Decoding the Psychiatric Space: Cross Country Comparison of Facilities for Mental Health Service Users

Evangelia Chrysikou; Eleftheria Savvopoulou; Jane Biddulph; Gabrielle Jenkin

doi:10.3390/ijerph19148832

Decoding the Psychiatric Space: Cross Country Comparison of Facilities for Mental Health Service Users

Int J Environ Res Public Health. 2022 Jul 20;19(14):8832. doi: 10.3390/ijerph19148832.

Authors

Evangelia Chrysikou¹, Eleftheria Savvopoulou², Jane Biddulph³, Gabrielle Jenkin⁴

Affiliations

¹ The Bartlett School of Sustainable Construction, University College London, London WC1E 6BT, UK.
² Independent Researcher, 10676 Athens, Greece.
³ Institute of Epidemiology and Health Care, University College London, London WC1E 6BT, UK.
⁴ Department of Psychological Medicine, University of Otago, Wellington 6242, New Zealand.

Abstract

Normalisation theory made perfect sense at the onset of de-institutionalisation. To map its influence on mental health facilities, research was conducted and began with ten facilities within England (UK) and France, followed by a further two in England and four in New Zealand. A checklist tailored to mental health facilities was used to measure the extent to which the facility looked domestic or institutional. Hence, the mental health checklist architecturally measured domesticity versus institutionalisation in psychiatric architecture. It consisted of 212 features, grouped into three main categories-context and site; building; and space and room-and was based on a pre-existing checklist designed for hostels for those with learning disabilities. The mental health checklist was developed and piloted in Europe and reflected European de-institutionalisation principles. Cross-country comparison revealed that patient acuity was potentially not a determinant of institutional buildings for mental health. Institutional facilities in France were detected, and some of the most domestic facilities were within England, with the most recent sample having a greater tendency towards the more institutional end. Those in New Zealand tended towards the most institutional. Across all 16 facilities, there were very few universal institutional and domestic features, raising the ambiguity of a clearly defined stereotype of facilities for mental health service users. Consequently, the current fluidity of design across and within countries provides a significant opportunity for designers and mental health providers to consider non-institutional design, particularly at the planning stage. The use of the mental health checklist facilitates this debate. Future research in other geographical areas and through further consideration of cultural differences provides further opportunities to extend research in this area, with the potential to enhance and improve the lived experience of users of mental health services.

Keywords: de-institutionalisation; mental health; mental health facilities; normalisation theory; psychiatric architecture.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Europe
France
Health Facilities
Hospitals, Psychiatric
Humans
Mental Health
Mental Health Services*

Grants and funding

The research that took place in 2000–2004 was funded by a Scholarship from Alexander S. Onassis Public Benefit Foundation for PhD studies at UCL. The continuation of this research that took place in 2015–2017 was funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska–Curie Grant Agreement No 658244. The research in New Zealand in 2017–2020 was funded by a Marsden Fast Start from the Royal Society of New Zealand (contract UOO1623).