Therapeutic architecture can be described as the people-centered, evidence-based discipline of the built environment, which aims to identify and support ways of incorporating those spatial elements that interact with people physiologically and psychologically into design. Architecture is an important factor in people's lives when they are well; when they experience ill-health and are less able to cope it becomes even more important. This book explores the design of specialized residential architecture for people with mental health problems. It sets out to show how building design can support medical and health related procedures and practices, leading to better therapeutic outcomes and an enhanced quality of life. Based on almost two decades of research, it aims to understand how architectural design interacts with the therapeutic milieu, the care programs, and actually living in the spaces. The book is divided into two main parts covering theory and research. Part one consists of three chapters: a brief introduction to old practices, current medical psychosocial and architectural thinking, and alternative thinking. Part two explores the research and conclusions derived from fieldwork. This book provides a fascinating insight into the effect that architectural design can have on all of us, but particularly on those with mental health problems. "Dr. Evangelia Chrysikou explains the many aspects of mental health and its relation to the quality of the built environment and I strongly recommend this very enjoyable book to anyone who would like to find out more about this important topic." - Prof. Alan Dilani, Ph.D. , International Academy for Design and Health "This book provides important, evidence-based data that will help to drive the design of new and refurbished psychiatric facilities and will no doubt become a highly-regarded resource for medical planners and architects." - Jo Makosinski , Editor, Building Better Healthcare

motw/Architecture for Psychiatric En - E. Chrysikou.pdf

IOS Press

IOS Press, Incorporated

United States, United States of America

Washington, District of Columbia, 2014

Amsterdam, Netherlands, 2014

producers:
VTeX PDF Formatter 1.0 (Windows)

Memory of the World Librarian: Slowrotation

Includes bibliographical references (pages 189-196).

Title Page 2
Acknowledgements 6
Table of Contents 8
Part 1 12
1 Introduction 12
1.1 Care in the Community 13
1.2 Design for Domesticity 15
1.3 Mental health service users and their needs 17
1.4 Towards a Model for Rehabilitation 19
1.5 Structure of the Book and Presentation of Ideas 20
2 History of mental health and its expression in architecture 22
2.1 The onset of psychiatry: from God-given medicine to the deep roots of Western psychiatry and "back" to the Great Confinement 22
2.2 From the ideals of the French Revolution to the asylums 24
2.3 The transition from the "second Age of Confinement" to social psychiatry 28
2.4 Social psychiatry and the return of the mentally ill into the community 29
2.5 The rationalisation of mental health care under the managerial perspective and the involvement of social services 36
2.6 Community Care in the UK and France from the Eighties on 38
2.7 Key messages regarding Community Care 42
3 My view: the SCP model 44
3.1 Opposing frameworks for the planning of mental health services 45
3.1.1 Specialists' concepts 45
3.1.2 Normalisation theory 46
3.1.3 Social exclusion in the community 49
3.1.4 From exclusion to social valorization 52
3.1.5 What lies between the asylum and the misinterpretation of domesticity: the need for a new paradigm 54
3.1.6 Safety and security 56
3.1.7 Competence 61
3.1.8 Personalisation and choice 64
3.2 The physical milieu of the psychiatric units 70
3.2.1 The interface with the community: location, scale and external appearance 70
3.2.2 Outdoor areas 72
3.2.3 Internal organisation of facilities 73
3.2.4 Decoration of facilities 75
3.2.5 Patterns 75
3.2.6 Colour 76
3.2.7 Light 77
3.2.8 Furniture and fittings 77
3.2.9 Dealing with tough budgets: small changes 77
3.3 Need for research 78
4 The physical context 82
4.1 The selection of cases 82
4.2 The SCP model': towards a critical scoping of the concept of Domesticity 84
4.3 The design of the user-centred questionnaires 85
4.4 The conduct of the fieldwork 85
4.5 The need for an architectural checklist 86
4.6 The detailed design of the Checklist 87
4.7 Advantages and limitations of the methodology 89
Part 2 90
5 The physical milieu of research: the unit buildings 90
5.1 The care regimes 90
5.2 Building descriptions 95
5.2.1 Bois St Joseph 95
5.2.2 Elan Retrouve 96
5.2.3 Francois Tosquelles 96
5.2.4 Geraniums 98
5.2.5 Rene Capitant 100
5.2.6 Albany Lodge 101
5.2.7 Forest Lodge 103
5.2.8 Lakeside 104
5.2.9 New Bridges 106
5.2.10 Small Heath 108
5.3 Qualitative Evaluation of Case Studies 109
5.3.1 Safety and security 109
5.3.2 Competence 113
5.3.3 Personalisation and choice 117
5.3.4 Does size matter? 126
6 Architectural Checklist analysis 142
6.1 Overall performance according to the checklist 142
6.1.1 The foyers'/wards' performance according to the checklist 142
6.1.2 The Context and Site features 142
6.1.3 The "Building" group of features 143
6.1.4 The Space and Room Group of features 144
6.2 Overall Frequencies of Institutional features 145
7 The users' perspectives 156
7.1 Safety and security 156
7.1.1 Staff 156
7.1.2 General organisation of the building and building features mentioned by staff 157
7.1.3 Service users' concerns on safety related issues 159
7.1.4 Issues related to safety and security that could be connected to design implications 160
7.1.5 Staff and service user perspective on the safety and the security of the facilities 161
7.2 Competence 162
7.2.1 Staff views on service users' competence 162
7.2.2 Spatial organisation issues related to service users competence according to staff 163
7.2.3 Service users' concerns regarding competence 165
7.2.4 Spatial organisation issues related to service users competence according to service users 165
7.2.5 Main findings related to competence for staff and service users 167
7.3 Issues related to personalisation and choice 168
7.3.1 Staff on issues regarding psychosocial aspects of care 168
7.3.2 Staff on personalisation and choice design features 170
7.3.3 Service users on personalisation and choice regime related issues 174
7.3.4 Service users on personalisation and choice issues that were relevant to the space of the foyers/wards 175
7.3.5 Main findings on personalisation and choice 179
8 Conclusions 184
8.1 The cross cultural comparison 184
8.1.1 Safety and security 185
8.1.2 Competence 188
8.1.3 Personalisation and Choice 190
8.2 Further research 194
8.3 The significance of architecture and design 195
References 200

2025-10-27