Closed psychiatric departments have locked doors.
That is unavoidable.
But it does not mean that the indoor environments need to have a heavy, institutional feel. The opposite is actually a precondition for achieving successful care.

White’s assignment to design Östra Hospital’s new acute psychiatric care unit was welcome, as the activities had been conducted for far too long in old-fashioned premises at Lillhagen. At the same time, however, there is relatively little scientific knowledge about how a good care environment ought to be designed. The fact that the aesthetics and function of the premises are very important for recovery is absolutely clear.

But how exactly?

An intensive dialogue with the operation and an in-depth understanding were required to compensate for the lack of a clear checklist.

“We worked from the goal of creating a free and open atmosphere, of avoiding all associations with compulsion and power,” says Stefan Lundin, the architect responsible for the design.

The design includes a welcoming entrance with an entrance hall that is three storeys high. Large glazed section and illuminated, red-stained birch panels set their stamp on a room that meets everyone – relatives, staff and patients on parole.

“The emergency reception is directly adjacent to the entrance hall, and from their you move into a bright, calmly decorated reception area,” says Maria Wetter Öhman, chief architect. “The partitioned waiting areas are connected to a separate courtyard housing vegetation and artistic decoration.”

The psychiatric activities are grouped around a central passageway that connects to the top storey of the entrance hall. All the public areas are situated along this passageway. A café, training rooms, physiotherapy and occupational therapy. Also to be found here are the entrances to the actual treatment areas, as well as to administration and management. One side of the passageway is flanked by green gardens and French-style balconies with seating areas.

One difference from earlier sites is that we have gathered all personnel categories within the treatment department, close to the patients. We have also tried to create a more uniform discussion environment by designing special discussion rooms.

The care departments are based on three cornerstones:

The garden

A verdant oasis surrounded by buildings. The ‘protected outdoor area’ stipulated in the programme requirement has taken on a freer meaning, even for patients admitted for compulsory treatment. No staff cards are required here, and some patients even have their own exit to the garden. “We believe this to be the single most important solution,” says Stefan Lundin.

The centre of the treatment department houses a day room, kitchen, dining room, activity room and department station grouped around a small, glass-covered winter garden.

“This is the ‘corridorless department’ that was requested, a solution that provides the patient with the potential to move about in an entirely different way compared to a long, narrow corridor,” points out Maria Wetter Öhman.

The accommodation group

The traditional Swedish glass veranda has inspired the shared living corner in the accommodation group, with its 4-5 beds. The accommodation group is visually connected to the ‘Heart’, but can be separated off and used for patients with similar diagnoses.

“When it comes to the individual treatment rooms, the idea has been to inspire several spatialities. In the bed with your first look out through the window. In the adjacent armchair with a blanket over your legs. Or with your legs drawn up in the lantern-like window niche, with the door ajar and looking out towards the ‘Heart’. The design is intended gradually to increase the patients’ personal spheres, from their own room, to the garden, café and public areas, before finally ‘breaking through the bubble’ to the rest of us and to a normal life.”

An overall desire on the part of the operation was to break the stigmatisation associated with psychiatric care. We hope and believe that we have succeeded in contributing to this.

The Östra Hospital project

In brief:
New building for psychiatry at Östra Hospital, Göteborg

The people behind Östra Hospital

Architecture:
Maria Wetter Öhman, head of project, Stefan Lundin, design manager, Krister Nilsson, administrative architect, Stig Olsson, administrative engineer, Ann-Marie Revellé, function programme, Jonas Häggström, Maria Södervall, Jerry Jansson
Landscape:
Ulf Rehnström
Interior:
Elisabeth Rosenlund, head of project, Elisabeth Sandberg, administrator
Environment:
Anna Graaf

Figures

Gross area:
18 800 square metres
Estimated construction cost:
SEK 347 million, excluding land. Interior design cost: SEK 15 million
Occupation:
October 2006