Mental Wellness is not just the absence of mental illness. When

talking about mental health, it is not limited to treating mental health concerns only, but

rather is concerned with our emotional, psychological and social well-being (American

Psychiatric Association, 2015). Mental health is the foundation for self-esteem, learning,

communication and thinking. A person‟s mental wellness is a subjective feeling of

contentment and satisfaction despite of external factors such as challenges and personal

problems (American Psychiatric Association, 2015). Everyone has a fluctuating state of

mental health. Therefore, it is possible for someone suffering from a mental illness to

achieve a high degree of mental health. Likewise, someone who does not have a mental

illness may experience poor mental health (Komrad). According to Dr. Harry Kroft,

M.D., a triple board certified psychiatrist, good mental health means:

 a high degree of self-awareness- being able to recognize when things are wrong

and knowing what you want to improve

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  being tuned in to your thoughts to test how right these thoughts are, in line with

the reality to the life that you are living

 recognizing mind-body-spirit connection and that an improvement of the spiritual

and physical also improves the mental (vice versa)

According to Dr. Jane Myers, M.D, an internationally renowned leader in

professional counseling, mental wellness by its very essence cannot be separated from

physical and spiritual wellness. As Dr. Renato Obra would say, “There is no health

without mental health”.

2.1.1.1 Mental Health Conditions

Mental illness cannot be checked through blood or body fluids alone. It is

diagnosed by a psychiatrist or clinical psychologist after studying symptoms.

To help in diagnosing and classifying one‟s mental health, symptoms are grouped

in two broad categories: neurotic and psychotic. At a point in a person‟s life, it is

common to experience neurotic conditions. These are extreme forms of “normal”

emotional experiences such as depression anxiety or obsessive compulsive disorder.

Psychotic symptoms affect around one in 100 people. These are conditions where one‟s

mental health is already interfering with a person‟s perception of reality where judgments

and thoughts are impaired (Benjamin Sadock, 2015).

To diagnose a mental health condition, World Health Organization‟s International

Classification of Diseases (ICD) system is used as a reference. This lists known mental

health problems and their symptoms under various sub-categories and is updated every

fifteen years. The following is the classification of psychiatry according to the ICD:

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Schizophrenic Spectrum refers to psychotic symptoms in which prominent

hallucinations or delusions are present. Under the schizophrenic spectrum are

schizophrenia, delusional disorder, brief psychotic disorder, schizophreniform disorder,

schizoaffective disorder, substance induced psychotic disorder, psychotic disorder due to

another medical condition and catatonia.

Bipolar Disorder is characterized by severed mood swings between depression and

elation. There are four variants: bipolar I disorder, bipolar II disorder, cyclothymic

disorder, bipolar disorder due to medication.

Depressive Disorders are characterized by sadness, irritability and in severe cases,

suicidal ideation. Premenstrual Dysphoric Disorder, Substance Induced Depression and

Disruptive Mood Dysregulation Disorder are all under depressive disorder.

Obsessive-Compulsive and Related Disorders are associated with repeated thoughts or

repeated activities. Variants include: OCD, Body Dysmorphic Disorder, Hoarding

Disorder, Hair-Pulling Disorder, Skin-Picking Disorder and Substance-induced OCD.

Trauma or Stressor – related Disorder is caused by exposure to a natural or human

made disaster such as experiencing abuse. Reactive Attachment Disorder, Disinhibited

Social Engagement Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder,

Adjustment Disorders and Persistent Complex Bereavement Disorder are under this

disorder.

Dissociative Disorders includes four speci�c disorders (dissociative amnesia,

dissociative fugue, dissociative identity disorder, and depersonalization/derealization

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disorder) and is characterized by a disruption in the usually integrated functions of

consciousness, memory, Identity, or perception.

Somatic Symptom is characterized by high levels of anxiety and persistent worry which

includes illness anxiety disorder, functional neurological symptom disorder,

psychological factors affecting other medical conditions and factitious disorder.

Feeding and Eating Disorders are characterized by a marked disturbance in eating

disorder which includes Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder,

Pica, Rumination Disorder and Avoidant / Restrictive Food Intake Disorder.

Elimination Disorders can be caused physiological or psychological factors. It is the

inability to maintain bowel control and the inability to maintain bladder control.

Sleep – Wake Disorders includes insomnia, hypersomnia, parasomnias, narcolepsy,

breathing-related sleep disorders, restless legs syndrome and, substance-induced sleep

disorder and circadian rhythm sleep-wake disorders.

Sexual Dysfunctions are related to change in change in sexual desire or performance

such as Erectile Disorder, Orgasmic Disorder, Arousal Disorder, Penetration Disorder

and Medication-Induced Sexual Dysfunction.

Gender Dysphoria is characterized by a persistent discomfort with one‟s biological sex

and in some cases have the desire to have sex organs of the opposite sex.

Substance-Related Disorders include substance use disorder, alcohol related disorders

and gambling disorders.

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Neurocognitive Disorders are characterized by changes in brain structure that result in

impaired learning such as delirium and both mild and major neurocognitive disorder.

Personality Disorders include paranoia, schizoid, histrionic, avoidant, narcissistic,

borderline, and dependent personality disorders.

Paraphilia is where a person‟s sexual interests are directed primarily toward objects

rather than people including fetishism, sexual sadism (inflicting pain) and transvetism

(cross-dressing).

(Benjamin Sadock, 2015)

Some experts argue that the systems depend too strongly on the medical approach

towards mental health diseases. These experts argue that it implies the roots of emotional

distress are simply in brain abnormalities and do not mention the social causes of distress.

They argue that this leads to a dependence on anti-depressants and anti-psychotic drugs

in spite of known major side-effects and poor evidence of their effectiveness (BBC ,

2013).

2.1.1.2 Levels of Care in Mental Health Facilities

The proposed facility welcomes clients even without a diagnosis and is visiting

mainly for the purpose of getting the benefits of each treatment. However, for patients

diagnosed with mental health issues, it is important to know which level of care the

facility provides.

“Level of care” in mental health treatment refers to the setting, frequency and mode

in which treatment is delivered. Separate facilities are used for different kinds of level.

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Clinicians help determine this based on their assessment and may make recommendations

about the patient‟s care. The following is an overview of the levels of care for mental

health treatment, from least to most intense.

1. Outpatient Psychotherapy

This is usually the first contact that patients have with mental health providers.

Patients in this level of care usually attend one hour-long psychotherapy session per

week. This kind of treatment may involve / collaborate with other primary physicians and

treatment could other people like family, in addition to individual therapy. Outpatient

psychotherapy can take different forms based on the approach of the therapist.

2. Intensive Outpatient Program (IOP)

When the therapist concludes that Outpatient Psychotherapy isn‟t enough, Intensive

Outpatient Program is recommended. Through a higher level of care, the clinician

believes that the patient would benefit from additional treatment, group support and

patient education. Treatment may involve different types of groups and support such as a

nutrition education group, coping skills group or meeting with a dietitian. Treatment can

last 3-4 hours long where patients visit 3-6 days per week.

3. Partial Hospitalization Program (PHP)

A patient is recommended for PHP if he/she would show signs of impairment in their

daily functioning due to mental health, but would not appear to be self-harm. PHP is

usually recommended after the patient is discharged from inpatient treatment. Treatment

periods for people in PHP take about 6 to 8 hours on an average. Treatments include

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therapy, educational groups in which coping skills and other concepts are taught,

individual therapy, art therapy and meals are recommended. PHP is usually attended at

least for a week before “stepping down” to less intensive care.

4. Inpatient Hospitalization

Inpatient hospitalization is recommended for patients who are in risk of harming

themselves and to others. The patient stays in a hospital for a few days up to a few weeks

in rare scenarios. The patient sleeps at the hospital, attends group therapy, has the

opportunity to learn concrete coping skills and recover from a crisis in their mental

health.

5. Residential Treatment

A clinician would recommend residential treatment in long-standing, severe

functional impairment. Reaching residential treatment would mean that the patient in rare

cases is nonresponsive to all other forms of treatment. Patients in this treatment live in the

premises of a treatment center, attending various forms of group and individual therapy

that will support them in achieving long-term recovery from their illness.

(Graff, 2013)

The proposed facility falls under the category of both Outpatient Psychotherapy

and Intensive Outpatient Program. This draws the line on patients that can benefit the

most in the type of service the proposal offers. Outpatient Programs cater to mild to

moderate forms of mental health disorders wherein the patient does not need a round-the-

clock care and has the ability to engage in therapeutic interventions well.

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2.1.2 Mental Health Issues in the Philippines and in Cebu

Filipinos have suffered from mental health illnesses over the years and according

to the National Statistics Office, have become the third most common forms of morbidity

in the nation. Among Filipino adults, 17 to 20 percent experience psychiatric disorders

while 10 to 15 percent of Filipino children suffer from it (Magtubo, 2016). The World

Health Organization reports that half of mental disorders begin even before at the age of

14. A 2010 national census states that among 1.4 million Filipinos with diagnosed

disabilities, 14% of this population accounts for mental disabilities. These mental

disorders in the list are depression, anxiety disorder, schizophrenia, acute and transient

disorder and stimulant-related disorder. A 2016 survey conducted by the Philippine

Health Information System on Mental Health (PHIS – MH) showed that schizophrenia is

the top mental health problem in the Philippines, affecting 42 percent of the study cohort

consisting of mostly male. According to Lourdes Ignacio of the University of the

Philippines College of Medicine, one in three Filipinos has a mental health problem. In

the Philippines, neuropsychiatric disorders are estimated to contribute to 14.4% of the

global burden of disease (WHO, 2008).

In Cebu, the Vicente Sotto Memorial Medical Center (VSMMC) Behavioral

Sciences Department has expressed an alarming increase of mental disorder cases in

Cebu – from 8000 in 2010 to 16,000 last 2017 (Alangilan, 2017). Milan Ratunil of the

VSMMC Psychiatric Department said that most of these cases brought to VSMMC were

diagnosed with depression.

According to the World Health Organization, most of these people diagnosed with

mental disorder attempt suicide or have thoughts about it. Suicide is the second leading

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cause of death globally according to the 2014 global report. Dr. Renato Obra, Psychiatric

Chief of VSMMC stated that Cebu has the highest number of suicide cases here in the

country. Almost every day, someone who attempted suicide is treated. Suicide stems

from a form of mental disorder that wasn‟t prevented nor treated. Hope Line, a suicide

hotline launched last August has also been experiencing an increase ever since it

launched, and at most, received 521 calls in just the first 18 days since it launched

(Pineda, 2016). 28% of callers are males and 72% are females with a high risk found

among the 21-30 year old bracket (Palicte, 2016).

Despite of these available data on diagnosed cases of mental health issues, it is

important to be aware of that these are only diagnosed cases in medical facilities.

Underreporting of these cases is common. Psychiatrist Dr. Dinah Pacquing-Nadera

comments that the strong Catholic faith which frowns upon suicide discourages family

from reporting. According to Senator Grace Poe, who filed a resolution addressing the

increasing reports of depression and suicide in the country, many people in the

Philippines look at depression and other forms of mental illnesses as something that one

would eventually snap out of. With that, many people are embarrassed to seek help.

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2.1.3 Addressing Mental Health

The World Health Organization defines health as the balance of mental, physical

and spiritual aspects. Mental health is the foundation of an individual‟s well-being and

how he/she functions in a community. The connection of mental health and chronic

diseases is bi-directional. Therefore, diseases can lead to certain mental health issues just

as much as mental illness can cause to the development of chronic diseases. The problem

of the mind is a problem of the body physically, spiritually, emotionally and socially. Dr.

Glenda Basubas, a psychiatrist for more than 20 years believes that the human person is

made up of spirit, mind and body. She emphasized on a holistic approach in the treatment

of depression and other mental health issues. Many practitioners and doctors believe that

the improvement of mental health can only stem from the improvement of our overall

well-being. The principle is that, mental health treatments have a “side-effect” of

improved physical, spiritual and emotional experience. Research conducted by the

Mental Health Foundation showed that depression alone causes a 67% risk for heart

diseases and 50% risk of death from cancer. According to Dr. Steven Ehrlich from The

Center for True Harmony Wellness Medicine, modern psychiatry does much to help the

physical and at times, emotional, but flatly ignores the energetic and spiritual parts of our

being.

According to Dr. Radam, a practicing psychiatrist, addressing mental health

issues should have a holistic approach wherein treatments cater to their well-being. This

is where complementary treatments are used.

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 “A paradigm that acknowledges the need for addressing the physical, emotional,

social and spiritual components of the individual patient would be profoundly more

effective” (Ehrlich, 2010).

2.1.4 Conventional Treatment

Conventional treatment in dealing with mental health disorders is what most

psychiatric facilities offer for their patients. Medication and psychotherapy usually go

hand in hand and is considered to work best in improving symptoms of mental health

disorders (Sadock, 2007). After diagnosis using assessment tools, the psychiatrist decides

which medication or psychotherapy the patient receives. Psychotherapy may be delegated

to other qualified medical staff.

2.1.4.1 Psychotherapy

Talk therapy / Psychotherapy is an important treatment for mental health

disorders. It is not merely talking about your problems; it is also working towards

solutions (Depression and Bipolar Support Alliance, 2016). Talking therapies involve

talking to someone that is trained to help you deal with distress. Talk Therapy is a

conventional approach used by outpatient clinics for mental health. Most of talk therapy

focuses on thoughts, emotions and current events on the life of the patient. It helps the

patient understand the mental health condition, define goals, cope with stress, make sense

of events, identify triggers, improve relationships and end destructive habits (Rosemary

Crouch, 2014). Depending on the need of the mental health disorder, the kind of talk

therapy a patient receives varies such as Cognitive Behavior Therapy, Dialectic Behavior

Therapy, Interpersonal Therapy and Family Focused Therapy. People who receive talk

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therapy actually continue to improve even after therapy ends because of the

understanding they gain. It helps the patients begin to manage strong and often

uncomfortable feelings more effectively (Barth, 2010). A professional therapist that

gives talk therapy may be a psychiatrist/doctor, psychologist, clinical social worker or

nurse practitioner (WebMD). Support groups also fit for giving talk therapy. When

having a mental health disorder, one of the things that heals you the most is knowing that

you are not alone and being able to connect to people who are suffering the same way as

you are, gives a person much more comfort than any other therapies do.

2.1.4.2. Medication

Medications play a significant role in treating mental disorders and conditions.

These work by balancing neurotransmitters in the brain that affect our mood and

emotions. According to their principal functions, psychotropic drugs are divided into six

groups:

 Anxioytic drugs reduce anxiety because of their general calming effect.

Sometimes, these are referred to as “minor tranquilizers” and in some cases

“sedatives”.

 Hypnotics promote sleep and many of these drugs are of the same type as

anxiolytics.

 Antipsychotic drugs are sometimes referred to as major tranquilizers because they

control delusions, hallucinations and psychomotor excitement in psychosis.

 Antidepressants relieve symptoms of patients diagnosed with depressive

disorders. Aside from that, it also treats chronic anxiety and obsessive-compulsive

disorder.

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  Mood-stabilizing drugs are given to patients to prevent recurrence of disorders.

 Psychostimulants are given most especially to children in the treatment of

hyperactivity syndromes. These elevate the mood but are not used for this purpose

due to the dependency it can cause.

2.1.5 Complementary Treatments

The mind-body approaches for treating depression, anxiety and other mental

health conditions are being used at an increasingly higher rate (Zeigler Burnett, 2016).

According to Dr. James Lake, M.D., a psychiatrist at the Stanford University Hospital

and founder at the American Psychiatric Association‟s Caucus on Complementary,

Alternative and Integrative Mental Health Care, half of the people who self-treat cases of

depression or anxiety use alternative therapies such as meditation and herbals. These

approaches are more accessible and are an acceptable complement to other treatments. At

the same time, it can also be used as an alternative for those who prefer to be treated as

they offer means for patients to be able to learn skills to help them self-manage their

symptoms while empowering them to take charge of their health. Dr. James Lake, M.D

wrote that “extensive research has confirmed the medical and mental benefits of

meditation, mindfulness training, yoga, and other mind-body practices."

The National Center for Complementary and Integrative Health (NCCIH) lists the

following as mind–body practices for mental health: acupuncture, massage, meditation

(including mindfulness and guided meditation), expressive therapies, exercises, spinal

manipulation, t'ai chi or qigong and yoga.

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2.1.5.1 Acupuncture

Acupuncture has the ability to enhance wellness, mend performance and help

people heal from chronic pain, as recognized by the World Health Organization.

According to Dr. John Koleda of the American College of Traditional Chinese Medicine,

the dissatisfaction of conventional medicine such as antidepressants in dealing with

mental health problems, have led many Americans to turn into age-old holistic modalities

to alleviate such problems. Acupuncture works by releasing endorphins and improving

circulation of blood and lymphatic fluids. It also decreases cortisol, our body‟s stress

hormone, as well as lowering blood pressure. In Chinese Medicine, mental health

problems are due to the blockage of the Qi (vital energy) of the body. It is the Qi that

regulates the spiritual, mental, emotional and physical balance (Maciocia, 1989). In a

recent study at the University of Arizona, results showed that acupuncture worked for

65% of the depressed patients and after eight weeks, these patients were no longer

depressed. Acupuncture is comparable to Cognitive Behavorial Therapy which

psychiatrists and psychologists commonly used to treat mental health disorders

(Errington-Evans, 2011). Alongside for mental health disorders, acupuncture can also be

greatly beneficial for physical health.

2.1.5.2 Massage

Known for its physical benefits such as easing muscle pain and lessening of

fatigue, many go for massages to relax. However, more than just being a physical

treatment, massages have benefits to our mental health. The connection between

massages and our brain lie mainly on the muscle called psoas (Gibbs, 2017). This muscle

is the deepest muscle in one‟s core, connecting the lumbar spine to the femur, which

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allows us to flex our trunk forward when bending over to pick something up. Because

the psoas muscle is connected to our diaphragm, this muscle is also linked to our stress

responses. On prolonged periods of stress, this muscle contracts as well. The psoas

muscle is vital to psychological well-being because of its direct connection to our breath

(Northrup, 2018).

Researchers at Taiwan‟s E-Da Hospital and College of Medicine conducted a

study on massage and its benefits to anxiety and depression. The findings showed that

there was a significant reduction in the symptoms. Kyushu University also concluded that

massage helped in reducing anxiety and improving the mood of patients (Neely, 2016).

The same study concluded that serotonin and dopamine levels of study participants had a

30% decrease after undergoing massage, as well as a reduction in cortisol or otherwise

known as the stress hormone.

2.1.5.3 Meditation

Meditation is a mindfulness exercise that turns one‟s focus to a single point such

as your breathing to be in a state of profound, deep peace (Deinstmann, 2015). It is a state

of thoughtless awareness (Madhav Goyal, 2014). The origin of the practice came from a

Buddhist concept that is now widely accepted in mainstream psychotherapy.

A revolutionary study conducted by the Harvard Medical School showed that

meditation practice improves areas of the brain that are linked to self-regulation, learning

and well-being. It also showed to reduce the amygdala – the part of the brain responsible

for fear, anxiety and stress. According to a research in the journal Frontiers of

Neuroscience, meditation proves to enhance cognitive functions and enhance focus as it

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is a way to have better control over emotions. It thickens the brains myelin, a tissue that

protects the brain from disorders and diseases. Regular meditation will not change the

factors that damage our mental health such as the demands of school and work. However,

what it does is increase our resiliency. In a program conducted by the University of

Technology in Australia, nurses and midwives attended a one-day workshop on

Mindfulness Based Stress Reduction (MBSR), and after 8 weeks of practice, researchers

showed a significant improvement in the mental health of participants (Foureur, 2013).

Meditation also shows to be an effective alternative for people with major depression

disorders and showed to be as effective as antidepressants in an experiment and critical

review conducted by the Department of Psychology of the University of Aarhus,

Denmark. Practicing meditation even on short periods can have lasting effects which is

vitally important for people who are exposed to regular stress on a daily basis. Sara Lazar

of the MGH Psychiatric Neuroimaging Research Program and a Harvard Medical School

instructor, states that although practice of meditation is associated with a sense of

peacefulness and relaxation, several studies prove that changes in the brain structure

cause these reported developments and people are not only feeling restored because they

spent time relaxed. Aside from mental health benefits, meditation also plays a part in our

physical being by helping people deal with chronic pain. Highlighting the relationship

between meditating and feeling sensations of pain, meditators were detected to have

changes in how the brain reacts to pain in a study conducted by the Wake Forest School

of Medicine.

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2.1.5.4 Art Therapy

Art is also a form of psychotherapy. Therefore, arts can be used by a person to

communicate feelings without having to say them out loud. While it can be a tool used to

communicate, it is also a way for people to understand themselves. This is sometimes

referred to as “expressive therapy”. It uses the creative process to represent inner

thoughts while developing awareness (Department of Health - Government of Western

Australia). Guided imagery or visualization techniques may be used in art therapy. A

study published in the Journal of Addictions Nursing showed that in the United States,

35% of addiction treatment programs integrate art therapy with women and adolescents

highly responsive to it. Art therapy is to be considered for people with psychosis and

schizophrenia as recommended by The National Institute for Health and Care Excellence

in the UK. A study performed by the University of Granada in Spain confirms the

contribution of art therapy to aid in the treatment of mental disease. According to the

study, art can help people manage behavior, reduce stress, develop interpersonal skills,

increase self-esteem and awareness. Art therapy can help address emotional difficulties,

trauma and loss, PTSD, cognitive problems and neurological problems.

2.1.5.5 Exercise

Exercise isn‟t all about slimming down or muscle size. Exercise can meaningfully

improve one‟s physique as well as contribute so much more in a person‟s total wellbeing.

Physical activities such as exercise can increase feel-good chemicals called endorphins in

the brain. Even a short burst of 10 minutes of brisk walking surges our mental alertness.

(Mental Health Foundation) . Exercise is a powerful mental disease fighter, especially

for depression as it encourages all kinds of changes in the brain including neural growth,

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reduced inflammation and new activity patterns while relieving stress and tension.

(Jeanne Segal, 2017). When someone is stressed, physical discomfort is also felt. These

physical symptoms can in turn lead to even more stress which becomes a vicious cycle

for the mind and body. Exercising is an effective way to disrupt the cycle by relieving

tension in the body. In cases like ADHD, exercising reduces its symptoms as it promotes

and improves concentration, mood, memory and motivation - working in the same way as

medications (Jeanne Segal, 2017). Exercising also helps with post-traumatic stress

disorder or trauma as it affects our nervous system and decreases immobilization stress

response that characterizes PTSD. Other benefits of exercise to our mental wellbeing

include stronger resilience to hard emotional challenges, higher confidence, sharper

memory and better sleep (Breene, 2013).

2.1.5.6 Chiropractic Manipulation

Most people associate chiropractic care with lessening the bodily aches caused by

injuries, being inactive all day, accidents and etc., but over the years, several studies have

showed that chiropractic care has its benefits for mental health. A study published in the

Journal of Upper Cervical Chiropractic Research, showed that 76% of the 2,818 patients

who were undergoing chiropractic care reported an improvement in their mental health as

well as positive changes in stress management. Dr. Herman Schwartz in his book,

“Mental Health and Chiropractic: A Multidisciplinary Approach”, reported of a

significant improvement on 350 patients diagnosed with a mental disorder after receiving

chiropractic care. Dr. Willard Carver, a pioneer in the field of mental health and

chiropractic care, described this practice as “the biological bridge that scientifically

connects these two very important departments, psychology and physiology, of human

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experience.” Chiropractic manipulations work because our brain is regulated by our

body‟s chemistry and the process is all regulated by the nervous system. Often, people

turn to medications that are used to alter the brain chemistry but those looking at a non-

medication therapy find that re-alignment of these vertebrae have its benefits as well

(Pisaro, 2015). Aside from improving flow of the body‟s chemistry, chiropractic care

helps in mental wellness because it decreases any physical pain that may be clouding the

mind. As pain declines, mental clarity increases.

2.1.5.7 Qi-gong

Qigong is an ancient form of Chinese yoga that cultivates the “qi” (life energy). It

works both the body and the mind, aiming to reduce stress that eventually creates clarity

and tranquility of the mind. In view of Qigong‟s principle of integrating and harmonizing

one‟s mind, breath and movement, it is a useful mindful exercise for people with mental

health disorders (Lloyd, 2009). Mindfulness in treating mental health disorders via

relaxation or concentration is a way for patients to be relieved by their present stressors

(Cheung, 2002). Compared to traditional forms of exercise such as jogging and aerobics,

Qigong is relatively gentler. The pattern of therapeutic progress Qigong contributes is

comparable to serotonin selective reuptake inhibitors (SSRI) which is a classic anti-

depressive agent (Stahl, 2000). Professionals such as occupational therapists and physical

therapists, as well as doctors can undergo training in which they are eventually able to

apply this in their settings (Lloyd, 2009).

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2.1.5.8. Yoga

A practice that is used to improve many mental and physical benefits is yoga.

Through physical postures and controlled breathing, yoga yields many benefits. From a

physical aspect, the movements of yoga help create flexibility and strengthens the spine

while overall increase the overall mobility. From a mental aspect, the practice causes

calmness of the mind. Yoga offers specific advantages to those in recovery. Studies have

shown that yoga has a correlation with the inhibition of the dopamine surge that results

from using drugs. According to the British Psychological Society, yoga emphasizes

willpower and controls our stress response which has a great impact on both anxiety and

depression. Yoga is also proven to increase memory capacity, improve attentiveness and

reduce the effects of traumatic experiences. A study conducted by the Harvard Medical

School reported the effects of yoga on mental illnesses. The study took place in a

psychiatric hospital with inpatients diagnosed with bipolar disorder, major depression and

schizophrenia and at the end of just one yoga class, results showed that levels of anger,

tension, anxiety, fatigue and hostility dropped significantly. The spiritual aspect of yoga

is in holding your pose and focusing on the mind-body connection, regardless of the

circumstances through an awareness of yourself and your experience (MacGregor, 2013).

More than 90% of people who practice yoga started because of its physical benefits, but

they stay with yoga for emotional or spiritual reasons.

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2.1.6 Biophilic Design

Humans are innately inclined to nature. This inclination to affiliate with nature is

called “Biophilia”. Due to the surrounding natural context where the human mind and

body developed in, this affinity has become a factor in human wellness (Blair, 2012). In

a collaborative workshop between scientists and architects at the village of Woods Hole,

Massachusetts in 2002, the interface between architecture and neuroscience was

explored. It was the first workshop of what today is the Academy of Neuroscience for

Architecture. Participants of the workshop were divided into groups – comprising of

architects and scientists in one group. The architects measured what they can in the

environment such as the light intensity, color, temperature, airflow and all other qualities

one could measure meanwhile the scientists measured the human physiological responses

such as stress hormones in saliva, changes in breathing, heart rate and etc. Truly the

interrelationship between nature, architecture and neuroscience is being recognized and

given more importance (Sternberg, 2009).

With the sprawl of the urban built environment, degradation of the natural

environment has caused an increasing separation between human and nature. A solution

to this disconnection and an approach that fosters beneficial contact between people and

nature in modern buildings and landscapes is Biophilic Design (Blair, 2012).

2.1.6.1. Biophilic Attributes

According to Dr. Stephen Kellert and Archt. Elizabeth Calabrese, authors of the book

“The Practice of Biophilic Design”, the following are experiences and attributes of

Biophilic Design:

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  Direct Experience of Nature

Attributes: light, air, water, plants, animals, weather, natural landscapes and fire

Light. Exposure to natural light in particular is essential to one‟s wellbeing. Aside from

contributing to the comfort and pleasure, it can also facilitate way finding and movement.

Lighting can also be played around with and add to aesthetic appeal of the place through

a artistic interplay of lights and shadows.

Air. Aside from economic reasons, natural ventilation adds to human productivity and

comfort. By access and exposure to the outside with the use of operable windows and

engineering strategies, the natural ventilation of a structure is enhanced.

Water. Water gives the benefits of relieving stress, enhancing one‟s performance and

health, promoting satisfaction in the built environment. It is most pleasing when water

integrated in the built environment is clean and in motion.

Plants. One of the most successful strategies for bringing direct experience of nature into

the built environment is through vegetation. Its benefits include reducing stress,

contribute to physical health, enhance productivity as well as improve comfort. Plants

should focus on local rather than exotic ones.

Animals. While animal contact can pose as a challenge, its presence plays an integral part

of people‟s experience. Through design strategies such as feeders, green roofs, gardens,

aquaria and aviaries, positive with animal life can be achieved.

Weather. Perceiving and being able to contact with weather in one‟s built environment

gives both satisfaction and stimulation. This may be achieved through direct exposure as

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well as by stimulating weather-like qualities through manipulation of airflow,

temperature and humidity. Views to the outside, operable windows, porches, decks,

balconies, and more are design strategies that can be used.

Natural Landscapes and Ecosystems. An interconnection of plants, animals, water, soils,

rocks and geological forms makes the ecosystem. Over artificial scenery, even natural

ordinary ones are preferred by most people. By providing views, observational platforms,

direct interaction or active participation, contact through the natural system is fostered.

Fire. The experience of controlled fire in one‟s built environment becomes a source of

comfort. Through fireplaces and hearths, fire becomes a satisfying presence. This,

however, may only add to thermal discomfort especially in the Philippines where

temperature is high.

 Indirect Experience of Nature

Attributes: images of nature, natural materials, natural colors, stimulating natural light

and air, naturalistic shapes and forms, evoking nature, information richness, age,

tarnishing or change of time, natural geometries and biomimicry

Images of Nature. Representational expressions of nature especially when repeated and is

abundant, gives the users of the place emotional and intellectual satisfaction. These can

be achieved through the use of canvases, pictures, computer simulations and other

depictive means.

Natural Materials. Natural materials, when minimally altered from its natural state elicit

positive visual and tactile responses. Wood, stone, cotton and leather used as materials

for furnishings, fabrics and other exterior and interior designs are prominent.

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Natural Colors. Application of colors in a biophilic approach should favor muted earth

tones and occurrence of highly artificial, contrasting and vibrant colors should be

avoided. However in the use of bright colors, the designer should be cautious and

emphasize on appealing environmental forms such as flowers, sunsets, rainbows and

certain plants and animals.

Stimulating Natural Light and Air. Artificial light can be designed to simulate qualities of

natural light while processed air can stimulate qualities of natural ventilation. This is

made possible by advances in building technology.

Natural Shapes and Forms. Applying naturalistic forms in the built environment gives

dynamic and ambient qualities of a living system to a static one. These forms and shapes

are very diverse and is very appealing.

Evoking Nature. Designing a structure that aims to evoke nature may not necessarily

follow what occurs in nature but draw from design principles and characteristics of the

natural world. The experience is revealed through imaginative depictions of it. For

example, the form of the Sydney Opera House suggests the qualities of a bird.

Information Richness. The natural world is described as the most information-rich

environment people will ever encounter. Places that provide diversity and a wealth of

options and opportunities tend to make its users respond positively.

Age, Change and the Patina of Time. Nature has the capacity to respond adaptively to

changing conditions brought about by dynamic forces of growth and aging. Design

strategies in applying this attribute include the use of naturally aging materials,

weathering and a sense of the passage of time.

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Natural Geometries Mathematical properties are found and encountered in nature.

Examples are hierarchically organized scales and self-repeating yet varying patterns. The

most prominent natural geometries include the Golden Ratio ad the Fibonacci Sequence.

Biomimicry. When forms and functions found in nature are adopted or used as a design

solution, it is called biomimicry. Being able to technologically capture characteristics of

nature give utilitarian benefits as well as provoke human appreciation for the ingenuity of

other life forms. Examples include the structural strength of spider webs and the

bioclimatic controls of termite sounds.

 Experience of Space and Place

Attributes: prospect and refuge, organized complexity, integration of parts to wholes,

transitional spaces, mobility and wayfinding, cultural and ecological attachment to place.

Prospect and Refuge. Prospect refers to long views of the surrounding setting, allowing

users to perceive current activities around, while refuge provides sites of safety and

security. Application of this attribute is achieved through views to the outside, visual

connections between inner spaces and providing of sheltered/secure settings.

Organized Complexity. When intricacy is experienced in an orderly and organized way,

settings become satisfying to its users. Spaces that are reflected as complex tend to be

variable and diverse. Those that are organized have qualities of connection and

coherence.

Integration of Parts to Wholes. Developing wholes are spaces that users tend to want.

When parts comprise an integrated whole, the space becomes more satisfying. This can

be achieved by providing a central focal point either functionally or thematically.

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Transitional Spaces. Environments are successfully navigated when there is a clear

understanding of the connections between spaces facilitated by clear and distinct

transitions. These transitions can be courtyards, colonnades, doorways, thresholds,

hallways and many more.

Mobility and Wayfinding. The absence of clearly understood pathways, entry points and

exit points breeds confusion and anxiety. It is important to provide clearly understood

ones to evoke feelings of security while fostering mobility.

Cultural and Ecological Attachment To Place. A connection to a place and a sense that

the environment has distinct identity is considered to be a culturally relevant design. This

breeds emotional attachment. Both of these attributes often motivate people to conserve

and sustain both natural human built environments.

2.1.6.2 Benefits of Biophilic Design

While green architecture focuses on incorporating nature to be able to help the

environment and alleviate environmental issues, Biophilic Design focuses on the role of

nature to the built environment and its effect on people. The main benefits relevant to

healthcare environment can be summarized as:

Stress reduction and alleviation of mental health issues. Reduction in stress levels

is a key-factor in a person‟s well-being. At the cooperative workshop at Woods Hole,

Massachusetts, lower cortisol levels were linked to views of nature and natural landscape.

Aside from stress management, its positive psychological benefits encompass alertness,

attention, emotion and mood. Walking alone in natural settings can help mental health

patients by means of improving their self-esteem and vigor. The practice of being

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mindful in a setting close to nature is particularly beneficial as nature offers qualities of

getting one‟s attention yet still be calming.

Reduction of aggressive behavior. Contact with nature shows to reduce a person‟s

violence and being short-tempered by its effect on mental fatigue (Kuo, 2001).

Heightened levels of aggression have been linked in physical environments with

crowding, high temperatures and noise. With connection to nature, rejuvenating effects

take place (Kuo, 2001).

Improved staff performance and retention. According to a study conducted by

Cary Cooper, professor of Organisational Psychology and Health at Lancaster University,

perceptions of well-being can increase by up to 15% when people work in settings that

integrate natural elements. Connections with nature can provide opportunities for mental

restoration and as a result, is the capacity to perform better in highly focused tasks

(Kellert, 2015)

Increased patient satisfaction. Because of human ecology, patients get the most

out of healthcare when they are in an environment that fosters healing. This setting is

enhanced through a Biophilic approach. Connection with nature offers a lesser

intimidating place for patients to receive healthcare.

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2.1.6.3 Restorative Environment through Biophilia.

According to Stephen Kaplan, a psychologist specializing in environmental

psychology, connecting nature to the built environment introduces the following

components of restorative environments:

Being away. Settings that are well-connected with nature are preferred for restorative

opportunities. The seaside, the mountains, lakes and such are ideal places. However, in

the urban context, these kinds of destinations may not an option. Getting away does not

equate to distance that is why providing natural environments that are easily accessible

within the urban area offers an important resource.

Fascination. The clouds, the leaves, the sunsets or the sound of the birds are labeled as

“soft” fascinations and are all offered in a natural setting. These hold one‟s focus and

interest yet still leave abundant opportunity for reflecting and thinking.

Extent. Providing the sense of extent need not entail a big area. Even in small area where

space is limited, the sense of extent becomes successful when the setting is able to deliver

a feeling of being in a different world. Japanese gardens for example give a sense of

scope and connectedness. Historic artifacts give one the feeling of being connected to

past eras and environment, thus an extensive feeling to a larger world.

Compatibility.. Functioning in the natural environment would require less effort despite

of being more familiar in the built environment. In one‟s life, there are several patterns

that relate to natural settings such as caring for our pets, gardening, visiting zoos,

constructing shelter and etc.

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 In conclusion, the related literatures, studies and principles above help in the

whole study and would serve as a guide in coming up with a design for a mental wellness

facility. The data and facts gathered in the related literatures are all to be taken into

consideration to be able to answer to problems discussed, provide spaces for needs that

were mentioned and design appropriately for what are needed.

2.2 Review of Related Structures

2.2.1 Wellnessland Wholeness Center

The Wellnessland Wholeness Center

located at Sikatuna St.,Cebu City is a

boutique wellness center that offers

holistic treatments for healing and

promoting general health.

Figure 2: Reception Area of Wellnessland Wholeness Center

The center offers regular

workshops, seminars, cooking classes

and retreats to anyone interested. Among

these classes are nutritional classes,

meditation classes, yoga classes and etc.

They offer one-day retreats and

Figure 3: Meditation Garden of

overnight stays with over 20 rooms
Wellnessland Wholeness Center
available. The facility also welcomes group retreats.

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 A vegetarian café along with a demo kitchen and food store is in the facility as

well. In-house doctors, practitioners and nurses are in the facility as well. Patients with

different illnesses looking for an alternative / complementary approach to their general

health are welcomed in the facility and are also given treatment and non-pharmacological

prescriptions.

2.2.2. The Farm at San Benito

Located at Lipa, Philippines, The Farm

at San Benito is a luxurious wellness resort that

bridge Western medicine and alternative

healing. It is a medical wellness destination

resort with over 33 suites and villas. The

Figure 4: The Farm at San Benito
programs that the facility offers certified

professional guidance to attain and sustain optimal physical health, emotional well-being

along with spiritual growth. Their natural techniques in healing are geared towards

overall immunity, mental clarity, improved lifestyle habits, rejuvenation and etc. Aside

from overnight accommodations, programs and services offered in the facility include

medical consultations, live blood analysis, aqua lymphatic clearing treatment, infrared

sauna, flotation therapy, daily meditation, yoga and movement sessions. In the facility is

also a restaurant that exclusively offers raw, vegan food.

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2.2.3 Sodra Alvsborg Hospital – Psychiatric Department

Located in Sweden, Sodra

Alvsborg Hospital – Psychiatric

Department comprises of inpatient wards,

10-bed children and adolescent psychiatry

unit, 80-bed adult psychiatry unit and

administrative offices. The whole facility

Figure 5: Sodra Alvsborg Hospital

adopts a humanist approach that encourages human-nature interaction. The orientation of

the building takes advantage of the positive healing benefits of nature. Courtyards are

directed towards the east and all rooms offer views outwards, creating a sense of

freedom. A winding path leads to the garden allowing for extensive physical activities.

Patients also in the facility are fee to enjoy solitude or social interaction as they please.

The goal of the designers was to provide a setting with the dignity of a public building

without the feeling of a closed institutional facility through integrating nature into various

design elements.

2.2.4 Khoo Teck Puat Hospital

Khoo Teck Puat Hospital in

Singapore is one of the most biophilic

hospital in Asia. The first concept by

CPG Consultants was a V-shaped

configuration that opened to the

north. The facility was designed to

Figure 6: Khoo Teck Puat Hospital

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integrate natural airflow, access to natural light and carefully oriented views views

avoidin the rick of solar glare or rain entry. The heart of the development is the green

court, designed to be „forest-like”. At the upper levels, balconies with scented plants

bring nature experience to the patient‟s bedside. The hospital provided public public

spaces that are enjoyed by residents in the area, patients and staff. With these, community

programs such as dancing, tai-chi and Zumba are enjoyed by all.

2.2.5 Ostra Hospital

Ostra Hospital located in

Goteborg, Sweden was designed

by White Architects with the aim

to provide a facility with design as

an element of patient care. The

Figure 7: Ostra Hospital designers wanted to remove the

public‟s preconceived ideas of medical facilities as bleak institutional buildings. Thus, it

was designed to be a healing environment that supports connections with nature while

still providing the needs of a medical facility. The design incorporates visual connaction

with nature with patient rooms having views of the central garden. Non-visual coaction

with nature is achieved by operable windows bringing the sounds and smells from the

garden in. materials such as polished stone floors, hardwood floors, birch handrails and

unpainted wood were used.

41 | P a g e
 Chapter Three
Research Methodoloy

In order for the researcher to gain knowledge on the mental health condition in

Cebu City, secondary data were gathered through interviews of authorities and experts as

well as other reliable sources such as books and journals which was then summarized.

Quantitative data of reported cases for severe mental health disorders were gathered

through latest reports of statistics. Qualitative research was mainly used to gain an

understanding of what is needed for mental wellness both for conventional methods and

complementary methods. The interviews focused on treatments for mental health

disorders, the nature & behavior of patients, the kind of environment needed, the

approach towards good mental health and addressing mental health disorders through

both conventional and complementary methods. Presentation and discussion of data

gathered is critical to the achievements of the objectives.

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3.1 Research Framework

Figure 8: Research Framewor

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3.2 Research Environment

Cebu City, the “Queen City of the South” was

the locale of the study. Cebu City is one of the major

business centers in the Philippines, rapidly growing as

an industrial hub with more than 922, 611 total

population in 2015 Census (GovPH). Cebu City is a

significant center of commerce, trade and education in

Figure 9: Map of Cebu Province the Visayas.

3.3 Research Respondents

The interviews conducted with the following medical experts and practitioners

served as a source of information based on their knowledge, involvement, observation

and experience in their field:

Dr. Renato Obra, M.D., psychiatric ward chief of the Vicente Sotto Memorial Medical
Center

Dr. Romy Paredes , M.D, founder of the Self Health Empowerment Movement Inc. and
Holistic Doctor

Dr. Jecyl Adaya – Radam, M.D., practicing psychiatrist

Mary Anne delas Penas, OTRP, occupational therapist

Khrisa Thea Almeda, OTRP, occupational therapist

Carmen Averilla, resident of Brgy. Kamputhaw

Rommel Prangus, security guard at a facility in Brgy. Kamputhaw

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3.4Research Instruments

The instruments used that provided the researcher for a comprehensive study and

analysis are library resources such as the National Building Code of the Philippines,

Design Standards and Building Codes, The Practice of Biophilic Design and visits of

related structures. Reliable online sources also provided the researcher other needed

information in the form of news, journals and web articles. All the data from these

instruments were collected, analyzed and applied in the proposed building design.

3.5 Gathering of Data

In order to gain an understanding and knowledge on the mental health condition

of the populace of Cebu City, a visit to Vicente Sotto Memorial Medical Center –

Psychiatric Department was conducted first. This was achieved by interviewing Dr.

Renato. The interview conducted focued on the degree of mental health issues in Cebu

reported to VSMMC Psychiatric Department as well as the needed built environment

these patients need.

Dr. Jecyl Amaya – Radam was interviewed to gain further understanding of the

treatments given to patients – through both conventional and complementary methods.

Through her expertise, knowledge on how these treatments work was gained. As a

practicing psychiatrist, she was also asked on the particular spaces needed for a mental

health clinic.

Dr. Romy Paredes, M.D., was interviewed about the importance of wellness and

taking natural methods in terms of improving one‟s health, as well as the setting

necessary for such.

45 | P a g e
 Visits to existing wellness centers in Cebu were part of the research in order for

the researcher to observe the spaces in a wellness center firsthand. These facilities were

the Wellnessland Wholeness Center in Sikatuna St. and the Ananda Marga Wellness

Center in Mandaue City.

Ms. Mary Anne delas Penas, OTRP and Ms. Khrisa Almeda, OTRP, were

interviewed about the complementary treatments that occupational therapists perform to

patients, as well as the flow of activities they give to patients as delegated by a

psychiatrist.

Mrs. Carmen Averilla, a resident of the chosen vicinity of Brgy. Kamputhaw and

Sir Rommel Prangus, a security guard at the same vicinity were interviewed about the

existing conditions and problems of the chosen site.

3.6 Treatment of Data

The qualitative and quantitative data were categorized according to their

application and use, and then analyzed in the following manner to come up with concrete

solutions that meet the purpose of the proposal:

Interviews conducted to doctors and medical experts such as Dr. Romy Paredes

M.D., Dr. Renato Obra, M.D, Dr. Jecyl Radam M.D., Mary Anne delas Penas OTRP, and

Khrisa Thea Almeda, OTRP were taped and transcription were done. Necessary data

were noted and integrated in the study.

Pictures were taken and observations were listed down during visits to related

structuraas namely, the Ananda Marga Wellness Center, Vicente Sotto Psychiatric

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Department, Wellnessland Wholeness Center and Metro Psych Facility in order to gain

knowledge on the spaces these kinds of facilities have which were then integrated in

coming up with the list of spaces for the proposal.

Other relevant data gained through library and online researches about Mental

Wellness – its complementary and conventional treatments, and Biophilic Design were

all analyzed, rephrased and contextualized in such a manner where it is relevant to the

study.

Based on all of the data collected, the researcher aimed to give answers to

problems observed which were then translated architecturally. The profound

understanding on mental wellness, mental disorders and Biophilic design were all critical

to come up with the best solution.

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 Chapter Four
Data Presentation and Analysis

4.1 Client

Metro Psychiatry Incorporated is a group of psychiatrists that have been

involved in advocacy and provision of mental health services. The group was registered

with the Securities and Exchange Commission in February 24, 1999 and its Board of

Directors is still connected with the National Center for Mental Health in Mandaluyong.

4.1.1 Vision and Mission

Metro Psychiatry Incorporated shall be a leader in setting the standard in the provision of

quality mental health services in the country. We shall provide:

1. Services that fully understand and adequately respond to the biopsychosocial needs of

the clients, family, and community.

2. Training activities and programs for health workers, clients, family and community.

3. An environment conducive to relevant research activities and mental health advocacy

4.1.2 Treatment Approach

We employ a dynamic variety of treatment modalities without compromising the

integrity of the therapeutic community which constitutes the backbone of our

rehabilitation program. This includes the integration of behavioral and cognitive

approaches, creative and experiential seminars, 12-step meetings, family system

approaches. (Metro Psych Facility)

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4.2 Users

Primary Users
Patients Refers to patients whom appropriate psychiatric
assistance are in all outpatient clinic
Refers to patients recovering or are “stepping down” from a
level of care who need first outpatient care as they resume a
regular way of life
refer to psychiatric patients referred for prehospitalization
evaluation
Guests Refers to general populace who can benefit from therapeutic
intervention and wellness practices who may or may not have
been diagnosed with any mental health disorders
Medical Staff Psychiatrists Refers to doctors specializing in the field of
psychiatry
Psychologists Refers to experts specializing in the field of
psychology
Nurse Refers to medical practitioners that aid doctors
Medical Refers to medical practitioners in charge of the
Doctor physiological health of the patients
Occupational Refers to medical practitioners that perform
Therapist occupational therapies to patients
Chiropractic Refers to medical practitioners practicing
Doctor chiropractic manipulation
Wellness Yoga Refers to an instructor that teaches in a yoga
Practitioners instructor class
Masseus Refers to persons in charge of giving massages
Qi-gong Refers to an instructor that teaches in a qi-gong
instructor class
Acupuncture Refers to a person who performs acupuncture
practitioner
Secondary Users
Administration Chief Director Refers to person in charge of overseeing and
running the facility
Accountant Refers to person in charge of the finances
Cashier Refers to person in charge of receiving
payments
Security and Security Refers to person in charge of securing the
Maintenance guards safety of the facility
Personnel Janitors Refers to personnel in charge of the cleanliness
and other maintenance needs of the facility
Cooks Refers to personnel in charge of preparing and
serving food for dining area
Table 1: List of Users

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4.3 Related Laws and Design Standards

In order for the proposed mental wellness facility to be efficient and attainable,

certain design guidelines by reliable sources were followed while laws implemented by

the government were carefully considered into the planning of the architectural solution.

4.3.1 Time Saver Standards for Building Types

Mental Health Clinic

The psychiatrist assumes responsibility in providing services such as diagnostic,

consulting and delegating different therapeutic services to other professional staff that

includes various disciplines. This staff compromise of representatives of related

disciplines such as mental health nursing, physical and occupational therapy and other

rehabilitation. The psychiatrist serves as director that the function of the team is effective

in daily practice. He/she retains overall authority but may delegate administrative as

distinct from clinical responsibility to a nonmedical executive or administrator.

Admission policies for outpatient clinics are mostly “open door‟ or “walk-in” – accepting

both self-referrals and referrals from other professionals.

The design should be non-institutional. The following are suggested design attributes:

openers in space planning, live plants, design for groupings of 4-8 persons, comfortable

light levels, freedom for hanging pictures, warm surface finishes in natural materials,

views outside, contact with outdoors and visual access to mainstream of activity.

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4.3.1.1 Spatial Needs:

Admitting offices

This space should be convenient to receptionist and located near front door.

Ancillary Services

Spatial needs compromise of waiting areas, secretarial space, public toilets, lounge and

work areas such as library or work room.

Waiting Areas

This space should be distributed throughout office areas and be limited to 8-12 patients.

Children’s Treatment

This space must be adjacent to entrance and therapist‟s office where there is area for

observation as well. Because of possible mess, a work sink should be provided and

materials in surfaces used must be easy to clean.

Office Space

This should motivate communication between patient and therapist and contain doctor

and at least four or more patients. Arrangement of furniture should be flexible.

Conference Space

This should at least accommodate sixteen people and be suitable for staff meetings,

presentations and staff work area. This space can be used for group therapy and should be

accessible to office spaces and rest rooms.

Staff Lounge

This should accommodate at least eight people and is adjacent to staff toilets, storage,

small pantry or kitchenette and work room.

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Occupational Therapy

Depending on the program, this space consists of both quiet and noisy activities. An

office for the program director is provided but may be without staff offices.

Recreational Therapy

Large social spaces for games, inactive outdoor and indoor areas for quiet, canteen-type

dining areas, library and gym with its own dressing rooms are all requirements of social

recreational therapy.

4.3.1.2. Design Guidelines in terms of Circulation

Use for Socialization

Circulation spaces can also be used for social contact and strictly for transportation from

one area to another. Informal contacts, pausing along the way to look at views or

stopping for coffee are all activities that take place in circulation areas that also

encourage socialization.

Entry – Waiting Area

Arriving persons should be greeted by an employee of staff out in the open and waiting

areas should be in sight of the receptionist. Waiting areas should be located out of main

traffic pattern and adjacent are drinking fountains, toilets, payphones, as well as vending

machines.

Contact with Staff

Informal social areas should be provided where people are more likely to pause. Director

of Center should be adjacent to other staff offices for interstaff contact.

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Orientation

Orientation of spaces depends on sun-wind orientation and views outside. There should

be clear relation of program spaces where users are able to know where to go. When in

need of privacy, closed doors should be kept at minimum but rather, separation can be

provided by turns in corridors or screens.

Time use

Community meeting areas should be located near front door where the rest of the facility

can be locked especially during night time.

Variety

Contrasting design elements can give clue to the kind of activities users can associate in

certain areas. For example, corridor outside program area widens to allow informal

interaction and locker areas are lit by skylight.

Zoning

Program elements should be related to public accessibility, acoustical separation,

circulation, type of activities, scheduled/nonscheduled use, frequency of use, time of use,

unique or common use, sole staff / sole patient use, joint use, relation to front door, need

for outdoor and natural light and need for privacy and controlled access.

4.3.2 1996 Revised Zoning Ordinance of the City of of Cebu

 Parking for Office / Recreational Buildings: 1 parking slot for every 100 sqm

Gross Floor Area

 Parking for health club: 1 parking slot / 25 sqm of Gross Floor Area

The provision of Rule XIX of the National Building Code requires 100% of the

parking requirements of the dominant use and only 50% of each of the non-dominant use.

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4.3.3 RA 1378 Revised National Plumbing Code of the Philippines

Table 2 shows the minimum required number of water closets, urinals and

lavatory per building type as required by the Plumbing Code of the Philippines. The

spaces and building types the designer based on have the closest qualities of a mental

wellness facility.

Space Required no. of Water Closet / Required no. of

Urinal lavatory

Waiting Room 1 WC per room 1 per room

Public Building for MALE MALE:
employee use 2 WC for 16-35 employees 1 for 1-40 people
1 urinal
FEMALE
FEMALE 1 for 1- 40 people
2 for 16-25 employees
Hospital for employee use MALE MALE:
1WC for 1-15 employees 1 for 1- 40 people
1 urinal
FEMALE
FEMALE 1 for 1- 40 people
1 WC for 1-15 employees
Office / Public MALE MALE:
Buildings 1 WC for 1-100 people 1 for 1- 200 people
1 urinal for 1-100 people
FEMALE
FEMALE 1 for 1- 40 people
1 WC for 1-200 people
Table 2: Minimum Required Number of Restroom Plumbing Fixtures

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4.3.4 National Building Code of the Philippines

4.3.4.1 Development Controls

RULE VII

Occupancy Use: Commercial – 2

Principal

2. Massage and Sauna Parlors

3. Health Studios and reducing salons

Accessory

3. General hospitals, medical centers, multi-purpose clinics.

Building Height Limit

Number of allowable storeys / floors above established grade : 6

Meters above highest grade: 18 m

RULE VIII

Commercial - 2

Total Lot Area: 4, 985 SQM

Allowable Maximum Bldg Footprint = Total Lot Area – Land Required for

Yards/Courts

=4,985 sqm – (25%) (4985)

=3,738.75 SQM

% of Total Lot Area

Maximum Allowable Percentage of Site Occupancy: 75%

cross checking:

PSO = AMBF / TLA

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 = 3738.75 sqm / 4985 sqm

= 0.75 (100)

=75%

Maximum Allowable Impervious Surface Area (Paved Open Spaces): 20%

4,985 SQM (0.2) = 997 sqm

Minimum Unpaved Surface Area (Unpaved Open Spaces): 5%

4,985 SQM (0.05) = 249.25 sqm

Total Open Space within Lot (ISA + USA) : 25%

997 sqm + 249.25 sqm = 1246.25 sqm

Setbacks

RROW WIDTH (m) FRONT(m) SIDE(m) REAR (m)

30 above 8.00 5.00 5.00
25 – 29 6.00 3.00 3.00
20 – 24 5.00 3.00 3.00
10 – 19 5.00 2.00 2.00
Below 10 5.00 2.00 2.00

Table 3: Minimum Required Setbacks

4.3.4.2. General Provisions

Light and Ventilation

Every building shall be designed, constructed and equipped to provide adequate light and

ventilation.

Measurement and Percentage of Site Occupancy

I. The measurement of site or lot occupancy shall be taken at the ground level

and shall be exclusive of courts, yards and light wells

II. The maximum site occupancy shall be governed by the use, type of

construction and height of the building and the use, area, nature and the

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 location of the site and be subjected to the local zoning requirements and rules

and regulations of the National Building Code.

Size and Dimensions of Courts

I. Provided that the minimum horizontal dimension of court shall not be less

than 2.00 meters, minimum size of courts shall be governed by the use, type

of construction and height of the building as provided in the rules of

regulations promulgated by the Secretary.

II. Inner courts shall be connected to a street or yard, either by a passageway with

a minimum width of 1.20 meters

Ceiling Heights

I. Habitable rooms with artificial ventilation shall have ceiling heights not less

than 2.40 meters measured from the floor to the ceilings.

II. For buildings of more than one-storey, the minimum ceiling height of the

first-storey shall be 2.70 meters and that for the second storey 2.40 meters.

Succeeding storeys shall have an unobstructed typical head-room clearance of

not less than 2.10 meter above the finished floor.

III. Rooms with natural ventilation shall have a ceiling height of not less than 2.70

meters.

IV. Mezzanine floors shall have a clear ceiling height not less than 1.80 meters

above and below it.

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Size and Dimensions of Rooms

I. Rooms for human habitations shall be at least 6.00 square meters with least

dimension of 2.00 m.

II. Kitchens shall be at least 3.00 square meters with least dimension of 1.50

meters.

III. Bath and toilets shall be at least 1.20 square meters with least dimension of

0.90 meters.

Air Space Requirements in Determining the Size of Rooms

I. School Rooms shall have a minimum space of 3.00 cubic meters with 1.00

square meters of floor area per person

II. Offices shall have a minimum space of 12.00 cubic meters per person

III. Habitable rooms shall have 14.00 cubic meters of space per person

Doors

I. Doors, windows and the like less than 3.40 meters above the pavement or

ground line shall not project beyond the property line when fully opened

except for fire exit doors.

II. Exit door shall swing in the direction of exit travel when serving any

hazardous areas or when serving an occupant load of 50 or more.

III. Width and Height. Every required exit doorway shall be of a size as to permit

the installation of a door not less than 900 millimeters in width and not less

than 2.00 meters in height.

IV. Door Leaf Width. No leaf of an exit door shall exceed 1.20 meters in width.

V. Every required exit door shall give immediate access to an approved means of

egress from the building.

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Windows

I. Every room intended for any use, not provided with artificial ventilation

system as herein specified in this Code shall be provided with a window or

windows with a total free area of openings equal to at least 10% of the floor

area of room, and such window shall open directly to a court, yard, public

street or alley or open water courses.

Ventilation Skylights

I. Skylights shall have glass area not less than that required for the windows that

are replaced. They shall be equipped with movable sashes or louvers with an

aggregate net free area not less than that required for open able parts in the

window that are replaced or provided with approved artificial ventilation of

equivalent effectiveness.

Artificial Ventilation

I. Whenever artificial ventilation is required, the equipment shall be designed

and constructed to meet the following minimum requirements in changes:

 For rooms entirely above grade and used for office, clerical or

administrative purposes or as stores, sales rooms, restaurants, markets,

factories, workshops or machinery rooms, not less than three changes or

air per hour shall be provided.

 Rooms entirely above grade and used as bakeries, hotel or restaurant

kitchens, laundries other than accessory to dwellings and boiler rooms not

less than ten changes of air per hour shall be provided.

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  Other rooms used for assembly purposes, with seats or other

accommodations not less than 0.03 cubic meters or air per minute shall be

supplied for each person.

Water Supply System

I. Whenever available, potable water requirements for a building used for

human habitation shall be supplied from existing municipal r city waterworks

system (MCWD).

II. The design, construction and operation of independent waterworks systems of

private housing subdivisions or industrial estates shall be governed by existing

laws relating to local waterworks system.

III. Piping installations inside buildings and premises shall conform to the

provisions of the National Plumbing Code of the Philippines.

Wastewater Disposal System

I. Sanitary sewage from buildings and neutralized or pre-treated industrial

wastewater shall be discharged directly into the nearest street sanitary sewer

main of existing municipal or city sanitary sewerage system in accordance

with the criteria set by the Code on Sanitation and the National Pollution

Control Commission.

II. All buildings located in areas where there are no available sanitary sewerage

systems shall dispose their sewage to septic tanks and subsurface absorption

filed.

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Stairs and Exits

I. The construction of stairs and exits shall conform to the occupant load of

requirements of buildings. Determining occupant load of building is done by

dividing the floor area assigned to that use by unit area allowed per occupant.

II. No obstruction shall be placed in the required width of an exit except

projections permitted by this Code.

III. Stairways serving an occupant load of more than 50 shall not be less than 1.10

meters while stairways serving an occupant load of 50 or less may be 900

millimeters wide.

IV. The rise of every step shall not exceed 200 millimeters and the run shall not be

less than 250 millimeters

V. Handrails shall be placed not less be than 800 millimeters or more than 900

millimeters above the nosing of treads. .

Number of Exits

I. In all occupancies, floors above the first storey having an occupant load of

more than 10 shall not have less than two exits.

II. Mezzanine floors if greater than 185 square meters or 18.00 in any dimension

shall have at least two stairways to an adjacent floor.

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4.3.5 Accessibility Law
Batas Pambansa 344 Implementing Rules and Regulations Amendments

4.3.5.1 General Provisions

Accessible Ramps

I. Ramps shall have a minimum car width of 1.20 m and a gradient not steeper

than 1:12

II. Ramps with a total length longer than .00 m shall be provided with

intermediate landings with a minimum length of 1.50 m.

III. Handrails on both sides of the ramp at 700 mm and 900 mm from the floor of

the ramp shall be provided with 300 mm long extension at the top and bottom

of ramps.

Accessible Entrances

I. Entrances shall be accessible from arrival and departure points to the interior

lobby.

II. In case entrances are not on the same level of the site arrival grade, accessible

ramps should be provided as access to the entrance level.

III. Entrances with vestibules shall be provided with a level area with at least 1.80

m depth and a 1.50 m width.

Corridors

I. Corridors shall have a minimum clear width of 1.20 m to allow for both a

wheelchair user and a non-PWD to pass. Where space is required for two

wheelchairs to pass, the minimum width shall be 1.80 m.

II. Turnabout spaces shall be provided at or within 3.50 m of every dead end

corridor.

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 III. In walkways, corridors should be maintained level and provided with a slip

resistant surface.

Washrooms and Toilets

I. Accessible water closet stalls shall have a minimum area of 1.70 m x 1.80 m.

One moveable grab bar and one fixed to the adjacent wall shall be installed at

the accessible water closet stall for lateral mounting; fixed grab bars on both

sides of the wall shall be installed for stalls for frontal mounting.

II. A turning space of 2.25 square meters with a minimum dimension of 1.5 m for

wheelchair shall be provided for water closet stalls for lateral mounting.

Switches

I. Manual switches shall be positioned within 1.20 meters to 1.30 meters above

the floor.

Workstations

I. The access aisle shall have a minimum width of 920 mm.

Open Spaces

I. Walkways or paths should be given defined edges either by the use of planters

with dwarf walls or a grass verge, or similar, which provides a texture

different from the path.

Signage

I. Signs on walls and doors should be located at a maximum height of 1.60 m

and a minimum height of 1.40 meters.

Parking Area

I. Accessible parking slots should have a minimum width of 3.70 m.

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 II. A walkway from accessible spaces of 1.20 m clear width shall be provided

between the front ends of parked cars

III. Pavement markings, signs or other means shall be provided to define parking

spaces for the handicapped.

4.3.6 National Fire Code

Means of Egress

I. The width of any means of egress shall not be less than 915 mm.

Arrangement of Exits

I. Exits shall be located and exit access shall be arranged so that exits are readily

accessible at all times.

II. Corridors shall provide exit access without passing through any intervening

rooms other than lobbies and other spaces permitted to be open to the corridor.

Travel Distance to Exits

I. Exits shall be so arranged that the total length of travel from any point to

reach an exit will not exceed 46.00 m in any place of assembly for spaces not

protected by approved, supervised sprinkler system and 61.00 m in areas so

protected.

Aisles

I. When serving 60 seats or less, aisles shall be not less than 76 cm wide.

II. The length of travel to an exit door by any aisle shall be not greater than 46 m.

64 | P a g e
4.4 Site Selection and Site Analysis

This section shows how the researcher was able to choose the most suitable site for

the proposal which is then analyzed based on its existing conditions.

4.4.1 Site Selection

CRITERIA FOR EVALUATION

A. Site Capacity (20%) – The lot must be ample enough to accommodate the building

footprint as well as large open spaces for roads, parking and green areas.

EVALUATION FOR SITE CAPACITY

1-Lot size is inadequate to meet the suggested minimum lot size requirement set in the

national building code both for AMBF and TOSL

2 – Lot size is adequate to meet the suggested minimum building footprint requirement,

yet is insufficient for open space requirement

3 – Lot size meets both the suggested minimum building footprint requirement and total

open space in the lot.

4 – Lot size exceeds up to 50% of the minimum requirements

5 – Lot size exceeds up to 100% of the minimum requirements

B. Accessibility to transportation (15%) – The lot must be accessible either by public or

private vehicles and ideally should be close to major roads and highways.

EVALUATION FOR ACCESSIBILITY TO TRANSPORTATION

1 – The site is inaccessible to private and public vehicles.

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2 – The site is only accessible to private vehicles and is 500 m away from a major road.

3 – The site is only accessible by private vehicles and is less than 500 m away from a

major road.

4 – The site is only accessible by private vehicles and is located along a major road.

5 – The site is accessible by private and public vehicles and is located along or near a

major road.

C. Accessibility to and availability of utility and service needs (electricity, water,

communication service, waste management) (15%) -In order for the facility to be livable,

access to utilities should be readily available.

EVALUATION FOR ACCESSIBILITY TO UTILITY AND SERVICE NEEDS

1 – No existing utilities and services is accessible to the site due to remoteness or height.

2 – Existing utilities and services are very far from the site due to remoteness.

3 – Existing utilities and services are far from the site but are accessible.

4 – Existing utilities and services are available near the site

5 – Existing utilities and services are available within the site

D. Noise / Visual Quality (15%) – The site must be away from visual and auditory

nuisance.

EVALUATION FOR NOISE AND VISUAL QUALITY

1- The site is next to facilities that generate loud and harmful noises, as well as visual

nuisance that hamper with the function of the site.

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 2- The site is located near facilities that generate loud and harmful noises, as well as

visual nuisance that hamper with the function of the site.

3- The site is relatively noisy due to vehicular noises but noise levels do not pose as a

major nuisance. No significant views and vistas are around.

4- The site is relatively peaceful with no significant views or vistas.

5- The site is peaceful with excellent views and vistas.

E. Neighborhood Compatibility (15%) – The site must complement and be compatible

to facilities within its radius.

EVALUATION FOR COMPATIBILITY WITH ADJACENT LAND USE

1 – No major commercial, institutional and residential facilities are located within a 1km

radius of the site.

2 – No commercial, institutional and residential facilities are located within a 500 m

radius of the site.

3- No commercial, institutional and residential facilities are located within a 100 m radius

of the site.

4 – The area is surrounded by a combination of commercial – institutional, commercial –

residential, or institutional – residential.

5 –The area is equally surrounded by commercial, residential and institutional facilities.

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F. Existing Vegetation (10%) - Ideally, the site must have existing vegetation to be able

to incorporate these into the design rather than introducing new vegetation to the whole

facility.

EVALUATION FOR EXISTING VEGETATION

1 – The site has no existing vegetation.

2 – The site has at least 10% existing vegetation.

3 – The site has at least 20% existing vegetation.

4 – The site has at least 30% existing vegetation.

5 – The site has at least 40% existing vegetation.

Vulnerability to natural hazards (flooding, fire hazard, pollution) (10%) – Site

should be free from natural hazards.

EVALUATION FOR VULNERABILITY TO NATURAL HAZARDS

1 – Site in proximity to several hazards.

2 – Site is in proximity to three or more hazards.

3 – Site is in proximity to two hazards.

4 – Site is in proximity to one hazard.

5 – Site is free of any potential damage/injury from hazards.

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Sites to be evaluated:
The following sites presented are areas all located in Cebu City‟s Commercial – 2

zone in accordance to the Land Zoning Map of Cebu and are subjected for evaluation

using the criteria presented.

Site A

Site A is a 2,300 sqm lot located in

Sanjercas Ville Road, Lahug Cebu City

Source: Google Earth

Figure 10: Site A

Site B

Site B is a 5000 sqm lot located in D.

Jakosalem St., Brgy. Zapatera, Cebu City

Figure 11: Site B

Source: Google Earth

Site C
Site C is a 4, 895 sqm lot located in

Molave St., Brgy. Kamputhaw Cebu City

Source: Google Earth

Figure 12: Site C

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4.4.2. Multicriteria Analysis
Table 4 shows the evaluation of each site that would eventually lead to the most

appropriate site for the proposal. Each site is rated to how much it fits to the criterion and

a short description of the reason for such rating is provided in the table as well.

SITE A (Lahug) SITE B (Zapatera) SITE C (Kamputhaw)

SITE CRITERIA % DECRIPTION SCALE DECRIPTION SC DECRIPTION SCAL
ALE E
SITE
CAPACITY
The lot has an The lot has
The lot must be area of 2,300 an area of
ample enough to sqm which is 5000 sqm The lot has an
accommodate the enough for the which would area of 4895
building footprint 20 facility 4 provide 5 sqm which 5
as well as large however, it is ample spaces would provide
open spaces for constrained at for indoor ample spaces
roads, parking and the sides by outdoor for indoor
green areas. neighboring spaces. outdoor spaces.
structures.

ACCESSIBILITY The site is Located The lot is only a

away from the along 50 m walk away
The site must be major road, D.Jakosalem, from C. Rosal
adjacent to Gorordo Ave. vehicles that St where PUJ‟s
adequate roads by 300 m. pass by the pass. It is also
that will allow for 15 However, it is 3 area are 4 accessible to 5
fast and easy accessible by mostly taxis private vehicles.
access to the private and private
facility both vehicles. vehicles. The
through public and Road adjacent area is easily
private vehicles. is 8 m wide located.
only.
ACCESSIBILITY
TO UTILITY AND
SERVICE NEEDS Utility and
service needs
In order for the 15 Utility and 5 Utility and 5 are readily 5
facility to be service needs service needs available.
livable, access to are readily are readily
utilities should be available. available.
readily available.

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NOISE / VISUAL The site is Located along a The area is
QUALITY relatively busy road, the peaceful due to
peaceful with area is its location
The site must be no visual relatively noisy however, there
away from visual nuisance. 4 due to vehicles. 3 are no
15 4
and auditory However, views Visual quality significant
nuisance. and vista aren‟t isn‟t that good vistas or views.
special either. either.
COMPATIBILITY The site is The area is The area is
WITH surrounded by surrounded by surrounded
ADJACENT mostly commercial, mostly by
LAND USE commercial and residential and commercial and
The site must residential 4 institutional 5 residential
15 4
complement and be establishments. establishments. establishments.
compatible to
facilities within its
radius. Most
compatible zones are
commercial,
institutional and
residential.

EXISTING The site has a There are a few There are plenty
VEGETATION few trees and trees and of trees in the
greeneries greeneries site where it can
Ideally, the site must around. around. be used to plan
have existing around outdoor
vegetation to be able 10 4 4 spaces.
to incorporate these 5
into the design
rather than
introducing new
vegetation to the
whole facility.

VULNERABILIT There are no

Y TO NATURAL There have reported cases
HAZARDS There have been reports of of severe
10 been reports of 3 flooding in the 3 flooding and
4
The site must be flooding in the area during fire hazards in
located away from area during heavy rain. the area.
hazards such as heavy rain. Pollution due to Pollution exist
flooding, pollution, Pollution due to vehicles is due to vehicles.
landslides and fire. vehicles is also prevalent.
prevalent. Reports on fire
also exist which
makes it a
hazard.
OVERALL TALLY SITE A = 78 % SITE B = 85 % SITE C = 92%
Table 4: Multicriteria Analysis

Table 4 shows that Site C, located at Brgy. Kamputhaw is most appropriate for the proposal.

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4.4.3. Macro Site Analysis
The following macro analysis shows data of the area in larger patterns, particularly in relation to
the whole city of Cebu.

4.4.3.1 Zoning Map

Figure 13: Cebu City Zoning Map

Source: Cebu City Planning and Devt
Office
Figure 13 shows that the site belongs to a Commercial – 2 zone which is the appropriate
classification of the building type of the proposal.

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4.4.3.2 Slope Map

Figure 14: Slope Map

Source: Cebu City Planning and Devt
Office

Figure 14 shows that the site belongs to an area with 0-8% slope which means that it is
relatively flat and free from steep terrains.

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4.4.3.3 Land Forms Map

Figure 15: Land Forms Map Source: Cebu City Planning and Devt
Office
Figure 15 shows that the site belongs to lowland.

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4.4.3.4 Road Network Map
To be able to know how the site is accessed, figure 16 shows the different road

networks surrounding the site. Both major roads and minor local streets surround the site.

The site is adjacent to Molave St. and is closest to J.Solon Drive on its right and

Archbishop Reyes Ave on its left.

Figure 16: Road Network Map

The following are the minor and major roads that surround the site:

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4.4.3.5 Transit Map
Knowing which PUV routes pass near the site is important to know as some users

of the site may opt for this kind of transportation. Figure 8 is a transit map that shows the

codes of the PUVs that pass by the road networks as shown in Figure 16. All other roads

not part of the PUV‟s routes above are used by private vehicles, taxis, motorcycles and

service vehicles.

Figure 17: Transit Map

The following are the different PUV routes passing through nearby road networks:

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4.4.3.6 Movement Network
Figure 18 shows vehicular movement along the roads that surround the site. All

other areas allow pedestrian movement.

Figure 18: Movement Network

The arrows show vehicular movements by either private or public transportation around
the area:

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4.4.3.7 Proximity Map
In order to know the vicinity of the site, the figure below shows the major

establishments surrounding the site within a walkable radius of 500 meters. It is

surrounded mostly by institutional, commercial and residential establishments.

Figure 19: Major Establishments within a 500 m radius

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4.4.3.8 Average Temperature & Precipitation

Figure 20: Average Temperature and Precipitation Source: www.sunearthtools.com

Figure 20 showcases Cebu‟s maximum temperature in a given day for every

month. Hot days are represented by the dashed red lines, while the cold nights are

represented by the ones dashed blue. Hottest days are experienced in the months of

March, April and May. Meanwhile, temperature is low at December, January and

February

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4.4.3.9 Average Temperature & Precipitation

Figure 21: Sunny, Cloudy and Precipitation Days

Source: www.sunearthtools.com

The graph in Figure 21 shows the monthly number of sunny, partly cloudy, overcast

and precipitation days of Cebu. Days with less than 20% cloud cover are considered as

sunny, with 20-80% cloud cover as partly cloudy and with more than 80% as overcast.

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4.4.4. Micro Site Analysis
Figure 22 shows the site for the proposal.

Figure 22: The Site Source: Google Earth

Land Use: Commercial – 2

Area: 4, 985 sqm.
Land form: Lowland
Soil type: Faraon clay
Type 3 Climate: Wet and dry seasons are not pronounced. November to April is
relatively dry and relatively wet during the rest of the year. Seasons are not very
pronounced.

Figure 23: View of site from Molave St. Figure 24: View of site from Molave St.

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4.4.4.1 Lot Plan

Figure 25: Lot Plan

POINTS DISTANCE BEARINGS

1-2 65.00 M S 82d E
2-3 61.42 N 9d E
3-4 34.7 N 81d W
4-5 21.69 N 0d W
5-6 47.00 N 85d W
6-1 82.98 S 5d E

Table 5: Lot Description

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4.4.4.2 Sun Path Diagram

The orientation of different spaces inside should be able to aid in the thermal

comfort of the users. Figure 26 below shows the sun path in relation to the site.

Figure 26: Sun Path Diagram Source: www.sunearthtools.com

The north side does not obtain direct heat from the sun, but rather obtains illumination
from the sun. This orientation is best for spaces that are occupied by people for the entire
day.

The southern face is the best orientation to be able to obtain maximum controlled sunlight
with the aid of sun shading devices.

The eastern face is the best orientation for spaces that are used later in the day because
the east is where the sun rises in the morning. Heat is less intense in the afternoon at
eastern side.

The western face is best for spaces that are not frequently used and should make use of
sun shading devices to mitigate direct sunlight from the sun.

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4.4.4.3 Wind Rose Diagram

In the Philippines, prominent winds are generally classified into two sources: the

southeast monsoon or Amihan and the northwest monsoon or Habagat. Maximum natural

ventilation should be taken into consideration when orienting spaces. Passive cooling is

well obtained when buildings are faced towards these orientations.

Figure 27: Wind Rose Diagram Source: www.sunearthtools.com

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4.4.4.4 Land Adjacency Map

Figure 28: Land Adjacency Map

Figure 28 shows areas adjacent to each side of the site. The site is bounded by
residential structures on its right and front, vacant lots on its rear and front, and a
commercial structure on its left.

4.4.4.5 Movement Network

Figure 29: Movement Network

Figure 29 shows one way direction of private cars along Molave St., as represented

by the blue arrow, and the pedestrian movement, as represented by the orange line.

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4.4.4.6 Contour Map

Figure 30: Contour Map

Figure 30 shows the contours of the site with a 1 meter increment. This would
also reflect the natural direction of the drainage of the site which is towards the right side.
In the planning of the site, it is ideal to follow the natural slope of the site or to make use
of cut and fill technique as means of respecting topography.

Elevation Profile

Figure 31: Longitudinal Section Source: Google Earth

Figure 32: Latitudinal Section Source: Google Earth

Figures 31 and 32 show that the highest elevation within the site is 124 ft while

the lowest is 113 ft. The difference between these elevations is 11 ft or 3.3 m.

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4.4.4.7 Existing Vegetation

Figure 33 shows the kinds of trees that grow in the site. Ideally, these trees are to
be conserved and cutting them should be avoided. Rather, the designer should incorporate
these existing vegetation to the design.

Figure 33: Existing Vegetation

Figure 35: Acacia and Bamboo trees in the site Figure 34: Mahogany tree in the site

Figure 36: Molave tree in the site

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4.4.4.8 Overlay Map

Figure 37: Overlay Map

Figure 37 is an Overlay Map showing existing conditions of the site that is

integral in the site planning of the proposal. The orientation, prevailing winds, sun path,

views, vehicular and pedestrian flow, road, existing trees, and the topography/contour are

all shown in Figure 37. From this, the designer is guided in the total site and space

planning, especially in the orientation of which spaces are most suitable for the different

areas of the site later on in the planning process.

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4.4.4.9 SWOT Analysis
Table 6: SWOT Analysis

Table 6 shows an assessment of the site based on its strengths, weaknesses,

opportunities and threats. Strengths refer to positive internal factors of the site.

Weaknesses refer to negative internal factors. Opportunities refer to positive external

factors while threats refer to negative external factors.

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 4.5 Space Programming
The following are the spaces of the proposal classified according to their major zones:
Administration Area
 Admin Lobby
 Chief Director‟s Office
 Conference Room
 Accounting Office
 Cashier
 Record Section
Operations and Maintenance Office
 Janitors‟ Area
 Supply Room
 Security Office
Mental Health Clinic
 Information
 Lobby
 Psychiatrists‟ Office
 Occupational Therapy Room
 Waiting Aeas
 Toilets
 Group Therapy Room
 Family Therapy Rooms
 Medical Clinic
Human Resource and Development Area
 Admin Lobby
 Chief Director‟s Office
 Conference Room
 Accounting Office
 Cashier
 Record Section
Wellness Center
 Lobby
 Information
 Multipurpose Room
 Toilets
 Shower
 Acupuncture Room
 Chiropractic Room
 Massage Room
 Meditation Areas
 Gym
 Qi‟gong-Yoga Room
 Locker
 Prayer Room
 Auxiliary Kitchen
 Dining Area
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4.5.1. Space Proximity Matrix

The following show the relationship of spaces either directly, indirectly or none at

all. Directy related spaces complement eachother‟s function than the rest and should be in

close proximity. Indirectly related spaces may or may not be in close proximity. Spaces

that have no relationship may be located far from eachother as their functions may be

different.

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4.5.2. Bubble Diagrams

Figure 38: Major Zones Bubble Diagram

Figure 38 shows the space bubble diagram of the major zones of the

facility consisting of the mental health clinic, the wellness center, courtyard,

administrative area, human resource area and the areas for operations and

maintenance. These spaces are divided into two: patient free zones and zones

which are open to patients or the public in general. Being able to distinguish the

two is important to organize the flow of both primary and secondary users. The

relationship of each is also shown above.

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 Figure 39: Administrative Area Bubble Diagram

Figure 39 shows the space bubble diagram of the administrative area which

compromise of the lobby, conference room, director‟s office, records section, cashier

and accounting office. The administrative zone is where most of the office work is

done in order to run the facility. These are classified into three zones: private semi-

private and public. Those who are directly related should be adjacent to each other

while those that are indirectly related may or may not be adjacent to each other.

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 Figure 40: Mental Health Clinic Bubble Diagram

Figure 40 shows the space bubble diagram of the mental health clinic. This

zone is where patients diagnosed with a mental health disorder go to receive

psychiatric outpatient care. These are classified into three zones: private semi-private

and public. Those who are directly related should be adjacent to each other while

those that are indirectly related may or may not be adjacent to each other.

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Figure 41: Wellness Center Bubble Diagram

Figure 41 shows the space bubble diagram of the wellness center. This

zone is where patients and the public practice wellness activities as well as

socializing activities. These are classified into three zones: private semi-private

and public. Those who are directly related should be adjacent to each other while

those that are indirectly related may or may not be adjacent to each other.

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 Figure 43: Human Resource Zone Bubble Diagram

Figure 42 shows the space bubble diagram of the human resources zone. This

zone is designated for employees to rest and recharge. These spaces are all private

spaces.

Figure 42: Operations and Maintenance Zone Bubble Diagram

Figure 43 shows the space bubble diagram of the operations and

maintenance zone. This zone is designated for employees in charge of the facility‟s

safety, and cleanliness. These spaces are all private spaces.

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4.5.3 Space Programing Sheets
In the space programming sheets, aside from providing the sizes, capacity,

equipment and critical factors, the designer also incorporated the preferred Biophilic

attributes that is intended to be experienced by the users of the facility. This is to ensure

that each space have certain Biophilic attributes that complements its function or

characteristic – dictating the overall architectural quality of the different zones.

4.5.3.1 Administrative Area

This area is for the managing, controlling, directing and coordinating tasks all

intended for running the facility. These are mostly where office works of non-medical

personnel take place and should be a patient-free zone.

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4.5.3.2 Mental Health Clinic

This area is for outpatient psychiatric care intended primarily for patients who are

either to be diagnosed or are already diagnosed with a certain mental health disorder.

This zone is the dominant use of the facility.

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4.5.3.3 Wellness Center

This area is intended not just for the patients but to the public as well who can

benefit from wellness practices that promote physical, emotional, spiritual and most

especially, mental wellness.

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4.5.3.4 Operations and Maintenance Area

This area is for spaces intended for the safety and cleanliness of the facility.

Users of this area are security guards and janitors.

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4.5.3.5 Human Resource Area

This area is for spaces intended for medical staff and other employees to

rejuvenate and rest during breaks. Most often, this space is of less importance in the

modern setting. But ideally, spaces like these are critical in the performance of the

employees.

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 Chapter Five
Summary of Findings, Conclusions and Recommendations
This chapter presents answers to the problems discussed in the research,

encompassing how it was derived and applied to the study. This also summarizes how

these answers were translated architecturally in terms of design solutions, desired

qualities and as to how it can be improved by future researchers.

5.1 Architectural Program

Knowing first the flow of activities and what conventional spaces are in mental

health clinics and wellness centers were done in order to gain a general idea of the areas

to be designed and included. The initial listing and sizes of spaces were based on the

Department of Health‟s guidelines on mental health facilities. Knowledge on ideal design

qualities was gained through intensive research of library resources. Visits to related

facilities also gave the designer a point of comparison between current design flaws of

existing structures and ideal design solutions that should have been done. Minding this

gap, the designer consciously integrated what is ideal to the proposal. Furthermore, the

list of spaces was made sure to answer to the needs of not just the patients but to all the

users of the facility. Each space was designed to be ample enough, with the right design

qualities in terms of minimum standards required and ideal design qualities.

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Figure 44: Experience of Biophilic Design

(Kellert, 2008)

To be able to come up with an overall design quality that would give the users a

healing experience not just through medical interventions, user experience through

Biophilic Design was the design solution used. It was integral to know the psychological

impact of the different attributes of Biophilic Design to be able to come up with an

efficient architectural solution of a mental wellness facility. An experience of Biophilia,

either direct, indirect or through the nature of space, was made sure to be incorporated in

each space through repeated and layered application of its attributes.

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 5.1.2 Tabulation and Sizing of Spaces

Table 7 shows the overview of the list of spaces, the activities that happen within
each space, its location and size according to the number of users. All area per square
meter meets Department of Health‟s Guidelines in the Planning and Design of a Hospital
and Other Health Facilities (2004).

Space Activities Area / user No. of Users Total

(sqm) Area
(sqm)
Administration Area
Admin Lobby Receiving Area 0.8 40 32
Chief Director‟s Managing, checking 6 3 18
Office and assessing
progress of the
facility
Conference Room Hold meetings and 1.8 40 72
conferences for staff
Accounting Office Tracking and 6 2 12
monitoring of
expenses

Cashier Payment 6 2 12
Record Section Storing of records 6 1 6
TOTAL GROSS AREA : 152 sqm
Total Gross Area with 30% for circulation: 197.6 sqm
Human Resource and Development Area
Staff Lounge Resting 1.4 40 56
Staff Locker Rm. Storage of personal 0.7 40 28
belongings
Staff Restroom Hygienic purposes 1.7 10 17
TOTAL GROSS AREA : 101 sqm
Total Gross Area with 30% for circulation: 131.3 sqm
Operations and Maintenance Office
Janitor‟s Area Break room for 2.1 3 6.3
resting
Supply Room Storage of cleaning 6 1 6
instruments
Security Office Guarding of facility 6 2 12
TOTAL GROSS AREA : 24.3 sqm
Total Gross Area with 30% for circulation: 31.59 sqm
Mental Health Clinic
Information Welcoming of guests 1.4 2 2.8
and for inquiries
Lobby Receiving 1.4 30 42
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Psychiatrists‟ Offices Diagnosing and 5.02 12 60.24
treating patients
Psychologists‟ Offices Assessment and 5.02 12 60.24
counseling
Occupational Therapy OT treatment and 5.02 20 100.4
Room assessment and office
for Occupational
Therapists
Waiting Areas For waiting 0.8 30 24
Toilets Hygienic purposes 1.7 12 20.4
Group Therapy Room Counseling 1.8 10 18
Family Therapy Counseling 1.8 12 21.6
Rooms
Medical Clinic First-aid treatment 8 3 24
TOTAL GROSS AREA : 362.68 sqm
Total Gross Area with 30% for circulation: 471.49 sqm
Wellness Center
Lobby Receiving Area 1.4 30 42
Information Welcoming of guests 1.4 2 2.8
and for inquiries
Multipurpose Room Lectures / Audio – 1.8 30 54
Visual presentations
and various uses
1.7 24 40.8
Toilets Hygienic purposes
Shower For taking a bath 1.5 10 15
Acupuncture Room Acupuncture 7.5 2 15
treatment
Chiropractic Room Chiropractic 7.5 2 15
treatment
Massage Room Massage treatment 7.5 4 30
Meditation Areas Mindfulness practice 1.4 30 42
Gym Physical exercise 3 15 45
Qigong – Yoga Room Yoga / Qi-gong 5 30 150
practice
Locker Storage of personal 0.7 30 21
belongings
Prayer Room Spiritual practice 1.4 30 42
Auxiliary Kitchen Cooking 8 2 16
Dining Area Eating 1.8 30 54
TOTAL GROSS AREA : 584.6 sqm
Total Gross Area with 30% for circulation: 759.98 sqm

CALCULATED BLDG. FOOTPRINT: 1,591.96 sqm

Table 7: List and Sizing of Spaces

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 5.2 Findings and Conclusions

Based on the study conducted, the following sections provides answers to how the

designer was able to meet with the objectives stated.

5.2.1. Requirements for a mental health facility that promotes mental wellness

through integration of conventional psychiatric care and complementary

treatments, applying the principles of Biophilic Design

Findings

The study conducted led to the information of the paradigm shift in addressing

mental health from strictly using conventional psychiatric care methods, to incorporating

wellness practices that are preventive and educational at the same time. Being able to

incorporate mind-body practices rather than just a sole focus on traditional psychiatric

care tends to be more effective in addressing mental wellness.

Conclusions

As a response to this, the researcher concludes that a mental wellness facility

should integrate both conventional and complementary treatments for mental health. This

facility can be divided into two: mental health clinic and wellness center.

Mental wellness is addressed by the promotion, prevention and healing of

identified disorders. From this, educational and wellness practices, alongside psychiatric

treatments need to complement each other in a setting that allows efficiency in terms of

function. Healing will not be as effective if the same institutional design is used and the

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built environment does not foster any positive responses to its users. Knowing the human

innate inclination to nature and the bountiful benefits of experiencing the natural

environment, it would be best if the same benefits were experienced indoors. Thus, in

order to provide the best architectural solution, the designer concludes that Biophilic

Design is highly beneficial for the users of a mental wellness facility.

5.2.1.1. Spatial requirements in a mental wellness facility that offers

outpatient psychiatric care services and wellness treatments in addressing

mental health

Findings

Wellness practices function as complementary treatments while psychotherapy and

medication function as conventional psychiatric care. The integration of a mental health

clinic with a wellness center is most appropriate to be able to provide a setting for these

functions.

Conclusions

The mental health clinic should be designed to have a non-institutionalized

impression for patients, allowing a less intimidating feeling. The design should foster

patient-doctor relationship. Psychiatrists and psychologists‟ offices, occupational therapy

rooms, therapy rooms both for group and for family, medical clinic, receiving areas, as

well as waiting areas are provided to cater to the needs of both primary and secondary

users

The choice of which wellness practices to provide was based on the National

Center for Complementary and Integrative Health‟s list for mind-body practices for

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mental health. This list was further verified by research respondents who work in the

field of psychiatry, and solidified by other reliable sources, especially on the benefits of

each practice on mental health. Spaces such as acupuncture room, chiropractic room,

massage room, meditation areas, gym, yoga/qi-gong room, prayer room as well as areas

for socializing, receiving and support areas are provided in the wellness center.

Other support spaces such as the administration area, human resource and

development area and the operations and maintenance offices all play significant roles in

running the facility. These spaces are patient-free zones where only authorized personnel

are allowed.

5.2.1.2. Application of Biophilic Design principles

Findings

According to Dr. Stephen Kellert, whom many people consider as the father of

Biophilic Design, his framework that presents Biophilic attributes as different

experiences of nature is a more practical methodology for an effective application of

Biophilia in architecture. The three kinds of experiences of Biophilic Design are

presented in this framework. These are namely: the direct experience of nature, the

indirect experience of nature and the experience of space and place. Direct experience

refers to actual contact with the natural environment and features which includes plants,

animals, water and etc. Indirect experience of nature refers to representations of nature in

the environment such as natural materials, natural shapes and forms and etc. Lastly, the

experience of space and place refers to spatial features such as prospect and refuge,

organized complexity and etc. In totality of this framework, Biophilia is presented as an

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experience in design. This is also the framework that the designer concluded to be

appropriate for the proposal.

Conclusion

In conclusion, repeated and sustained engagement with nature should be applied

in order for the design approach to be effective and to fulfill the intention of the designer.

The biggest design challenge was being able to be coherent enough in the application of

the said attributes and experiences of Biophilic Design. To be able to do so, the different

attributes of each kind of experience were applied from small interior spaces, to the

building as a whole then towards the outdoor areas of the proposal in multiple layers and

scales. Every space in the proposal has in them certain Biophilic features that are to be

experienced. Attributes that make up the different experiences of Biophilia were applied

in such a manner where one complements the rest of the other attributes, resulting in an

overall integrated whole. This allowed for a Biophilic experience all throughout.

5.2.1.3. Technical and planning standards and existing laws for effective and

functional design proposal

Findings

Both the local and national government has set implementing laws and

regulations for mental health facilities, as well as general provisions and development

controls in accordance to its building type. The list of spaces provided by the DOH are

general names of the spaces needed and it was the designer‟s prerogative to choose which

specific spaces and functions were to be incorporated, as long as it follows the standard

and function being provided. In the study, local ordinances and other national laws or

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codes were made sure to be followed. Design qualities recommended, especially towards

the Biophilic aspect of the design, were applied.

Conclusions

The designer concludes that design guidelines and laws should be consciously

abided for the design to fit in the local setting. Space requirements provided by the DOH

in their Guidelines in the Planning and Design of a Hospital and Other Health Facilities

were followed to be able to know the minimum area required per person. The minimum

was exceeded up to a reasonable extent- enough to ensure ample space for biophilic

features to be integrated. DOH‟s assessment tool for the licensing of an acute-chronic

psychiatric care facility was also used as a guideline into the design quality the proposal

needs in order to be approved by the government. This guideline encompasses the service

capability, personnel, equipment and list of spaces a facility needs. Aside from these

documents, references to the National Building Code of the Philippines, Cebu City

Revised Zoning Ordinance, Accessibility Law, National Plumbing Code and Fire Code of

the Philippines were all used to be able to design appropriately. Other design solutions

and principles were from Time-Saver Standards for Building Types and various books

written by Dr. Stephen Kellert, the father of Biophilic Design.

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5.3 Recommendations

Based on the study conducted, specifically in regards to the condition of mental

health disorders, the researcher recommends a built environment that gives not only

treatments but preventive, promotional and educational approaches as well. With this, it

is recommended to integrate both psychiatric care and wellness practices for optimum

mental health not only for patients but to the general populace.

Knowing how the physical environment affects humans mentally, the quality of

the built space should foster healing. With this, an application of Biophilic Design is

recommended as it gives bountiful benefits psychologically. Repeated and sustained

application of the different attributes should be experienced in order for the application to

take effect and be successful.

Furthermore, it is recommended to make use of existing laws and design

guidelines provided by varied implementing agencies to produce a design suitable for the

local setting such as the National Building Code, local ordinances and guidelines

published by the DOH or other agencies for health settings.

For researchers in the future who wish to continue this study, Biophilic Design

discusses more specific attributes and other frameworks that one could follow. In this

study, experience of Biophilia was the main framework used. Future researchers could

also focus on a single attribute alone and make it as the main component of the design

solution, for example Biomimicry within the entire structure. The study also focuses on

the application of Biophilia in a mental wellness facility. Future researchers may apply

the same design approach to a different type of building such as office buildings or

schools.

129 | P a g e
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 Appendices
Correspondences
May 5, 2018

Dr. Renato Obra

Psychiatry Department Chief
Don Vicente Sotto Memorial Medical Center

Dear Dr. Obra,

Good day!

With the goal of removing the stigma of mental health disorder and providing a facility in
addressing mental health issues, I am working on an undergraduate thesis entitled: A Proposed
Wellness Center in Cebu. I am a fifth year student of Architecture, Fine Arts and Design at the
University of San Carlos- Talamban Campus.

In line with this, I would like to request for your approval to conduct an interview and
acquire the following relevant data:

 Statistics of population of patients suffering from mental health disorders

 List of current programs and activities for patients suffering from such disorders
 Insights on the needs of the patients and the medical center
 Insights on the problem of mental health issues in Cebu

I am hoping for your help and response on this. I assure you that I will treat this data
responsibly and professionally.

Thank you very much and God Speed!

Respectfully yours,

Angel Ernestine S. Inajada

angel.ernestine@gmail.com

Noted by, Endorsed by,

Ar. Neil Andrew Menjares Ar. Margret D. Rosario, MTE

Design 9 Coordinator Chairperson of the Department
Of Architecture
May 28, 2018

Dr. Maria Jecyl Amaya-Radam

Amaya - Radam Psychiatric Clinic
Ma. Cristina Building

Dear Dr. Radam,

Good day!

With the goal of removing the stigma of mental health disorders and providing a facility
addressing mental health issues, I am working on an undergraduate thesis entitled: A Proposed
Wellness Center in Cebu. I am a fifth year student of Architecture, Fine Arts and Design at the
University of San Carlos- Talamban Campus.

In line with this, I would like to request for your approval to conduct an interview and
acquire the following relevant data:

 Conventional treatments received by patients suffering from mental health

disorders
 Alternative treatments (if any) recommended to patients
 Insights on the built environment these patients need
 Insights on the problem of mental health issues in Cebu

I am hoping for your help and response on this. I assure you that I will treat this data
responsibly and professionally.

Thank you very much and God bless!

Respectfully yours,

Angel Ernestine S. Inajada

angel.ernestine@gmail.com

Noted by, Endorsed by,

Ar. Neil Andrew Menjares Ar. Margret D. Rosario, MTE

Design 9 Coordinator Chairperson of the Department
of Architecture
 Research Instruments

Interviewee: Dr. Renato Obra, M.D., Center for Behavioral Sciences Chief in VSMMC
Interviewer: Angel Inajada
Date and Time: May 10, 2018 at 10:30 AM
Location: Vicente Sotto Memorial Medical Center – Behavioral Sciences

(A = Angel Inajada, R= Dr. Renato Obra)

(start of interview)

A: Good morning, sir. Ako diay tong ni hatag ug letter gahapon sir. Katong para
architecture na thesis.

R: Ah o katong mental wellness na facility?

A: Yes sir, kato. Part sa akong research before ko mu propose ug structure kay i-sabot sa
ang status sa mental health disorders diri sa Cebu. So mao unta na ako iask nga data
nimo, sir.

R: Ako, usa ko ka advocate sa mental health. Mao na, despite of my hectic schedule, mu
find time jud gihapon ko mu reach out sa media. Naa ko sa radio everyday sa DYHP.
But, I am not pushing on mental health alone – health in general.

A: So holistic siya nga approach, sir?

R: O, holistic. Thats why, before mu abot ug any mental health disorders, advocacy lang
sa akong una nga focus. Pero, naa miy hotline, kanang Tawag Paglaum. Ubay-ubay sad
jud ang manawag. Kanang legit nga callers ha, kay naa man say mga callers nga tawag2
lang para tanawn lang kung the hotline really works. Kining mga callers, kasagaran naa
juy suicidal thoughts tungod sa ilang personal problems.

A: Everyday jud na naay manawag, sir?

R: O, 24/7 ni ang hotline ug everyday naa sad juy manawag.

A: so far sir, aside sa hotline unsa may gi buhat sa government para ani nga issue?
R: Naa miy mga community programs. In fact, naka hatag mig talk sa University of San
Carlos sauna. Mu reach out sad mi sa southern and northern parts of Cebu. Sa Oslob to
last week.

A: Aside from preventive nga approach sir, unsay lain nga ibuhat para mental disorders,
medication ba?

R: Yes, medications okay ra. Pero, most appropriate rana siya sa psychosis. Putting it this
way, all psychotic problems are mental health problems. However, not all mental health
problems are psychotic problems. So in terms of other means of solving sa mga naa nay
disorders, visits to a psychiatrists jud ang maka tabang. Usahay man gud, kung bisag naa
nay record ang pasyente ug depression, sometimes ang family di nila itake seriously.
Usahay, binuangan pa.

A: kay wala kaayo sila kibaw or knowledgeable ana nga issues?

R: Yes, in some situation sad ang family ang cause ngano naa sila ana nga problema.
Mao na, dapat mu seek jud ug help. Kasagaran sa mga pasyente, dili man sad aware sa
mga support groups or asa lain na facility mu adto. Amo sad na sila i educate.

A: Sa outpatient nga department sa Vicente Sotto sir, pila man pud kabuok magpa
consult everyday?

R: At most, mga 80 – 100 patients siguro. Pero dala nana sila sa mga referrals kanang
gikan sa lain nga department nga naa puy mental health disorders.

A: Unsay kasagaran nila nga sakit sir?

R: mga mild to moderate cases ang naa sa outpatient ra. Kasagaran, mga anxiety issues
or depression. Schizophrenia pud. Ang sa Tawag Paglaum pud, kasagaran depression
unya mga laki kay unlike sa babay, mas naa man guy ma sturya sturyaan ang mga babay.
Mga laki kay theyre more likely to hide it and keep it in themselves.

A: Aw sige, sir. Mao ra ako kailangan nga data sir. Thank you, sir.

R: Sige Angel, have a good day.

(end of interview)

Interviewee: Dr. Jecyl Amaya - Radam, M.D., psychiatrist

Interviewer: Angel Inajada

Date and Time: May 30, 2018 at 2:00 PM

Location: Amaya - Radam Psychiatric Clinic

Ma Cristina Bldg, Fuente Osmena, Cebu City

(A = Angel Inajada, J= Dr. Jecyl Amaya - Radam)

(start of interview)

A: Good morning, doc. Mu interview ko nimo kadiyot doc ha regarding sa mental health
disorders nga naa sa akong letter.

J: O, sige okay ra. Where should I start?

A: Mu ask lang ko first doc about sa conventional treatment na ihatag ninyo sa inyong
patients. If patient ko diagnosed with a mental health disorder, what treatments akong ma
receive from a psychiatrist?

J: For conventional treatment, by the book ni. Duha jud na kabuok. First is through
psychotherapy, then next is through medication.

A: Unsa man sad ni nga medications particularly doc?

J: mga antipsychotics, antidepressants, antianxiety ug mga mood stabilizers ni siya

kasagaran. Ang gamit ani nila is to relieve symptoms of disorders. Another conventional
way is through psychotherapy. Mao ni siya ang nonpharmacological approach, meaning
there is no use of medication but only through talking.

A: Unsay most common na psychotherapy doc?

J: Cognitive behavioral therapy jud ug supportive psychotherapy.

A: While naay conventional method, unsay most common na complementary or
alternative treatments?

J: Yes, important sad jud ang alternative treatments kay when patients know about this,
ma practice mani nila elsewhere. Dili lang sa clinic, para sila mismo kamao sila unsay
dapat buhaton. For example, physical exercise, mindfulness techniques such as yoga and
meditation, massage therapy, arts therapy ug music therapy.

A: Unsay behavior sa mga patients kasagaran doc?

J: For outpatient, okay rajud sila tanawn from the outside since mild to moderate raman
na ila. Mas dali ma alleviate. But sometimes, patients suffering from mental health
disorders may have symptoms that cannot be managed such as agitation, aggressive
behavior ad suicide attempts. These cases are best managed in an inpatient psychiatric
facility.

A: What kind of environment do these patients need doc?

J: Ang environment that these patients need to have should cater to their whole well-
being and approach is biopsychosocial spiritual.

A: Sa years of practice nimo doc, naa ba juy stigma in regards to this issue?

J: Yes. The stigma these patients feel and receive jud are from other people so they rarely
seek professional help. Dapat naa jud untay seminars held starting in school kanang
elementary pa hantud college in regards to mental health disorders, even in the workplace
to reduce the stigma and help them recognize any symptoms in themselves. Also, to
educate them on what to do. Sometimes, patients, instead of seeking professional help,
mu adto ug mananambal.

A: Sge mao ra doc. Thank you sa imong time doc!

(end of interview)
Interviewee: Ms. Khrisa Almeda, OTRP

Interviewer: Angel Inajada

Date and Time: June 8, 2018 at 5:00 PM

Location: Coffee Bean and Tea Leaf , Ayala Center Cebu

(A = Angel Inajada, K= Ms. Khrisa Almeda)

(start of interview)

A: Hi Ms! Ga thesis ko run of a mental health facility in an outpatient level lang. Mu ask
lang ko of an overview of occupational therapy.

K: Sa occupational therapy, kami ang mu tabang sa patients to get back on what they
normally do before sila nagka sakit. For example, hilig ug gardening ang patient sauna,
then mao na among idevelop nga skill balik para mu go back sila sa ilang normal
routines.

A: Unsaun man sad ninyo pag kahibaw unsa nga treatments ihatag?

K: Gikan man jud na sa psychiatrist ang order. Naa nay referral form gi ingun unsay
current condition sa patient ug unsay therapy ihatag.

A: Unsa may examples sa treatments? For instance, naay mu go through ug occupational

therapy.

K: Mu ask mi first about sa imong life through interview. For example, mom ka. Then
ikaw ang mu cook sa imong family. Then pag start nga na diagnose ka ug something
mental health related nga mu hinder ani nga duty, aside sa therapy sa psychiatrist,
tabangan ka ug occupational therapy. Mag culinary therapy ta then akong iobserve imong
lihok.

A: Through observation ra ang inyo assessment tanan sa patients?

K: Naa manay lain2 assessment tools pero kasagaran aside sa direct observation, naa sad
mi mga questionnaires or mga actions na ipa buhat para ma further understand.
A: Pwede ba by group na therapy?

K: Yes! Pwede kaayo. For instance, if kani sila 5 kabuok patients na recommend ni sila
for art therapy, then mas efficient if by group sila itreat.

A: Pila ka patients in a day ang inyo ma handle?

K: Depende raman. Sa mga i-OT jud kay usahay 5, or usahay 10. Usahay gani gamay ra
kaayo ang mu tunga nga pasyente.

A: Unsa mostly ang diagnosis sa inyong patients?

K: Lain2 man pero kasagaran kay kanang mga na abuse, naay depression, or anxiety or
kanang gikan sila go through ug traumatic na experience, sometimes schizophrenia.

A: So unsa ang murag relation ninyo sa psychiatrist ug psychologist?

K: Mu report mi nila sa conditions sa patient. Kung unsay progress na ani nga patient kay
gikan man sad nila ang form about sa patient.

A: Okay thank you kaayo sa time. Mao ra akong questions.

K: Okay you‟re welcome, Angel. Goodluck sa thesis.

(end of interview)
Interviewee: Ms. Mary Anne delas Penas, OTRP
Interviewer: Angel Inajada
Date and Time: June 12, 2018 at 3:00 PM
Location: Coffee Bean and Tea Leaf, Ayala Center Cebu

(A = Angel Inajada, M= Ms. Mary Anne delas Penas, OTRP)

(start of interview)

A: Hi Ms! Thank you for agreeing to meetup with me.

M: Sure, no problem! Unsa may ganahan nimo ma hibawan?

A: Mu ask ko about Occupational Therapy and treatments na commonly ihatag ninyo sa

patients. If for example naa koy schizophrenia or anxiety or depression, unsay mga
therapies na ihatag sa OT nako? Mu work mo hand in hand sa psychiatrists di ba?

M: Yes, we do. Amo mga activities para nila kay arts and crafts kasagaran. Or kana ilang
possible leisure activities para ma redirect ilang negative thoughts sa activity so ma
minimize na ilang mga symptoms. Pero, cautious lang mi sa area like kanang somewhere
nga safe enough para maka likay sa ilang suicidal ideations.

A: So mga art therapy na?

M: Yes mga art therapy, meal prep activities, gardening activities.

A: Naay other alternatives like yoga, meditation ug uban wellness activities?

M: O, pwede kaayo na. Mas maayo ga ilang environment is somewhere nga maka give
ug opportunities for outdoor activities para ma refrain ilang restricted feeling nga
psychiatric ug setting.

A: Unsay most common jud na treatment nga di mu gamit ug medication?

M: Expressive activities jud then mu fall na under ang arts and crafts, role playing, etc.
kay sa kana man gud nga patients kay restricted na ilang emotions kasagaran so bali
thrugh expressive activities kay naa silay outlet for their feelings and emtions. Then mag
processing nalang with the OTs after nila do sa ilang activities.

A: After nana ni hatag ug psychotherapy ang psychiatrist nila or sometimes wa nay

therapy ihatag ang psychiatrist like dritso na kamo?

M: Sometimes, kay irefer na sa psychiatrist ang patients namo para kami na ang mag
give u treatments based sa ilang order.

A: Kasagaran pila ka OT ug psychologist?

M: Depende raman sa center. Pero mostly mu average ug 5 siguro then for psychologist
kay mga 1 or 2 kung gamay ra ang center. Mag work mi sa OT nga room. Diha rami mu
stay even if walay patients so naa nasad tanan materials gamit namo para give ug
treatment.

A: Sige okay, mao ra ako mga questions, miss.

M: Sige, no problem!

(end of interview)
Interviewee: Dr. Romy Paredes, M.D.
Interviewer: Angel Inajada
Date and Time: June 23, 2018 at 3:00 PM
Location: Wellnessland Wholeness Center, Sikatuna St. Cebu City

(A = Angel Inajada, R= Dr. Romy Paredes)

(start of interview)

A: Good afternoon, sir! I‟m Angel, sir. Ako tong ni email nimo to conduct an interview
unta about your facility.

R: Ah yes, Angel. So unsa man akong ma help nimo, Angel?

A: Mu ask ko sir sa imong approach towards dealing with patients nga naay mental
health disorders kay I understand nga natural imong method.

R: Yes, for me. I empower the patients first and encourage them to take charge of their
health. Kasagaran, doctors have this very authoritative impression. Take this, take that,
dayun. Pero, it all boils down into two: toxicity and deficiency. Toxicity, meaning naay
something imong lawas nga di mao unya angay irelease or deficiency wherein your body
lacks something. You are your own doctor and I am only here to guide you in the
process. For mental health disorders in particular, it is very important to let the patient
know first on what they are going through and make them understand. Sometimes, the
most comforting thing for a patient with such disease is to know that they are not alone.

A: Naa bay mga mentally ill na mu visit sa imo facility doc and particularly what
treatments do you give?

R: Aside from having talks with them, patients here have the choice on what activity to
participate on.

A: Unsay activities gi offer sa kani nga wellness center, doc?

R: Naay yoga classes, cooking classes, meditation classes and regular talks and seminars.
Lain-lain and scheduled na siya tanan. In here, we encourage holistic healing where
health is not divided but rather, taken as a whole. Kay interconnected raman ang lawas.
For mental health disorders, we should also take into consideration the physiological
aspect.

A: Interconnected jud siya doc noh?

R: Yes, I even have a patient now nga na diagnose ug depression. Sunod sunod ang patay
sa iyang family. First, iyang husband. Then, iyang only child nga bata intawn na
aksidente. Tungod sa depression matod pa sa iyang psychiatrist sauna, nagka develop
iyang lawas ug cancer.

A: Unsa may na observe nimo sir kasagaran sa mga psychiatric na facilities?

R: I have worked before in an inpatient psychiatric facility and how inhumane some
treatments were. For example, kung naay schizophrenic diha nga naay episode of
insanity, they let them bite a wet towel and then electrocute them. Na solve ilang
schizophrenia? Wala. Of course, mura lang ug na solve kay wa na, hilom naman. Pero the
cause and the symptoms is not actually managed. Igo ra magpa hilom.

A: What environment do you suggest doc in a mental health facility?

R: A place where people can really socialize would be great. Kana bitawng naa na sa
design daan, pero dili murag obvious jud kaayo. Mu suggest lang ang place, for example
couches in front of eachother para diha na dayun, magka sturya2 ang mga pasyente and
connect with one another. Also, incorporate nature. Nature is very much healing man gud
noh? Instantly maka relax ug relieve ug stress which is very important in a medical nga
setting.

A: Spiritually sir unsay naa sa wellness center?

R: We have prayer rooms nga inclusive ug religion. But sometimes the yoga and
meditation itself is spiritual, di kailangan ug prayer room jud.

A: Sige sir mao ra akong mga pangutana sir. Thank you for your time.

R: Sige Angel ha, goodluck sa thesis!

(end of interview)
Interviewee: Carmen Averilla, resident of Brgy. Kamputhaw
Interviewer: Angel Inajada
Date and Time: June 30 2018 at 3:00 PM
Location: Molave St., Cebu City

(A=Angel Inajada, C= Carmen Averilla)

(start of interview)
A: Good afternoon Ma‟m, pwede ko mu interview? Naa ra unta koy mga pangutana
about sa inyong lugar.
C: Aw unsa man dai?
A: Unsay problema diri dapita Mam? Baha-on ba siya?
C: Dili raman.
A: Miski kusog na?
C: Wala rajud. Okay ra jud kaayo.
A: Uso ang kawat?
C: Aw kana, problema. Mao na amo jud ni ilock ug hipos ang naa diri sa karenderia ma
gabii kay mga ka tulo nami na kawatan.
A: Mao ba Ma‟m. Ngitngit sad ni diri magabii?
C: O, ngit2 sad jud. Pero didto unahan hayag2 naman. Mingaw man gud mao kuyaw
gamay lakaw basta gabii diri.
A: Sige Ma‟m mao ra. Salamat
(end of interview)
Interviewee: Rommel Prangus, security guard at nearby facility
Interviewer: Angel Inajada
Date and Time: June 30 2018 at 3:30 PM
Location: Molave St., Cebu City

(A=Angel Inajada, R=Rommel Prangus)

(start of interview)

A: Good afternoon, sir. Pwede ko mangutana kadiyot ra?

R: O, sige. Unsa man dai?
A: Baha ba diri dapita, sir?
R: Dili raman. Way problema ana.
A: Sa kawat, sir?
R: Sa diri lang na building mam, wala raman. Didto guro sa unahan kay medyo walay ga
bantay na didto dapita.
A: One-way raman ni diri dapita sir sa?
R: O, one way ra nya usahay gamiton sa mga delivery nga trucks ni nga dan kung padung
sila sa pikas, di nalang sila mu tuyok pa. Mu counterflow lang sa sila gamay.
A: Sige sir, mao ra. Salamat.
R: Sige mam.
(end of interview)
Site Appraisal

1. 1. SITE TECHNICAL DESCRIPTION

INFORMATION POINTS BEARING DISTANCE ADJACENT
PROPERTY
1-2 65.00 M S 82d E Vacant/residential
2-3 61.42 N 9d E Residential
3-4 34.7 N 81d W Vacant Lot
4-5 21.69 N 0d W Vacant Lot
5-6 47.00 N 85d W Vacant Lot
6-1 82.98 S 5d E Commercial
AREA
2. SUBSURFACE FACTORS
A. GEOLOGICAL Eocene to early Miocene sedimentary formations
HISTORY
B. TOPSOIL TYPE Faraon Clay
C. SUBSOIL TYPE Faraon Clay
D. SOIL BEARING 3000 lb / square ft.
CAPACITY
E. DEPTH OF 120 m well depth
WATER TABLE
F. SUSCEPTIBILITY Low
TO SOIL
EROSION
3. NATURAL SURFACE FEATURES
A. VEGETATION a. Types of Plants Mahogany / Acacia / Molave
b. Sizes of Plants 6m to 12m high
c Location Distributed within the site
d. Shade Pattern Partial – full shade
B. TOPOGRAPHY a. Landform Plain
b. Gradient / Slope Highest elevation: 125 m
Lowest elevation: 113 m
c. Contour Interval 1m
d. Runoff Pattern Towards rear and right side of lot
C. ECOLOGY a. Presence of None
domesticated
animals
b. Presence of wild Certain species of local birds
animas
D. CLIMATE a. Solar Orientation North faces rear part of lot
South faces part adjacent to road
East and West both face residential structures
b. Wind Amihan on NE (November – May )
Orientation & Habagat on SW (June – October)
c. Temperature Hottest Ave. Temperature : 30.99°C
Coldest Ave. Temperature: 24°C
Average Normal Temperature : 27.39°C
d. Humidity Highest Relative Humidity: 81%
Lowest Relative Humidity: 75%
e. Rainfall Average rainfall : 1,750 mm per year
For an hour period: 5.6 mm to 85.3 mm
4. MAN-MADE FEATURES
A. ACCESS a. Ingress N. Escario St/C.Rosal St. to Molave St.
POINTS b. Egress Molave St. to Gorodo Ave.
B. STREETSCAPE a. Architectural Dominantly modern
Style
C. UTILITIES a. Sanitary Available
 b. Water Supply Available (MCWD)
c. Storm Drainage Available
d. Power Source Available (VECO)

D. LAND USE a. Site Character Lowland with gradual slope

b. Area 4, 895 sqm
c. Usage Vacant
d. Adjacent Use Dominantly residential and commercial
E. CIRCULATION a. Linkages Directly adjacent to Molave St.
b. Vehicular One-way direction by private vehicles
Traffic
c. Pedestrian Accessible
Traffic
d. PUV Routes None in Molave St. but is available in surrounding road
networks
F. OPEN SPACES a. Parks None within a 500 m radius
b. Playgrounds Nearest playground inside Ayala Center Cebu site
G. ACTIVITIES a. Residential Present around the site
b. Commercial Present around the site
c. Educational Present around the site
5. SOCIAL DEMOGRAPHICS
A. POPULATION Cebu City as of 2015 census: 923, 000 persons
PROFILE Sex Ratio: 97 male per 100 female
64.5% were over 18 yrs. old
B. POPULATION For Metro Cebu: 2,186 persons per square km.
DENSITY
C. EDUCATIONAL Of the household population over 5 yrs old in Metro Cebu:
LEVEL PROFILE 27.8% attended elementary education
33.4% had reached or finished highschool
13.7% were college undergraduats
16.9% were academic degree holders
D. ECONOMIC For Metro Cebu: manufacturing industries, shopping centers, educational institutions,
PROFILE financial institutions, and other service-oriented institutions
E. ETHNICITY AND Dominantly Filipino – Cebuano
CULTURAL
TYPOLOGY
6. AESTHETIC AND SENSORY FACTORS
A. PERCEPTION a. From car No significant nuisance nor positive experience
b. By walking No proper sidewalk in Molave St. and feeling of being in
danger is evoked
c. By bicycle No proper bicycle lane in Molave St. and feeling of being in
danger is evoked when vehicles pass
B. SPATIAL a. View/s of the site A vandalized fenced is the only view of the site
PATTERN b. Views from the site Medium – high rise buildings are seen from within the site
as well as vegetation from rear part of the lot
C. EXISTING a. Potential for new Commercial buillding
SPACES use
D. SIGNIFICANT a. Landscaping Existing trees (Molave, Acacia and Mahogany) in the site
NATURAL b. Water Features None
FEATURES c. Rock Formations None
7. HAZARDS
A. TSUNAMI None
B. FLOODING Low susceptibility
C. EARTHQUAKE Low susceptibility
D. VOLCANIC None
ERUPTION
E. LANDSLIDES None
F. STORMS Moderate susceptibility
G. FIRE Low susceptibility
H. POLLUTION Low susceptibility
I. CRIME High susceptibility
 AGAINST
PERSON/PROPE
RTY
J. OBSTRUCTIONS Perimeter fence
8. REGULATORY FACTORS
A. LOCAL a. Classification Commercial – 2
ZONING b. Restrictions Principal: Health studios, reducing salons, massage and
ORDINANCE sauna parlos
Accessory: Medical centers, general hospitals and muti-
purpose clinics
c. Easements Front: 5m
Rear: 2m
Sides: 2m
d. Floor Area PSO: 75%
Ratio TOSL: 25%
e. Parking For office / recreational bldgs: 1 parking slot for every 100
sqm GFA
For health club: 1 parking slot for every 25 sqm GFA (non-
dominant use)

B. NATIONAL a. AMBF 3, 738 sqm

BUILDING b. BHL 18m
CODE c. ISA 997 sqm
d. USA 249.25 sqm

Surveyed and Appraised by:

Angel Ernestine S. Inajada

 Angel Ernestine S. Inajada
BS ARCH 5

PERSONAL CONTACT

DATE OF BIRTH: Oct. 1, 1996 MOBILE: 09561478719

BIRTH PLACE: Talisay City, Cebu EMAIL: angel.ernestine@gmail.com

RELIGION: Roman Catholic ADDRESS: Lawaan I, Talisay City, Cebu

RELIGION: Roman Catholic

NATIONALITY: Filipino

EDUCATIONAL ATTAINMENT

PRIMARY

School: Saint Theresa’s College School: Asian College of Technology

Year Attended: 2007—2013 Year Attended: 2002—2007

Date of Graduation: March 2009

SECONDARY

School: Saint Theresa’s College

Year Attended: 2009-– 2013

Date of Graduation: March 2013

TERTIARY

School: University of San Carlos

Year Attended: 2013 – Present

SOFTWARE SKILLS

AUTOCAD MICROSOFT OFFICE APPLICATIONS

SKETCHUP ADOBE PHOTOSHOP

3DMAX ADOBE ILLUSTRATOR

AFFILIATIONS / ACHIEVEMENTS
UAPSA MEMBER: USC CEBU CHAPTER (2014-2017)

USC ARCHITECTURE SOCIETY, MEMBER (2013-2018)