HEALING THROUGH ARCHITECTURE

IN PSYCHIATRIC HOSPITALS
AREA OF STUDY:
• Specific requirements of the mentally ill from their
surrounding environment.
• Design principles which are known for having a positive
impact on the users. (patients, staff, family)

AIM OF THE PAPER:

• The aim of this paper is to study what the mentally ill
patients expect from their surrounding spaces and the
designing factors and principles which which help in catering
to this, thus leading to a healing environment.
 RELEVANCE OF THE STUDY

The present condition of most of the psychiatric hospitals in

India is miserable. Instead of the patients being healed, they are
put under tremendous amount of stress; inhuman living
conditions being a major reason. Creating a better place for the
mentally ill will bring about a change in the society’s perspective
and will lead to social progress of the nation.
 METHODOLOGY
• To study what the mentally ill patients require and expect from
their surrounding spaces by referring research papers and
books written by various scholars in the field of hospital design
and psychology.

LIMITATIONS
• This paper focuses on the specific design requirements of
patients suffering from schizophrenia, dementia and autism in
addition to some of the general design principles such as light,
color, etc. for creating a healing environment.
 INTRODUCTION
WHAT IS A HEALING ENVIRONMENT?
• Healing environment is a space which reduces stress, is
psychologically supportive in order to help patients and families
cope with illness, hospitalization and sometimes, loss.
• It is a space which creates a sense of positivity using various design
facets which include:
1. Specific needs of the mentally ill and how architecture can cater to
fulfill these needs
2. Various design principles(light, colour, open spaces, etc) which
help to increase the pace of self healing.

This paper deals with the merging of “user-friendly”

architectural and environmental design components that
create an integral healing environment. The paper discusses
the positive effects of specific components on patients and
staff.
 SPECIFIC NEEDS OF A MENTALLY ILL PATIENT

1. Spaces of interaction
• Sociopetal spaces
 Sociofugal spaces

ABOVE. Although this seating has great positions

for groups to socialise it also offers secluded spots
facing outwards (sociofugal), appropriate for
solitary needs.

It isn’t a fact that ALL spaces are sociopetal

spaces that make it successful, but rather,there
are sociofugal spaces for people to retreat to .
2. A dignified environment:
Spaces which are cleaned and
maintained on a regular basis.

3. A free and open atmosphere:

Patients must be able to
exercise control over
immediate surroundings.

4. Flexibility of spaces
• Safety and security
• Safety specifically addresses the need to keep staff and patients out of
harm’s way through physical elements in design, while security allows the
freedom of movement for patients within the facility without
compromising treatment and the safety of the patients, staff, and the
community.
• Observation
• Closely related to security is the issue of observation, which is ideally
achieved through passive surveillance. Innovative ways to increase the
potential for staff to check on patients
• Providing secure courtyards is becoming the standard approach, but there
are other ways of maximizing observation without intruding on the
patients. Wide corridors with regular gathering spaces enable a low key
approach to observation, and single loaded corridors with uninterrupted
views to external spaces also allow staff to continue with their work while
keeping an eye on activities throughout the facility.
• Avoidance of visual disturbance
• Visual disturbance can take many forms, but mental health facility
planners generally strive to provide a calm environment with ample space
and minimal clutter – through colour, light, furniture and art. A calm
environment free of technological distractions allows patients time and
space to reflect.
DESIGN PRINCIPLES TO PROMOTE SELF
HEALING
1. Light:
It is well documented that
daylight, artificial light and
sunlight can all provide
significant health benefits for
the general population, as
well as mental health
patients in particular.
2. Colour:
• Waiting Rooms, Recreation Rooms
Because these are shorter term stays, these areas
have more potential for color freedom and visual
activity than other public and clinical areas.
Visually stimulating, interesting, and textural
materials.

• Patient Rooms
If the space is too cool and lacking in contrasts, it is
believed to cause depression for many patients
and their families.

• Examination Rooms & Treatment Rooms

It is important that these areas do not feel clinical
but instead, inviting and safe.
3. Elimination of environmental
stressors:
• Noise
• Glare
• Indoor air quality

• WAY FINDING:
A patients sense of competence is
encouraged when spaces are easy to
find, without asking for help.
Way finding is not just about signs :
Installing more signs is not the
answer to all problems. Way finding is
everything one sees, hears, touches
and smells on every part of the
journey right from the start.
It needs to be planned right from the
initial stages of designing.
Flooring patterns
Change in material and colour
4. Access to nature
• Viewing nature induces positive emotions and diminishes negative
emotions through changes in blood pressure and heart activity.
• Fountains and other water features
• Multilayered greenery of mature trees and flowering plants.
• Connection of internal and external spaces.
• Controls blood pressure and heart rate
Special requirements of people with schizophrenia, autism and dementia (top 3
psychiatric illnesses )

1. Schizophrenia
Schizophrenia is characterized as having delusions (false beliefs), hallucinations
(distorted visual,auditory, tactile, gustatory, and olfactory perceptions), disorganized
speech and behavior, and/or lack of motivation and emotional expression.
The discussable subjects in architecture of treatment and maintenance centers
specified to schizophrenic patients are as follows :

The geometry and the form of space

Forms have psychological effects and information will be sent to the patient through
the specified form. Each form has a specific movement. The form should be chosen
in this usage in such a way that coordinated with the content space. Forms such as
rectangular induce movements and instead forms such as square, induce the focus.
By irregular forms, patients are forced to fantasize, while simple and symmetrical
forms can induce equilibrium. However, concave form is inviting while convex form
is repercussive. Finally, using the familiar form in the design helps the sick to create
second home in new environment.
2. Autism
Autism is characterized by impaired development in areas of social interaction,
communication and repetitive behavior, in addition to a keen sensitivity to touch,
sight, loud noises and certain smells and tastes. These symptoms become apparent
before the age of 3. People with autism are isolated in a world of their own. They are
obsessed with order and need to control their environment in an attempt to
understand it and make it predictable and consistent. Many people with autism can
learn and develop new skills through repetition, and can therefore be trained to work
and participate in the community.

A stimulating environment: Stimulation is the amount of information in a

setting that affects the human user. Lack of stimulation leads to boredom and a
weak connection to space, whereas high levels of stimulation create complex
scenes that overload the senses and lead to distraction. Patients then function
best under moderate levels of stimulation with regard to colors, light, noise,
and patterns.
A legible space: Because the organization of spaces can sometimes be
confusing to both the autistic and the schizophrenic, spaces need to be clear
and legible. In general simplifying design is key to avoiding disorientation and
confusion.
 3. Dementia

To accommodate a dementia sufferer every building element must be considered,

from the signage used throughout a care/retirement home, to the style of taps and
plumbing used within bathroom facilities. For example, patterns on the floor or a
mixture of colours can cause momentary confusion which can lead to trips or falls.
These issues all need to be considered for dementia friendly care home
environments/dementia friendly hospitals. Dementia sufferers often have visuospatial
problems and cannot see 3D, an issue which if not addressed through design can lead to
an increased risk of trips and falls. As many dementia sufferers often struggle to
negotiate stairs and there is an increased risk of falls due to confusion, having adequate
and suitable lift facilities within care homes is essential.
• CONCLUSION:
Studying the factors and principles for a healing environment in psychiatric hospitals based on the aim
and according to the proposed methodology, it has led to a clear understanding in terms of the design
principles to be incorporated for creating a healing environment which goes to show that architecture
itself has a major role in healing patients and making stressful situations for them easy to handle. It
should also be noted that psychiatric hospitals cannot be designed as ordinary hospitals because the
needs of the patients vary. The designers should make sure that these design principles are
incorporated in the designs as it is of utmost importance.

REFERENCES:
• Cox, Anthony and Groves ,Philip, 1981, DESIGN FOR HEALTH CARE, Portland, Butterworth-Heinemann Ltd
• Rosenfield, Isadore, 1969, HOSPITAL ARCHITECTURE AND BEYOND, U.S.A, Van Nostrand Reinhold Inc.
• Wernick, Jane, 2008, Building Happiness, U.K, black dog publishing.
• Hutchison. Elizabeth, 2015, Dimensions of human behavior:Person and Environment, USA, Sage publications
• Sternberg, Esther, 2010, Healing spaces- The Science of Place and Well-Being, USA, Harvard University Press

REFERENCES FROM THE INTERNET:

• https://www.hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf
• http://www.white.se/app/uploads/2013/01/Architecture_as_Medicine.pdf
• http://archivesma.epfl.ch/2011/051/schue_wicki_enonce/Wicki_Schuetz_Enonce%20theorique_architecture%20for
%20psychiatric%20treatment.pdf
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5663021/
• https://designforservice.wordpress.com/2008/02/09/sociofugal-and-sociopetal-space/