The prevailing model of psychiatric facility design does not fulfil its potential in supporting the healing process. A salutogenic approach can improve coherence and foster meaning, and will actually improve mental health outcomes, not only manage patient behavior. The current paradigm of the design of psychiatric facilities has a long history, but many historical approaches to the treatment of mental illness were not supportive to healing process. Vestiges of the ancient traditions of imprisonment and punishment of psychiatric patients can still be found in the buildings that healthcare designers are presenting today. In many other healthcare typologies there is a lot of value to be retained in existing models of care, but the same cannot be said for mental healthcare. To move into the future, we have to escape the past. It isn’t necessary to be explicit about the shortfalls of current paradigms, because, to designers, facility managers and directors, magistrates, nursing staff, clinicians, politicians and local community groups, the problem areas are quite obvious and need no elaboration. Instead, this paper outlines a challenge and methodology for designing a mental health facility that is appropriate for the task and supports the healing process. The challenge is to bring humanity, aesthetics, love and meaning back into the psychiatric milieu to address the cause of mental illness, not just manage the symptoms.
The future of healthcare
The current escalation of healthcare costs is financially, socially and environmentally unsustainable. Even in places that are highly dependent on private health insurance, government subsidies to the healthcare industry are a major economic problem. It is very expensive to treat an illness once it has become critical; the cost of keeping a person alive when they are suffering from the failure of a major organ is enormous. Researcher Aaron Antonovsky visualised health as a continuum and the progress of disease as entropicl, meaning the fall from a state of health accelerates. The more entrenched illness becomes, the more energy is required to arrest that fall. For this reason 80% of a country’s health budgets are spent trying to prevent the inevitable – the hospitalisation and treatment costs that arise in the last year of life from preventable disease.
2 With limited resources we must reverse the entropy of disease much earlier, while it is still affordable. Early intervention is much cheaper, but the benefits are not only economic but social and environmental as well – worldwide vaccination programmes and similar massive scale interventions have already tested this approach and them to be spectacularly successful. found
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