Objectives: The objective of this discussion paper is to deepen the discourse on the complex interrelationship between "healing architecture" and "safe architecture," here labeled "The healing and safety complex," for the benefit of those who want to make informed decisions in the design of future psychiatric wards.
Background: Today's psychiatric care sets the patient at the forefront. As a part of this ambition, the discussion regarding the patient's physical environment has also advanced. At the same time, staff are exposed to increasing threats and violence in their everyday work, which can lead to severe personal psychological suffering as well as physical injuries. The requirements of patients and staff are sometimes conflicting which has ethical implications.
Methods: The reasoning and arguments presented here mainly derive from discussions and dialogue with psychiatric facility management and other healthcare professionals in multidisciplinary working groups during the design process.
Results: Offering patients and staff a healing and safe environment is the most important architectural challenge in the design of psychiatric wards. How architects, management, and staff evaluate and balance the two aspects will have a crucial impact on the building's final design and atmosphere and thereby influence staff and patient safety as well as civil protection.
Conclusions: In everyday practice, it is up to the multidisciplinary design teams and management to become better informed in order to make "the right decisions to the best of their ability" as evidence is still limited when it comes to "The healing and safety complex."
Keywords: patient safety; patient-/person-centered care; psychiatry; security; staff safety.