Capstone whole

the doe foundation a

behavioral

health

treatment

center

for

the

temporarily

lost

dedication. for my parents, for teaching me to persistent, honest, and empathetic. for will, for teaching me to be sensitive, kind, and compassionate. for my friends, from all walks of life, for their stories and their strength. and finally, for you. for the child who just wants his mother to stop being depressed. for the veteran who can’t sleep at night due to the haunting remnants of war. for the girl who hears voices when she is completely alone in a room. and for the youth who believe that selfharm is the answer to not being perfect enough. your fragility is what makes you beautiful – you just need a little help.

i hope you find what you are looking for.

T A B L E

O F

C O N T E N T S

section 1: project introduction and design objectives

pages 1-11

section 2: historiography and contemporary global context

pages 12-23

section 3: visitable & nonvisitable case studies

pages 24-69

section 4: ergonomics & technical criteria

pages 70-93

section 5: topical explorations (human behavior, color, nature)

pages 94-109

section 6: existing site, context, climate, and zoning

pages 110-121

section 7: program development and documentation

pages 122-139

section 8: building analysis, code, regulations, & standards

pages 140-155

section 9: executive summary

pages 156-161

section 10: bibliography

pages 162-165

fig. 1

fig. 2

s e c t i o n

o n e:

introduction & goals

1

“it is during our darkest moments that we must focus to see the light.�

-aristotle-

NECESSITY fig. 3 The powerful, astringent need to treat the mentally ill among us strengthens each year, with a recently estimated half of all chronic mental illnesses beginning by age 14.1 Of this group, it has been noted that over 90% of children who commit suicide have a mental health condition, and an estimated 18-22 veterans commit suicide daily.2 These statistics prove that our society could take better care of the mentally ill, which begins with easy and available quality care.

2

Throughout time it has been proven that our facilities for the mentally and behaviorally ill are insufficient and cruel, treating patients like prisoners instead of providing supportive environments.

This lack of facilities for the disabled among us hurts not only the disabled, but also promotes the stigma surrounding mental illness.

Canadian actor Eric McCormack stated in a recent Huffington Post interview that “Most people, if you live

“THE ONLY THING I NEEDED TO CHANGE ABOUT MYSELF WAS THE IDEA THAT I NEEDED TO CHANGE” - anonymous fig. 4

fig. 5

in a big city, you see some form of schizophrenia every day, and it’s always in the form of someone homeless. ‘Look at that guy, he’s crazy. He looks dangerous.’ Well, he’s on the streets because of mental illness. He probably had a job and a home.”3 McCormack humanizes the mentally ill through keen understanding; we all know someone who is mentally ill, as it affects so many among us, and treating them as outsiders does nothing to create recovery.

This project is personal;

it has derived from years of working with dementia patients at a nursing home, as well as the daily struggles and ostracism of loved ones due to severe depression, schizophrenia, AIDS, and post-traumatic stress disorder (PTSD). A loved one once said, about the struggle with depression and selfacceptance, “The only thing I had to change about myself was the idea that I needed to change.” It took three suicide attempts to bridge that gap.

3

fig. 6 The goal of this research is to create a live-in treatment center for low income people, ages 14 and older, that restores dignity, incites creativity and exploration, and promotes self-acceptance. To meet the aforementioned goals, the space must be designed in a way that harmonizes the best aspects of healthcare, senior living, and hospitality design, to create a perfect amalgamation of safety, treatment, and comfort. Evidencebased design has proven that our environment directly affects our experiences, including our health. “The growing incidence of diabetes, heart disease, obesity and 4

mental illness has been related in part to poor city design,” according to thorough research done about mental health by Hassell Studio in 2014.4 This design will strive to accomplish a home-like space with room for exploration and freedom, diversity among mental illnesses, integration of learning key life skills with recovery, and the creation of a safe and “safe” place.

A safe place protects patients from danger, and a “safe” place promotes wellbeing and the hope for change.

fig. 7

P R E P A R A T I O N In preparation for designing this space, two case studies have been visited as precedents: ManorCare Huntingdon Valley, a nursing and rehab facility with a special unit for dementia patients, and the Abramson Center for Jewish Life, a nursing home with Independent Living, Assisted Living, and outpatient therapy.

Three key sources of research are the Department of Veterans Affairs Mental Health Facilities Design Guide, recently revised in 2014, Hassell Studio’s Future Directions in Design for Mental Health Facilities, and Sally Augustin’s 2009 text Place Advantage: Applied Psychology for Interior Architecture. Key statistics and official information regarding mental health has come from the National Alliance on Mental Illness (NAMI), as well as the National Institute of Mental Health (NIMH).

These key sources provide a solid foundation for designing a space that is sensitive and attuned to the needs of the behaviorally and mentally ill.

fig. 8 5

fig. 9

THE ROLE OF THE DESIGNER Our surroundings directly impact our experiences and our health.

A well-educated designer can create a space that provides everything the behaviorally ill could possibly need to get better, aside from willpower they must 6

find themselves. A few key issues a designer can improve upon, according to the Department of Veterans Affairs, are the on-stage and off-stage aspects of daily life, the minimization of movement, the promotion of independence, the successful support spaces for staff, and the reduction of risk.5 These five key points will be discussed thoroughly in a later chapter.

A designer has the potential to

fig. 10 create a safe environment for growth and change, something that other professionals do not have. Doctors can change lives, but without the well-appointed space and resources, it can be a challenge. Interior designers have the power to influence the world’s perception of the mentally ill.

The world sees this group of

“NATURAL LIGHT IS HEALING, AND THUS VALUABLE TO OUR WORK HERE.” - linda smith -

people as intrinsically lesser and by placing their treatment center in a sustainable building, with sustainable interior design, attributes a certain importance and value to them outright. The Chief Advancement Officer of the Washburn Center for Children in Minneapolis, Linda Smith, was interviewed by Julia Brown about the building’s LEED certification and positive effects on the children and staff: ““Natural light is healing and thus valuable to our work here,” she says. “The structure was designed so every therapeutic room receives natural light, which

creates a work environment supportive for staff as well.””6 Most recovery centers are plain, or are too luxurious to afford, and think nothing of sustainability.

As the world is taking greater interest in sustainable design and in green lifestyles, it would make the mentally ill look important to give them the opportunity to experience the new green lifestyle.

As the design will be located in an existing, LEED certified building, it will already be adaptive reuse and intrinsically sustainable. It is the designer’s responsibility to choose green materials and

planning strategies to create a healthy and sustainable space.

Many aspects of a mentally ill patient’s recovery are the designer’s responsibility, but the facility’s staff are the patients’ daily influencers. The client is a suicide survivor who has dedicated his life to helping the low-income mental health sufferers. He has gained enough community support to build a sustainable, non-profit treatment center for the mentally ill, allowing patients with little to no money to receive care in a safe setting. His goal is to create a 7

place that is budget-friendly in layout and materiality, and one that is also highly useful and aesthetically pleasing. He wishes to create individualization and personality among patients, and wishes for each wing and each room to be open to customization and differentiation. As someone who suffered with depression, he realizes the importance of making individuals feel important. These objectives tell the designer to think deeply about space-planning, materiality, and lighting, but also about the intricacies behind making people feel comfortable and special.

therapists, to volunteers, such as peer support technicians.

There are also all of the housekeeping, maintenance, dietary, and recreation staff, all of whom need organized, streamlined spaces to efficiently assist patients. As mentioned before, the “onstage, off-stage� principle not only affects patients, but impacts the spaces the staff use. Service corridors serve many purposes; they expedite meal service and housekeeping, create a truer sense of home, and hide unattractive processes from sensitive people. The apparent needs of the patientsbedrooms, therapy space, dining areas-take up a lot of The people who inhabit the space. However, the designer behavioral health center cannot forget more general are not just the patients, spaces, such as quiet rooms & however; there are dozens of comfort zones, or spaces away staff who treat patients daily. from environmental stimuli, Staff ranges from the most and spaces for group activity. qualified professionals, such These needs tell the designer as psychologists and rehab to be equally sympathetic to 8

fig. 11

fig. 12

fig. 13

fig. 14

the staff and the patients. will aide in designing a budget-friendly space, as well Patients at this center will as the ability to give back to the not only warrant sympathy community.

Implementing because of their conditions, programs such as a food cobut also due to their economic op or volunteer service would status. People from the worst not only provide funding for financial conditions will be the facility, but also dictate welcome to receive treatment, a whole new set of spaces as financial status should not for the design’s program. affect overall societal worth.

However, as the building will welcome those who cannot pay, budget will really need to be considered during the design process. Multipurpose spaces and flexible bedrooms 9

WELCOME fig. 16 While this treatment center will be open to anyone, its primary focus will be on urban and suburban people of all races, gender identities, and religions. As it will be a safe haven for those with little to no income, it will attract a diverse group of people.

The facility will only accept patients of ages 14 and older, as children with mental and behavioral health issues require a completely different type of care.This demographic of relatively metropolitan, low-income teenagers and adults encompasses everyone fig. 15 from veterans to suicidal 10

teenagers from local high schools. It will require careful planning, to keep similar illnesses together and safe from nurses’ medications and tools. It will need to have explicit wayfinding, to help schizophrenic patients find their way back to their room. It will have to have safe furniture and casegoods that never become a weapon against patients themselves, or against others. It will be a safe place for recovery and self-acceptance, because now is the time that the world needs it most.

ENDNOTES 1. “Mental Health by the Numbers,” NAMI: National Alliance on Mental Illness, January 1, 2015, https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers 2. “Mental Health by the Numbers,” NAMI: National Alliance on Mental Illness, January 1, 2015, https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers 3. Maggie Furlong, “‘Perception’ On TNT: Eric McCormack on his Schizophrenic New Role and Getting Away from ‘Will & Grace,” The Huffington Post, July 9, 2012, http://www.huffingtonpost.com/2012/07/09/perception-eric-mccormack_n_1654869.html 4. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf 5. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014, http://www.cfm.va.gov/til/ dguide/dgmh.pdf 6. Julia Brown, “Minnesota Mental Health Center for Children Lets in Natural Light,” Behavioral Healthcare, Winter 2015. http://search.proquest.co docview/1658373717?OpenUrlRefId=info:xri/sid:summon&accountid=28402

IMAGES 1. http://silviahartmann.com/art/raindrops-window-rainy-day.php 2. http://3dvision-blog.com/wp-content/uploads/2012/03/eye-up-close.jpg 3. https://churchcoffee.files.wordpress.com/2012/12/sad-man-silhouette-on-bench. jpg 4. http://crosswalkfamily.com/wp-content/uploads/2014/09/two-people-holdinghands-you-are-not-alone.jpg 5. http://www.cruzine.com/2013/04/22/creative-portrait-photography-laura-makabresku/ 6. http://pastlifetourist.com/wp-content/uploads/2014/10/o-hands-reaching-facebook.jpg 7. http://40.media.tumblr.com/tumblr_levc8ffMQQ1qgndexo1_1280.jpg 8. http://www.cruzine.com/2013/04/22/creative-portrait-photography-laura-makabresku/ 9. http://f.fwallpapers.com/images/old-man-face.jpg 10. http://www.smartfurniture.com/products/Eames-Plastic-Armchair-Dowel-LegBase.html 11. http://www.shawcontractgroup.com/Html/ShowProjectProfile/PP_stanford_ medicine 12. http://freshpatrol.com/wp-content/uploads/2013/06/poverty.jpg 13. http://i2.cdn.turner.com/cnn/dam/assets/140108171837-10-war-poverty-restricted-horizontal-gallery.jpg 14. http://www.archiproducts.com/en/products/8678/riletto-solid-wood-double-bedriletto-double-bed-team-7-naturlich-wohnen.html 15. http://www.cruzine.com/2013/04/22/creative-portrait-photography-laura-makabresku/ 16. http://fiusm.com/2015/09/03/caps-bring-group-counseling-sessions/

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fig. 1

fig. 2

s e c t i o n t w o:

historiography & contemporary global context

2

“everyone is a moon and has a dark side which he never shows to anybody�

-m a r k t w a i n-

ORIGIN STORY EARLY HISTORY Interest in mental health around the world dates back to the sixth century BC, when people began attributing their own insane behavior to themselves.1 Since then, around the world, mental health facilities have grown popular as they are no longer asylums or hospitals, and are treatment “homes� instead. Asylums such as the Bethlem Royal Hospital in London (fig. 3), the Public Hospital in Williamsburg (fig. 4), and the Eastern State 14

Penitentiary in Philadelphia (fig. 5) tortured the mentally ill until government ordered their shutdowns or changes of procedures.2 In the United States,asylum generally shifted from torturous to beneficial by the early 1900s, creating facilities with symmetrical form and space planning, with generous circulation and access to natural light.3 In London, mental treatment facilities were gaining popularity, with the rising importance of the Bethlem Royal Hospital for the

fig. 3

fig. 5

fig. 4

fig. 6

mentally insane. In the 12th century, it was built in Bethlem, but would move 400 years later to Moorfields.

The original building in Bethlem was a less linear layout-the 12 cellblocks were centered around a courtyard with a chapel in the middle, an exercise yard, and area for staff.4 The new building in Moorfields was larger and had a plan that was much more like the plans of the Public House and the Eastern State Penitentiary-its layout was linear with wings breaking

off around a central garden and lobby area (see figure 7).

The cellblocks quintupled in number, featuring new areas for criminals and incurable inmates, separated by gender.

The area was surrounded by gardens, each for a different type of ill inmate.5 Although the plan’s layout was similar to more modern facilities, its treatment was no better, and is the origin of the word “bedlam,” a play on the word “Bethlem,” which has come to mean sheer chaos. This building is considered one of 15

fig. 7 the most horrifying insane asylums of all time, due to the reported extreme torture and dismemberment of inmates.6 One hundred years after Bethlem was moved to Moorfields, The Public Hospital in Williamsburg, Virginia, became the first freestanding facility in America used solely for the ‘treatment’ of the mentally ill. These treatments 16

included forcing out evil spirits through bleeding, blistering, and vomiting.7 Although these plans for inmates were standard in 1773 when the Public Hospital was built, it included no specialization in plan and instead was rather plain: it featured a central hall, a stair, the keeper’s one-room apartment, double-loaded corridors with single cells throughout.8 This plan was essentially mirrored

on the second and third floors, appearing architecturally similar to local colleges and government buildings to draw minimal attention. It featured two small airing spaces where inmates could go outside, attended, to get fresh air in between the building and the high surrounding walls.9

ASYLUMS EASTERN STATE PENITENTIARY The Eastern State Penitentiary was built over fifty years later, in Philadelphia, Pennsylvania.

Built to be a prison for all Pennsylvania System criminals, the building quickly turned into a nineteenth century madhouse with bizarre and brutal treatment of inmates. For example, inmates could keep pets in their cells, but were often water boarded, wrapped in strait-jackets, and beaten with various iron tools.10 Its plan and exterior architecture varied

greatly from other designs of the time; it featured a radial plan (see figure 8), with seven cellblocks converging upon a central area.11 At their back ends, the cells opened up into small exercise areas, which were also enclosed by walls to prevent escape. Their cells all featured indoor plumbing and running water, and were fashioned out of stone and concrete, including a minimum amount of furniture so inmates could decorate.12 This facility combined poor, petty criminals, the mentally insane, and notorious criminal celebrities-most notably, American gangster Al Capone.

fig. 8

fig. 9 17

fig. 10

G L O B A L

fig. 11 18

What these three facilities have in common is not only their notability, but their general interior design choices and architectural decisions. All three were located in suburban areas that grew more urban with time.

During the Enlightenment, when these three asylums were built, people were becoming more interested in nature again.13 This is why all three facilities have plentiful gardens and access to some natural light in each cell.

Although the natural light was not plentiful, it was still something in comparison to the darker, more dismal precedents.14 The facades of the buildings are covered in windows, and in the Eastern State Penitentiary’s case, photos show that the ceiling through the corridors was full of skylights. Artificial lighting was minimal, with only wall sconces providing illumination to the corridors.

The patient rooms would be illuminated only by the corridor’s light, so in the evening without the sun,

“MENTAL ILLNESS CAN HAPPEN TO ANYBODY. YOU CAN BE A DUSTMAN, A POLITICIAN, A TESCO WORKER...ANYONE. IT COULD BE YOUR DAD, YOUR BROTHER, OR YOUR AUNT.” - frank bruno -

the rooms were dark and dismal.15 These buildings required long corridors for uninterrupted lines of sight to the many cellblocks and few areas of egress so patients could not escape. All three precedents were large, stone and brick buildings, meant to blend in with local architecture. They all featured long rows of cellblocks, centered around the entry vestibule and check-in area. None of them treated patients as people, in private bedrooms and therapy groups, but rather as criminals.16 British boxer and bipolar disorder

sufferer Frank Bruno said “Mental illness can happen to anybody.

You can be a dustman, a politician, a Tesco worker…anyone. It could be your dad, your brother, or your aunt.”17 It is for this reason that mental health facilities are not specific to one culture or one ethnicity-they transcend physical qualities and exist all over the world, in all climates and locations.

In various countries across Africa, insane asylums developed the same way that their northwestern counterparts in the United States did; they were prisons for the deranged and ill, featuring

torture, castration, and sexual abuse.18 There was one difference, however: the African treatment facilities “institutionalized racist practices,”19 with white Africans frequently in charge of the facilities, forcing the black inmates into crueler torture and worst living conditions than the white inmates.

Although white people were of the minority in Africa, they were still treated with more respect due to the success of white populations around the world. Blacks were often incarcerated because they openly disagreed with the colonial 19

government or considered colonial ideals not be progressive enough. This idea that citizens could be punished and declared mentally ill because they disagreed with their government was an issue that plagued African mental health facilities for hundreds of years.20 However, in China, mental illness has never been treated.

In 2010, Yin Li, the Chinese Vice Minister of Public Health, declared this an outrage and instituted a plan for 550 mental health support centers, such as mental hospitals, treatment centers, and psychological departments in general hospitals to be built.21 It is estimated that there are 4 qualified psychiatrists worldwide to every 100,000 mentally ill person, but in China, there are 126. With over 100 million mentally ill people in need of treatment, 20

China’s plan hopes to provide free treatment to those with severe mental illnesses such as schizophrenia (see figure 12 of a woman known to hear voices).22 This proves that while treating the mentally ill around the world is gaining importance, there are still millions of people of varied ethnicity and socioeconomic class with no access at all.

P O V E R T Y It has become evident that there is a large gap between treating those of middle to high income and those with little to no income, due to minimal government funding for the treatment of mentally ill people.23 The design and treatment trend suggests that people be treated in a home-like setting, or their actual home, to alleviate

fig. 12

fig. 14

fig. 13

fig. 15

the stressful relocation of patient to hospital. However, this trend has proven that private practices are the only types of care similar to this in thehealthcare sector and those are an extreme expense in comparison to government funded facilities which can accommodate those of a lower socioeconomic class.24 According to the National Alliance on Mental Health,“An estimated 26% of homeless adults staying in shelters live with serious mental illness and/or substance use

disorders.�25 Government funded or lower-expense facilities have the potential to alleviate this burden on shelters and on the economy of the Untied States, because $193.2 billion is lost in the country’s earnings per year due to treatment for serious mental illnesses not being accessible and affordable.26

21

ENDNOTES 1. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 2.

2. Carla Yanni, “The Linear Plan for Insane Asylums in the United States before 1866,” Journal of the Society of Architectural Historians, 2003. Page 26.

3. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 2.

4. “From Bethlehem to Bedlam,” Historic England, 2015, https://historicengland.org.uk/research/inclusive-heritage/disability-history/1050-1485/from-bethlehem-to-bedlam/ 5. “Health - Bethlem,” Victorian London, 2012, http://www.victorianlondon.org/health/bethlem.gif 6. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 2.

7. Carla Yanni, “The Linear Plan for Insane Asylums in the United States before 1866,” Journal of the Society of Architectural Historians, 2003. Page 26.

8. Carla Yanni, “The Linear Plan for Insane Asylums in the United States before 1866,” Journal of the Society of Architectural Historians, 2003. Page 26.

9. Carla Yanni, “The Linear Plan for Insane Asylums in the United States before 1866,” Journal of the Society of Architectural Historians, 2003. Page 27.

10. Te. Voelker and N Frazier, “Sources: The Social History of Crime and Punishment in America: An Encyclopedia,” Reference & User Services Quarterly, 2013.

Page 517.

11. Te. Voelker and N Frazier, “Sources: The Social History of Crime and Punishment in America: An Encyclopedia,” Reference & User Services Quarterly, 2013.

Page 517.

12. Te. Voelker and N Frazier, “Sources: The Social History of Crime and Punishment in America: An Encyclopedia,” Reference & User Services Quarterly, 2013.

Page 517.

13. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 3.

14. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 2.

15. Benjamin Reiss, “Theaters of Madness: Insane Asylums and Nineteenth-Century American Culture,” University of Chicago Press, 2008. Page 144.

16. Juliet L.H. Foster, “What can Social Psychologists Learn from Architecture? The Asylum as Example,” Journal for the Theory of Social Behaviour, June 2014.

Page 144.

17. Stephen B. Seager, “Behind the Gates of Gomorrah: A Year with the Criminally Insane,” Gallery Books, 2014. Page 52.

18. Sally Swartz, “Madness and Method: Approaches to the History of Mental Illness,” Psychology in Society, 2009. Page 70.

19. Sally Swartz, “Madness and Method: Approaches to the History of Mental Illness,” Psychology in Society, 2009. Page 73.

20. Sally Swartz, “Madness and Method: Approaches to the History of Mental Illness,” Psychology in Society, 2009. Page 72.

21. “Psychiatric Institutions in China,” The Lancet, 2010, Page 2.

22. “Psychiatric Institutions in China,” The Lancet, 2010, Page 2.

23. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_ designformentalhealth_2014.pdf. Page 3.

22

E N D N O T E S (C O N T I N U E D) 24. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf.

Page 3.

25. “Mental Health by the Numbers,” NAMI: National Alliance on Mental Illness, January 1, 2015, https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers 26. “Mental Health by the Numbers,” NAMI: National Alliance on Mental Illness, January 1, 2015, https://www.nami.org/Learn-More/Mental-Health-By-the-Numbers

IMAGES fig. 1 - http://www.eso.org/public/archives/images/original/eso0905a.jpg fig. 2 - https://wallpaperscraft.com/image/eye_eyelashes_pupil_black_and_ white_50284_2560x1440.jpg fig. 3 - http://www.gutsandgore.co.uk/wp-content/uploads/2013/01/Bethlem-Royal-Hospital-fourth-building.jpg fig. 4 - http://www.history.org/almanack/places/hb/images/publichospital.jpg fig. 5 - http://www.newsworks.org/images/stories/flexicontent/l_apeasternstatepennx1200.jpg fig. 6 - https://www.thenationalcouncil.org/lindas-corner-office/wp-content/blogs.dir/4/ files/2015/01/asylum-or-warehouse-image.jpg fig. 7 - https://upload.wikimedia.org/wikipedia/commons/6/6e/The_Hospital_of_Bethlem_(Bedlam),_St._George’s_Fields,_Lambe_Wellcome_L0011831.jpg fig. 8 - https://upload.wikimedia.org/wikipedia/commons/8/8b/Eastern_State_Penitentiary_Floor_ Plan_1836.png fig. 9 - https://upload.wikimedia.org/wikipedia/commons/d/dc/Eastern_State_Penitentiary_aerial_crop.jpg fig. 10 -http://www.asiagreenbuildings.com/wp-content/uploads/2013/12/carbajo-barrios-natural-light-in-attic.jpg fig. 11 - https://petroleusesletter.files.wordpress.com/2013/06/prison-cell-via-shutterstock.jpg fig. 12 - http://cdn.theatlantic.com/static/mt/assets/china/mentalbanner.jpg fig. 13 - http://www.cruzine.com/2013/04/22/creative-portrait-photography-laura-makabresku/ fig. 14 - http://www.veteranstoday.com/wp-content/uploads/2015/06/homeless.jpg fig. 15 - https://c2.staticflickr.com/2/1063/990843841_3122f7afa6.jpg

23

fig. 1

fig. 2

s e c t i o n t h r e e: c a s e

s t u d i e s

3

“my universe is my eyes and my ears. everything else is heresay.�

-d o u g l a s a d a m s-

CASE STUDY 1 fig. 3

INTRODUCTION The Madlyn & Leonard Abramson Center for Jewish Life, located at 1425 Horsham Road, in North Wales, PA, treats over 200 patients a day.

At approximately 410,000 square feet, the two-story building provides separate units for independent living and assisted living, with skilled nursing throughout.

The center opened in 2002 after two years of construction.

EwingCole designed it to meet 26

a high end clientele; the facility is considered “expensive,� but is not a luxury facility like a resort. As it includes constant one-on-one attention from nurses and certified nursing aides, a wide variety of treatments and activities, and completely private rooms, it is more expensive to live in and to maintain. Its high construction cost continues to grow as the facility expands every few years as more residents apply for admission and the private owners seek to provide more for the community. The client

fig. 4

fig. 5 is typically a middle to upper class Jewish male or female over 65 with various health issues.

The user varies from paid staff to volunteers, as well as the residents and the non-residents who stop by for for dialysis.

SITE INFLUENCE

Seated on over 70 acres of grass and forest (fig. 5), the facility has plenty of space for gardens, courtyards, private outdoor seating areas, fenced-in zones for crops, and for expansion. As the building is situated on a higher flood plane, there is little to no risk of flooding or great impact by severe storms.

The climate is temperate but in anticipation of strong snowstorms,

the roof is steeply pitched and the parking lot was purposely kept wide for easy snow removal and evacuation in case of a fire. The overall flatness of the site works well to allow plenty of parking including an additional lot in the back for staff. It also features a large section of strictly handicapped parking to appeal more to not only 27

fig. 5 the intended clientele, but also to visitors. It is located off of a major road (Horsham Road) in the wealthier suburbs and is situated back far enough for plenty of privacy and quiet. Average home value in Horsham is $262,390, nearly $100,000 more than Pennsylvania’s median home value of $164,200. This high cost of living keeps the area wealthier and than surrounding cities.

R E L E V A N C E This case study relates to a behavioral health center because their care for the aging population 28

is greatly impacted by dementia and Alzheimer’s. It features similar interior design and program details, such as nursing stations, private rooms, gathering space, therapy space, and enclosed outdoor areas.

It also encourages interaction with nature from the indoors, through large windows, window seating, and low planter beds in the town hall. Its concept, based on a “family home,” will impact the design of the behavioral health center, which will be inspired by not only the atmosphere, but also the careful planning.

D E S I G N

The style is very “modern senior living,” with bright colors subtly infused into a natural scheme. It is comfortable and serene, with areas that are linked closely to nature and are very customizable. The concept was a “family home,” as homes have different nodes for different people and an organizational scheme all their own. This building has three principal components: The Residence, The Inn, and Town Square. It has also received renovations to create an area for dialysis and outpatient treatment.

The facility was designed into clusters off of long corridors

that houseThe Residence andThe Inn, all built off of the Town Square atrium. The building also features a back corridor, which leads to the new dialysis and outpatient treatment center.

A R C H I T E C T U R E Its exterior is a traditional suburban style that appears like a large scale home that you would see in a Pennsylvania suburban development or neighborhood. It has wellkept vinyl siding and a shingled roof. It was built in typical slab-on-grade construction with steel framing and lots of glass. Large metal trusses support the pitched roof along with regularly placed structural columns to support the heavy mezzanine.

Its exterior is covered in light grey vinyl siding and brick and the pitched, shingled roof features a frosted glass skylight over the Town Hall. The exterior materials give the appearance of a large home, which refers back to the concept. It was not built with sustainability in mind; however, the many gardens and windows alleviate the need for additional artificial lighting during the day. Its HVAC is a traditional system with vents circulating air through the building.

fig. 6 29

fig. 7

fig. 8 30

The circulation can be initially jarring; upon entry there is a small lobby before the massive atrium, with corridors both left and right, an above mezzanine, and another corridor immediately around to the back of the lobby. Wayfinding is strongly implemented so the residents do not get lost because the facility is sensitive to those with memory impairment. In certain areas, wings are color coded for those with memory issues. For example, the purple resident wing features a bright purple wall at the end of the

hallway, and the hallway carpet has a purple border drawing the residents back.There is also a very obvious and easy to remember picture on these color walls; the purple area has a large, colorful photo of a guitar. In terms of signage, it is minimal and classic in terms of font choice, to make it feel like more of a home and less of an establishment.

I N T E R I O R The wings of the building are centered around the Town

fig. 9 Hall, a large atrium with frosted glass skylights to diffuse natural light. Each wing (fig. 11 & 12) features similar spaces, such as a flexible room and a card room. They each have nursing stations and dining halls, with options for private foodservice and public cafeteria-style dining.

Both floors feature administrative offices around the mezzanine and Town Hall, and travel between floors is only accessible through elevators or fire stairs. There are a variety of additional spaces that are located on top of each other, but vary between floors-on

the lower level, there is indoor gardening space and a bistro, and above it on the top floor there is an art studio and beauty salon.

The interior is full of sun which makes it feel inviting. The lobby and reception area is spacious, but it feels small in comparison to the massive atrium, or “Town Square,� adjacent to the security desk.

All materials used are warm: light green carpet with an organic pattern on it, a creamy beige stone around a raised, linear fireplace, light pops of orange and and blue on the furniture, and an overall

fig. 10 lightness due to the sun coming through the frosted glass pitched roof. Plants are everywhere, as well as scattered seating areas, for residents to talk with their families and for visitors to take a break from walking the building.

In the corridors’ walls, there are low, recessed seats for the same purpose. The wallpaper and textiles are subtle so that they will remain current for a long time.

There is also a lot of casework, including religious stations for Judaic relics and symbols so that the residents feel at home.

31

fig. 11 32

fig. 12 33

fig. 13 34

space. There are some large, wallmounted can lights as well, kept off during the day and turned on In some smaller lobbies, ones at night. The facility primarily uses that lead to other wings, there are recessed ceiling fixtures, as the fireplaces the residents can gather hallway ceilings are all acoustical around for conversation. Paintings tile. In the more public areas with of nature line the halls, and a 3form dropped, faux wood panel ceilings, panel with a botanical design there are randomly spaced recessed denotes entry into new spaces. The linear lights which create a more furniture is “standard” senior living playful appearance. Acoustics are furniture, from manufacturers fine in the space, including in the such as Fairfield Senior Living, atrium with its high ceiling, due to Flexsteel, and Kellex, with seat plush carpet and the acoustical tile depths reaching no more than 20 that covers the mezzanine’s ceiling. inches. The typical groupings of furniture include lounge chairs and couches around low coffee tables or raised tables for activities.

These arrangements are similar Upon visiting, a few qualities of the to typical residential interiors, to building were discussed to be both further the home-like aesthetic. good and bad. The patient rooms are private, with extremely large, low windows for those in wheelchairs to have easy visual access to nature.

They can be highly personalized The atrium (fig. 13) uses minimal and are spacious in general, with artificial lighting, as it is entirely premium rooms for high-paying open above with frosted glass independent living residents. They that filters light down into the include a living and a dining area, a

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USER SURVEY

L I G H T I N G

small kitchen, a bathroom, a closet, and a bedroom. Capable residents are granted special permissions, such as a microwave, if they are deemed capable. However, there is always the issue of residents disliking their neighbors, and the “dying in place” policy typically prevents residents from moving their rooms. There is also the issue of residents with memory impairment wandering into other peoples’ rooms, because the facility integrates those with memory issues into the rest of the population instead of having a separate wing. The staff also complains about small, cramped offices and administrative areas that are “fishbowls,” or completely enclosed in glass with minimal privacy. They also wish there were more storage spaces and additional large, open rooms for extra programming and activities. A final complaint is the lack of service elevators. The only elevators in the building serve two functions: carrying people and carrying service equipment together. This creates an issue

35

fig. 14 when meals are being delivered entertainment, held every Sunday. via the elevator and residents, staff, Staff reports that this area sees the and visitors are trying to circulate most use. through the building.

I think the building succeeds in The most successful aspect of the creating harmony between patients design is the Town Hall atrium, and visitors. I have noticed that which is like an outdoor experience often in nursing homes, residents and is extremely welcoming to are lonely in their double rooms, visitors. The staff feels that the because they either do not like residents appreciate it so much their roommate or their family because it is bright, clean, and does not visit because there is no pleasant, which makes it feel like privacy. The rooms are all highly it is not an institution. There are personalized, with residents also plenty of areas for residents to choosing their own bedspreads enjoy activities, like playing cards and putting up images of their and painting. The Town Hall hosts families and friends on the walls. the Jewish Shabbat ceremony, There is a sense of peace and calm held every Friday and Saturday that other nursing homes I have nights, and is the perfect area for experienced lack – talking is kept

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fig. 15 at a quiet, content level, and there is no foul scent or frequent patient outbursts or screams. People seem to be content in the space and even enjoy the more “youthful� spaces such as the bistro. The quantity of outdoor courtyards and gardens appeals to me as well, as there were dozens of residents using them when I visited. I think that sensitive people can greatly benefit from this natural connection, and I love that each wing has a small, accessible kitchen for residents to continue preparing their own basics like coffee and soup under supervision. My only critiques match those of the staff.

(right) diagram 1: circulation

blue dots note circulation through the building. green dot notes entry.

(left) diagram 2: public vs private

pink spaces are extremely private, as they are resident rooms. green spaces are semi-private, which includes offices.

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(above) diagram 3: datum

orange blocks show the 5 clusters divided up into 3 wings, all attached by orange lines that show direct circulation.

(right) diagram 4: room matrix

connected rooms have direct adjacency. orange notes spaces with high usage, green with moderate, and purple with low.

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ENDNOTES 1. “Horsham, Pennsylvania,� City Data, January 1, 2015, http://www.city-data. com/city/Horsham-Pennsylvania.html

IMAGES fig. 1 - http://data.hdwallpapers.im/aurora_over_a_dark_forest.jpg fig. 2 - https://isabellawxy.files.wordpress.com/2012/09/green_eyes_.jpg fig. 3 - https://www.teenlife.com/media/uploads/listings/madlyn-and-leonardabramson-center-for-jewish-life/tbNterRjgKer.jpg fig. 4 - photograph by amy leigh hufford. fig. 5 - photograph by amy leigh hufford. fig. 6 - photograph by amy leigh hufford. fig. 7 - photograph by amy leigh hufford. fig. 8 - photograph by amy leigh hufford. fig. 9 - photograph by amy leigh hufford. fig. 10 -photograph by amy leigh hufford. fig. 11 - photograph courtesy of the abramson center. fig. 12 - photograph courtesy of the abramson center. fig. 13 - photograph courtesy of the abramson center. fig. 14 - photograph by amy leigh hufford. fig. 15 - photograph by amy leigh hufford.

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CASE STUDY 2 fig. 1 the long-term patients and the bottom floor treating the cardiac and short-term ManorCare Nursing and patients. The bottom floor Rehab, located at 3430 also has a wing designated Huntingdon Pike in for dementia patients only.

Huntingdon Valley, PA, is an approximately 200,000 The center opened in square foot building. Its the early 1990s to private smaller size, in comparison owners. As ManorCare is to the Abramson Center, a chain, there are dozens means that its maximum of others in the area, all of patient capacity is only 140, which vary in quality. This which it has never reached. facility in particular is one Its typical census is between of the neglected facilities, 100 and 120. The building as it has barely been is split into two stories, upgraded since completion. with the top floor treating

INTRODUCTION

40

fig. 2

fig. 3 Construction costs were low, as the building includes the minimum amount of amenities and nearly all of the patient rooms are doubles.

The client varies; typical longterm clients are males and females over 65 with health issues, varying in severity, including extreme obesity. There are also younger residents, typically in the cardiac unit, who stay for a short period

of time after a heart attack, major forested, but the front is a wellsurgery, or substance abuse. manicured grassy hill with a few trees. There is an overflow parking lot adjacent to the building but it is inaccessible from the main As it is located on a small plot parking lot, located on the other of land on a major road and is side. As the building is at a slightly surrounded by suburban homes, lower elevation than the roads, the facility has high visibility and during the winter, the snow its exterior must be well-kempt. slides down the hills and creates The back of the building is heavily a treacherous area for walking

SITE INFLUENCES

41

fig. 4 and driving. Similarly, when it rains, the parking lot floods, but the water is removed by pipes that carry the water down to the lower, forested area, and away from the property. The climate is temperate but in anticipation of snowstorms, the roof is steeply pitched. The surrounding suburb is full of mansions and developments, but its location on Huntingdon Pike brings a lot of lower-income city patients, as the Pike leads right into Northeast Philadelphia.

behavioral health center because of their dementia unit and treatment of a younger population as well. It features similar interior design and program details, such as nursing stations, private rooms, gathering space, therapy space, and enclosed outdoor areas. Although it features those similarities, the facility in general is considered very low-end and outdated. The overall concept was to divide the building into very obvious wings to emphasize the differences among types of care.

The building has rearranged itself since then, in that the “wings� don’t determine the type of care, This case study relates to a as it is divided by floor instead.

R E L E V A N C E 42

I N T E R I O R The style is reminiscent of typical late 80s design preferred by senior citizens. It features the ornate wallpaper and old-fashioned furniture of their youth in the lobby and dining room, which is very different from the rest of the building. Those two spaces are the first two experienced by visitors and potential patients, yet are in the worst condition and are the least updated. The hallways, patient rooms, activities room, kitchen, staff lounge, and rehab/care areas are all very modern, as they have received the most updates.

More recently, the lower level has7

seen changes, with a minor expansion and redesign of the rehabilitation rooms and new carpet, flooring, wallpaper, and branding. The upper level has been untouched in over a decade. It is designed into wings, centralized around a main corridor and nursing station, appearing similar to a pinwheel in plan.

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Its exterior appears slightly home-like, but not in the same way that a true senior living facility does. It does not resemble a home, but embodies similar characteristics, such as vinyl and stucco siding, regularly spaced windows, and a pitched roof. The front of the building has a more welcoming feel, with a canopy over a narrow vehicular path, a bench for seating, and a dramatic, wood and glass door typically seen on an expensive residence. Its typical construction style is nearly invisible, aside from a few well-hidden columns, and a large retaining wall holding the hill back. Sustainability was not considered.

The interior architecture is lackluster; it is very typical, plain facility, as it is not an expensive place to live and does not provide the highest level of

fig. 5 43

fig. 6 care. The building takes care of many outpatients, so the designers probably skipped over unnecessary frills when deciding on finishes and program. The overall designs of the lobby and dining room are outdated, with damask wallpaper and furniture in mauve and sage tones. Subtly pink and mauve, the dining room has a few chandeliers throughout, casting an unappealing rosy glow. The rest of the facility, however, looks more modern, with a fig. 7 light blue scheme on the upper 44

level and a bolder scheme on the lower level. Bold and bright facility-promoting art adorns the walls on the lower level, with navy blue wallpaper covering the main hallway. The cream sheet vinyl with a darker border calling out where rooms are located is regularly buffed to maintain its sheen. Around the nursing station and in the resident corridors is new carpet tile, in a dark green, floral pattern with hints of color. The walls are relatively bare, aside

fig. 8 from some dated nature The building is “backwards” in paintings and wallpaper. this way, causing visitors and residents to be very confused, as you enter on the upper level (first floor) and have to go down to the lower level (second floor).

Simple circulation helps dementia Otherwise, it is simple, as there patients and other wandering are very few paths of circulation residents, as well as visitors, to and they all lead to dead ends.

CIRCULATION

easily find their way back to their room. After exiting the lobby, there is only one large, main hallway straight ahead to the nurses’ station. From there, signage highlights what numbered rooms are in each area. Second floor, or lower level, visitors and patients would take the elevator down.

The resident rooms surround the corridors, and are virtually the same on both floors. The main corridors end with the nurses’ station and private nursing room, with an adjacent, small bistro.

Around the nursing stations are the bathrooms, soiled and general

fig. 9 storage rooms, and beauty salon on the upper level. On the lower level it is the same, with a few resident rooms and beauty salon substituted for the physical and occupational therapy areas. The leftmost wing was also converted to a locked unit on the lower level for the memory impaired, dementia patients. A small activities room is nearly hidden on the upper level, and all of the administration spaces are hidden in a passcode-locked corridor near the entrance and fire stairs.

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fig. 10

fig. 11

fig. 12 13 46

L I G H T I N G/ A C O U S T I C S The space is well-lit, but requires primarily artificial lighting. As there are few “gathering” spaces in the building, most of the window walls are closed off to the main space because they are in patient rooms.

There is a large window at the end of each long corridor, but if you do not enter any of the rooms and are just in the hallways or kitchen, you cannot see any windows. The dining room has many, but none have a pleasant view, as they face the rest of the building and the large fence around the garbage and recycling. In terms of acoustics, the building is excellent, because the ceilings are low and are all covered in acoustical tile. Significant carpeting on the lower level also soaks up sound, and thus the upper level is slightly louder since there is linoleum tile instead of carpet.

The interior is not warm and inviting, but rather “calming”

due to the amount of light blue used. The furniture is very out of date in many spaces and does not match the newer updates to the building. Their condition is typically fine, but could use reupholstering. The art is primarily old brush paintings of nature, but there are facility pride wall features and branding throughout.

USER SURVEY The employees and residents have very strong opinions about the unsuccessful qualities of the spaces. Their major complaints are that the residents hate the double rooms and lack of gathering space for conversation. Families rarely visit, as there is no space to really do so. The corridors could stand to be another foot and a half wider, as there are no service corridors, so they are shared with food service delivery trucks, housekeeping carts, and nursing carts, as well as people circulating. The finishes are not home-like and warm at all,

and there are many cases of poor installation. Outdoor spaces are so poorly kept that residents never use them, and they are surrounded by huge, white fencing, so there is no view to what is beyond anyway.

Residents and visitors feel trapped in these areas, as they are totally empty as well. Staff also complains about the lack of storage and how poorly door jambs are wearing, as well as the poor installation of obviously crooked walls, and transitions between flooring types.

The positive aspects staff appreciate are the ease of circulation and adjacencies. Staff never have to go far to get where they naturally need to be. For example, the laundry room is adjacent to the elevator, which leads into the dining room where the clean bibs, placemats, and napkins need to be stored. The kitchen’s layout is also very successful, although the kitchen supervisor’s office is a 6’ box, which is extremely uncomfortable and entirely too small. Residents spend much of

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fig. 13 their time in the activities room exploration causes plenty of and in their own bedrooms. problems amongst residents; they argue often and complain I think the building was poorly about each other, and are often executed. The resident rooms lobbying for room changes are entirely too small, including because there is no breathing the one-patient rooms. They room. It feels very institutional are poorly planned and there due to lack of informal gathering is only one closet in the double spaces and poor choice of rooms, on one resident’s side. materials and furniture. I work The common complaint that in the building and can testify the hallways are too narrow is that the lack of personal space, also true, as 8 feet is too small lack of connection to nature, to accommodate a dining cart, and lack of gathering spaces for nursing cart, and people passing visitors does not improve patient through. The problem of close outcomes. Many patients wind quarters and minimal room for up coming in for short-term 48

fig. 14 and do not get better, so they wind up living there longer than intended, and are relocated from room to room multiple times.

Uprooting patients and having them realize that someday they will probably get moved to the dementia unit with people they hope to never become is very disconcerting. The space feels calm, but not in a pleasant wayrather in a way that feels like everyone is settling for something second-rate, something they will probably never get to leave.

(above) diagram 1: circulation

blue dots note circulation through the building. green dot notes entry.

(left) diagram 2: public vs private

pink spaces are extremely private, as they are resident rooms. green spaces are semi-private, which includes offices.

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(above) diagram 3: datum

orange lines note the datum through the space. blocked out areas highlight resident rooms, which are integral to the wings.

(above) diagram 4: room matrix

connected rooms have direct adjacency. orange notes spaces with high usage, green with moderate, and purple with low.

(left) diagram 5: adjacencies

blue spaces are staff-only. pink spaces are for housekeeping and storage. orange spaces are resident rooms. green spaces are auxiliary resident spaces, like therapy and bathrooms. dotted line notes circulation.

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IMAGES fig. 1 - photograph by amy leigh hufford. fig. 2 - http://www.heartland-manorcare.com/locations/manorcare-health-services-huntington-valley/ fig. 3 - http://www.heartland-manorcare.com/locations/manorcare-health-services-huntington-valley/ fig. 4 - photograph by amy leigh hufford. fig. 5 - photograph by amy leigh hufford. fig. 6 - http://www.heartland-manorcare.com/locations/manorcare-health-services-huntington-valley/ fig. 7 - photograph by amy leigh hufford. fig. 8 - photograph by amy leigh hufford. fig. 9 - photograph by amy leigh hufford. fig. 10 -http://www.heartland-manorcare.com/locations/manorcare-health-services-huntington-valley/ fig. 11 - https://www.google.com/maps/place/3430+Huntingdon+Pike,+Huntingdon+Valley,+PA+19006/@40.1481814,-75.0602638,2 70m/data=!3m1!1e3!4m2!3m1!1s0x89c6adffdb6d3375:0xe6cf66fba58abb49!6m1!1e1 fig. 12 - photograph by amy leigh hufford. fig. 13 - photograph by amy leigh hufford. fig. 14 - photograph by amy leigh hufford.

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CASE STUDY 3 fig. 1

INTRODUCTION The Mayerhof Care Campus for the Elderly sits on over 3.7 acres of land in Belgium.

Located at Fredericusstraat 89, in the city of Mortsel, the newly build facility cost over $206,308,800. It opened for business in 2014, after completion by architects from Areal Architecten and MBG (CFE) Construction.1 The client, Mayerhof, owns and operates the facility, and 52

had a large impact upon the design from conception. Their design strategy was to destroy the basic plan of dozens of adjacent rooms linked together by long, straight corridors, and to create a more domestic facility.2 The architects decided that a less rational and economic approach should be taken, in favor of a more community and care based approach.

Thus the building features various communal gathering spaces and open areas for additional programming,

fig. 2

fig. 3 exploration, and circulation.3 Designed into an abstract figure eight, the plan of the building reflects the client’s desire to have fewer linked corridors of rooms and one steady breezeway of circulation. The figure eight’s corners are open to create spaces for interaction and socialization, leaving the center areas open for courtyards.4

located on the same campus, all which contain assisted living facilities which help to create a staff of 105 personnel.5 They overlook the nursing home, and act as true housing units in comparison to the larger nursing facility. These facilities are for those who require less care than those located in the main building, who are privy to skilled nursing and rehabilitation.6 Between the main facility and the three adjunct there are large openings with terraces to act as a residential There are three adjunct facilities barrier, to allow sight but also

SITE INFLUENCES

fig. 4 privacy, as well as independence for the assisted living residents.7 Its site is a flat, suburban campus, surrounded by trees for privacy.

The rest of the area is primarily residential, and is away from the business district. The weather is relatively similar to the weather in Philadelphia; a temperate climate with some windy and rainy days, average snowfall, and warm springs and summers.8 Its proximity to the major city of Antwerp make it subject to traffic on highways leading into the city, but its status as suburb keep it quiet and separate.9 53

fig. 5

D E S I G N The long, linear corridor in the main facility wraps around the two courtyards and also nonprogrammatic outdoor space. As the facility houses most residents on the bottom floors, the program on the upper floors diminishes, allowing more space for terraces with beautiful views of the rural landscape and also protection from the wind.10 Every patient room has a view to the courtyards or to the surrounding nature, creating a lightness and openness to the outdoors that is both sustainable 54

fig. 6 and

conducive

fig. 7

to

recovery.11 a separate yet sameness on the campus. While the main The three adjunct buildings were building houses very different completed a few months after the functions than the adjunct ones main building. The construction do, they still operate in tandem.13 covered the site, and the users of the main building were thrilled to have access to more green space after the construction was completed. This proved the A final, unique design decision concept to the architects and the architects made was to spread client; residents and patients three entrances to the site out. would become healthier and more This, along with the variance in pleasant in a facility attuned to size and appearance of the indoor nature.12 An underground passage and outdoor spaces, creates an connects the main building to the “urban fabric” to the campus adjunct facilities for circulation as opposed to more rational during bad weather, and creates care centers.14 Variance among

“U R B A N F A B R I C”

building materials furthers the urban aesthetic and also notes different programming and hierarchy;; the main facility (nursing home) is built in reflected aluminum cladding, as “canvas to the sunlight,�15 while the adjunct facilities (assisted living) are built from pristine masonry and exposed concrete ring beams.16

INTERIOR FINISHES Interior finishes are simple and pure, to create a healthy and clean environment.

Wood paneling in a light chestnut finish provides warmth in the space, while most walls and various finishes are left white or light grey to create a lightness.

The outdoor courtyards feature bright turquoise tables and various living rooms are painted bright green and bright orange, creating stark contrast. The campus in general is relatively neutral, and the furniture is more modern in comparison to typical nursing facilities.

For example, the pieces are elevated on feet and are sleek, as opposed to the chunky, soft sofas usually seen.

fig. 8

fig. 9 55

fig. 10

fig. 11 56

The living spaces are heavily decorated as well, and the amount of windows with direct access to natural light defeats the need for excess artificial lighting.

A few decorative fixtures create a sense of home, but recessed lighting is typical in the rest of the facility.

Whether they are small and round or long and linear, the lighting is kept simple, without the chandeliers and sconces typical of other elderly care centers.

EVALUATION I think this facility succeeds because it is so different in terms of plan. The two previous case studies featured the long rows of rooms, but the rooms at Mayerhof surround courtyards, creating more of a residential feeling, and less of a healthcare one. I think the lightness in materiality succeeds, but I do not really think I would choose bright lime green and orange for the elderly.

fig. 12 Perhaps those colors work to energize them, but I would choose more textures and less vibrant colors.

The facility is also successful, in my opinion, in that it is located close to a major city. Antwerp is only a twenty-minute drive away, so families have easy access to their relatives. The underground passage is also a nice touch for when patients are transported from the adjunct facilities to the main facility during bad weather, but I worry about the safety of it as

fig. 13

there are no pictures. I wonder about its brightness and if there is additional programming in it, or if it is primarily circulation space. My final opinion is that the campus is probably a nice space to recover and spend your life as there is such a oneness with nature, allowing residents to explore the large space while supervised.

fig. 14 57

(left) diagram 1: adjacencies

blue spaces are resident rooms, green are more public, activity spaces, yellow are dining spaces, pink are support spaces, such as kitchens, storage, and restrooms, and purple spaces are administrative.

(right) diagram 2: datum

the blue line signifies the spatial datum line, and the pink spaces are the non-circulation spaces surrounding it.

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(left) diagram 3: circulation

green dots show entry, purple show general circulation, and blue show circulation among buildings.

(below) diagram 4: circulation section green dots show entry, blue show horizontal circulation, and the orange lines show vertical circulation.

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fig. 15 (above) diagram 5: spatial relationships

one of Areal Architecten’s spatial relationship diagrams. shows the main “figure eight” building as well as the three adjunct facilities.

(right) diagram 6: room matrix

connected rooms have direct adjacency. orange notes spaces with high usage, green with moderate, and purple with low.

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ENDNOTES

I M A G E S ( C O N T I N U E D) f

1. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 1.

2. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 1.

3. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

4. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

5. “Personeel,” Mayerhof Woonzorgcentrum Voor Bejaarden, 2015.

6. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

7. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

8. “Mortsel, Belgium,” World Weather Online, 2015.

9. “Mortsel, Belgium,” World Weather Online, 2015.

10. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 1.

11. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

12. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 1.

13. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

14. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 3.

15. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

16. “Elderly Care Campus / Areal Architecten,” ArchDaily, 2014. Page 2.

fig. 5 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 6 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 7 -http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 8 - http://www.mayerhof.be/data/images/cats/crop/1_1399472382_leefruimte. bruul.minisite.jpg fig. 9 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 10 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 11 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 12 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 13 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 14 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 15 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram

IMAGES fig. 1 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 2 - http://www.archdaily.com/498917/elderly-care-campus-areal-architecten/5355f623c07a8073400000a5-elderly-care-campus-areal-architecten-diagram fig. 3 - http://www.archello.com/sites/default/files/imagecache/header_detail_large/AluminiumMayerhof_Mortsel4.jpg fig. 4 - https://www.google.com/maps/place/Fredericusstraat+89,+2640+Mortsel,+Belgium/@51.1673193,4.4695073,566m/ data=!3m1!1e3!4m2!3m1!1s0x47c3fa0f87852a87:0x192876380b83407f!6m1!1e1

61

CASE STUDY 4 fig. 1 become somewhat of an oasis in the city, thanks to its rooftop space and the lush greenery Completed in 2014, the SK growing on controlled Yee Healthy Life Centre sections of the building.2 has already won dozens of awards for its innovation in Ronald Lu & Partners healthcare design.1 Designed describes the SK Yee Healthy

by Ronald Lu & Partners Life Centre as a “modest and constructed by EDM yet meaningful project.”3 It Construction Company was built on an empty site Ltd in an extremely urban where a warehouse used to part of Hong Kong, China, sit, and fully designed on the building sits on a small the interior with a rooftop site of only .09 acres. It is addition by RLP’s in-house surrounded by high-rise interior design team. The urban structures and has structure is lightweight and

INTRODUCTION

62

fig. 2

fig. 4

fig. 3 primarily steel and glass and has a large impact on the surrounding environment, even though it is so small.

D

E

S

I

G

N

RLP’s concept of pulsation came from the desire for interaction between the interior and exterior; each counseling room and functional area is attached to an outdoor garden, which allows natural light to enter the space.4 The facility acts as a safe-haven for citizens

of Hong Kong and features no resident rooms, as it is simply a facility for patients to visit regularly. It is a healing environment, featuring a home-like aesthetic, with gardens and a playground for patients of all ages. Finally, the rooftop garden is the standout feature of the facility for many; it is a quiet location, high above the loud streets of Hong Kong, with buildings on either side as sound buffers. It offers space for serenity and calm thinking as well as relaxation and ambience. The natural environment alone acts as a “counseling

room,� as patients do not need to speak or receive medication to feel better by simply stepping outside, as the sunlight and plant life offer a different kind of treatment.5

C I R C U L A T I O N Sustainable design, when fused with healthcare design, creates a space of peaceful healing and relaxation as well as is gentle on the environment.6 Upon entering, reception is unique as a tree grows in the center of the path of circulation.

63

fig. 5 Adjacent to reception is a corridor, leading to two adult counseling rooms and two children counseling rooms. Each room opens to a garden, and there is a walkable path around the building. Also adjacent to reception is a multipurpose room for group therapy and for activity sessions and games. Throughout the space there are playful locations for patients to lounge and unwind, as well as slides that access the outdoor spaces as a childlike touch that even adults can enjoy.7

64

fig. 6

CLIMATE & LIGHT Materials used to build the structure are simple: whitepainted steel and glass create the exterior, and white paint and wood with subtle pops of color create the interior. It is entirely lit by natural light, eliminating the need for much artificial lighting. To add to the sustainability of the structure, cross-ventilated windows allow it to be fully naturally ventilated and controllable by patients. They can open and close the vents to experience the temperature,

fig. 7 creating a place of respect and dignity for personal preferences.8 This works because Hong Kong is nearly always warm; it is a subtropical climate influenced by typhoons, and is thus warm yearround with temperatures rarely south of 50 degrees Fahrenheit.

Typhoons are common during July and September, which bring extreme rain, wind, and humidity.9 This could possibly have a negative effect on the plant life growing on the building, but in general, the plants and natural ventilation system improve indoor air quality and are low-carbon in nature.10

G

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E

E

N

E

R

Y

The green roof and green wall covers over 57% of the space, which is extremely high in comparison to other sustainable buildings but creates a pleasant ratio inside.11 These green features eliminate the need for air conditioning as they shade the space to keep it cool but pleasant. The surrounding buildings enjoy the view of the green roof, proving that it not only helps patients, but helps neighbors as well.12

P

L

A

Y

fig. 8

The playful areas in the space make it exciting for children to come to counseling, instead of being scared about their mental health.

Children counseling rooms feature playhouses in bright colors and holes in the wall to climb through and slide into a garden.13 This playful environment takes the stress out of therapy, and even the adult counseling rooms feature unique furniture choices and long bookshelves for a sense of serenity and safety.

Patients are carefully watched, but as they are in a pleasant environment, they thrive, instead of progress becoming stagnant.14 fig. 9 65

fig. 10

EVALUATION I think this facility sets standards high for healthcare settings, as they have found a formula that promotes patient success as well as architectural success. I think the colors and materials chosen are pleasing, as well as playful and relaxing.

People typically find blue to be the most relaxing of colors, but I find spatial experience to be more relaxing than color itself. I think that creating play areas for fig. 11 children and informal seating 66

areas is the most relaxing way to design a space that treats the mentally ill. I do worry about the safety of the rooftop area, however, as it is often recommended that places for the mentally ill have no points of access for suicide, such as jumping out of a window or off of a roof. I assume patients are only taken up there if they are deemed healthy enough and are accompanied by staff. Finally, I find the space successful because of its proximity to residencies and businesses in Hong Kong.

(below) diagram 2: circulation

green dots show entry and blue show general circulation.

(above) diagram 1: adjacencies

blue space is entry and reception, pink spaces are counseling rooms, yellow space is multipurpose, and orange spaces are various nodes for relaxation.

67

(above) diagram 3: sections

fig. 12

(left) diagram 4: public vs. private

lime green spaces are public; pink are private.

(above) diagram 5: room matrix

connected rooms have direct adjacency. orange notes spaces with high usage and green with moderate.

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ENDNOTES

I M A G E S ( C O N T I N U E D) f

1. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 1.

2. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 1.

3. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 1.

4.“SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 2.

5. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 2.

6. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 3.

7. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 1.

8. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 3.

9. “Climate of Hong Kong,” Hong Kong Observatory, 2014. Page 1.

10. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 2.

11. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 4.

fig. 6 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-and-partners fig. 7 -http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-and-partners fig. 8 - https://www.google.com/maps/place/Tuen+Mun+Hospital/@22.4077707,113.976782,228m/data=!3m1!1e3!4m2!3m1!1s0x3403fade2d37716d:0xe7c6554364c86bd4!6m1!1e1 fig. 9 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-and-partners fig. 10 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-andpartners fig. 11 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-andpartners fig. 12 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-andpartners

12. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 4.

13. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 5.

14. “SK Yee Healthy Life Centre,” ArchDaily, 2014. Page 5.

IMAGES fig. 1 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronaldlu-and-partners fig. 2 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronaldlu-and-partners fig. 3 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronald-lu-and-partners fig. 4 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronaldlu-and-partners fig. 5 - http://www.archdaily.com/590542/sk-yee-healthy-life-centre-ronaldlu-and-partners

69

fig. 1

fig. 2

s e c t i o n f o u r: e r g o n o m i c s & t e c h nical c r i t e r i a

“your present circumstances don’t you can go; they merely determine

2

4

determine where where you start.”

- nido qubein-

FURNITURE, FINISHES,& EQUIPMENT The most critical aspect of furniture, finishes, and equipment in a space with behaviorally ill patients is preventing those objects from becoming weaponry.1 Artwork and other dĂŠcor must be anchored to their corresponding surfaces, and the overall layout of the space should provide sightlines for staff to watch over patients when in areas with less safety installed.2 Patient beds must be heavy-duty platforms with mattresses that have no springs (fig. 3), because typical bedframes can be broken apart to become weaponry.3 Additionally, cords are installed on many bedframes for restraining particular 72

patients. This is legal and is not meant for harm, but rather restraint to calm or medicate rowdy patients. The cords must be shorter than 12� in length to prevent abuse by both patient and staff.4 A built-in desk is often provided in patient rooms, and should consist of a solid-surface writing top and no exposed structural hardware. A chair is required at the desk, and as it is a loose piece of furniture, it is important to choose a piece that cannot be easily dismantled.5 It should not have openings a patient could tie a sheet around and hurt work fine as long as a cushion is applied for comfort.6 In regard to clothing storage, built-in shelving or clear bins work best, as wardrobes and closets create many issues for consideration. For example, if a wardrobe is specified, a gypsum board soffit must be built above it so there is no elevated surface for a patient

fig. 3

fig. 4

fig. 7

fig. 5 to climb on.7 Marker boards are the preferred means of personalization in the space, as they are virtually hazard-free if they are securely anchored; tack boards are too hazardous.8 In patient bathrooms, there should be no exposed piping (fig. 6), and push-button flush actuators are preferable to handles; they should also have settings to prevent excessive flushing and flooding.9 The same rules apply to lavatories. In the living rooms, where there is loose furniture like tables and chairs, it is important that they weigh enough to not

fig. 6 be thrown easily. This can be mediated by putting sandbags or weights inside the furniture to delay assault.10 Choosing furniture that looks residential and has rounded edges (fig. 4 & 5) and cushions provides a warmer, safer atmosphere than plastic chairs or chairs that cannot withstand abuse. Televisions should be wallmounted flat screens, recessed into the wall, with a cord length shorter than 12�. In group therapy areas, there should be appropriate, heavy loose furniture, and ample locks because the room should be inaccessible when not supervised.11 73

fig. 8

E R G O N O M I C S, A N T H R O P O M O R P H I C S, & P R O X I M E T R I C S It is important to note that the user group can include physically disabled or geriatric patients, and thus considerations with furniture must be made. Chair seat depth should not exceed 20� and should have solid arms to allow frail patients to pull themselves out of chairs easily.12 See all following diagrams for further information, critical dimensions, and layouts.

74

fig. 9

fig. 10

fig. 118 75

fig. 12 76

fig. 13

fig. 14 77

fig. 15

fig. 16

M A T E R I A L S

fig. 17 78

The facility needs primarily healthcare grade furniture and materials, as bleeding, urination, vomiting, and self-harm are all viable possibilities.13 It is typical for sheet and click-together plank vinyl flooring (fig. 18) to be used in this space, as they are available in warm wood finishes but are hygienic and easy to clean.14 Rubber base (fig. 17), which is available in curved silhouettes to prevent bacteria from growing at the

seam, should be installed at the floor to wall transition.15 Walls can be covered in Class A Fire-Rated wallcovering, and can also be painted in an eggshell finish for easiest cleaning and minimal glare.

If a specialty panel is to be applied, it must not have sharp edges or be able to be used as a weapon in any way.16 In resident bathrooms, slipresistant flooring is required.

If tile is used, it should not be applied to walls, as it can be more easily dislodged.17 Shower heads and controls

should be recessed into a solid surface shower pan and wall panel (fig. 19) to prevent injury, and there should be no shower curtains.18 The panels and raised floor plan edges should prevent water from escaping. Durability is another main concern; treating fabrics with Crypton or Nanotex + Durablock finishes prolongs the fabric’s life, as they wick moisture away so bacteria cannot grow and stains do not set (fig. 15).19 In areas where carpet is used, tile is suggested for easy replacement (fig. 16), but must have a moisture-resistant backing system due to accidents in the facility.20

fig. 18

fig. 19

fig. 20 79

L I G H T I N G In resident rooms, typical 2x2 or 2x4 recessed fixtures can be installed into the ceiling, although and type of recessed lighting works well. It is important that no lighting hangs from the ceiling as they could become anchor points for suicide.21 These fixtures should be installed with tamper resistant screws and flush trim.

Wall-mounted over-bed lighting should be no more than 4� deep for ADA compliance, but thinner, flatter ones are preferable so they cannot be used as anchor points either (fig. 21). They should be fastened securely, with tamper resistant screws and high-strength acrylic lenses that cannot be broken easily.22 Daylight should be provided in all 80

areas possible, with views to the exterior, and are safe as long as the glass is laminated or tempered.

There are considerations, however: with sunlight comes necessary shading features, but it is not desirable to have drapes or blinds as they become weaponry easily.

An exterior shading device works best, or shades that are inaccessible from floor level and are remote controlled.23 Skylights must be placed strategically, as heat load and glare can be very upsetting for patients.

Lighting should vary and be creative to enhance the space, but must always be recessed fixtures with flush mounting (fig. 22).

Incandescent lighting is preferable to bright fluorescent lighting, which feels institutional.24

fig. 21

fig. 22

fig. 23

fig. 24

SUSTAINABILITY

fig. 25

While LEED is not typically considered for this type of design, as the primary concern and allowance in the budget always goes to security, there are some suggested ways to be sustainable. Using Crypton fabrics that are made of postconsumer recycled polyester, along with carpets that have recycled or recyclable backing, is an easy way. The existing building (The Phillip Merrill Environmental

Center, fig. 23-25) is a certified LEED Platinum building. It accomplishes this in many ways, such as by recycling rainwater for toilets, creating a rain pool in the site for rain to collect and be filtered into tanks, using gravel instead of concrete on the site for water to be returned into the ground, and the vast amount of daylight the space receives from the plentiful windows. This prevents the need for much artificial lighting during the day.

81

fig. 26

A C O U S T I C S In each room, at least one wall should be covered with a sound-absorbent material.

This can be acoustical ceiling tile or paneling, but should be provided to (fig. 26 & 27, 29) acoustically isolate spaces from external noise.25 It is critical for activity and therapy spaces to have enough acoustic control to keep them very quiet and private; this allows them to be spaces for private discussion. Keeping spaces acoustically protected also defends sensitive patients 82

from patients with outbursts; for example, patients with rage issues who might scream in the activity room could scare resting patients in adjacent rooms if there is no acoustic control.26 There should also be specific “quiet rooms,� where the volume is always low and it is protected from external noise for patients suffering from sensory overload.27 As typical, interior partitions will consist of gypsum board on metal studs, but partitions should have fiberglass batt insulation between studs for sound transmission control.28

fig. 27

fig. 28

fig. 30

VISUAL CONTROL The nursing station (fig. 28 & 30) is one of the most critical spaces in a behavioral health center, and should blend in to the rest of the space while remaining open to feel less “medical.�29 It fig. 29 must have a direct line of sight to

bedroom corridors and primary patient areas. However, HIPAA (The Healthcare Insurance Portability and Accountability Act of 1996) has declared visual privacy to be a right of patients, and thus resident rooms and bathrooms should be private from nurses unless need be.30 83

W A Y F I N D I N G & S I G N A G E Wayfinding and signage is not only important for residents, but for visitors as well. The success of the wayfinding is necessary for visitors to not need additional assistance from nursing staff, taking them

away from the residents. The signage should be bold and contrasting so it is easy to read, and should be attached to walls with tamper-resistant fastenings.31 It is best for wayfinding and signage to be painted on when possible, to avoid any additional features from hanging from the ceiling or wall to become anchor points. Using bold colors or fonts (fig. 31 & 32) helps

fig. 31 84

patients in particular to find their way, and associating an image with an area helps those with severe memory issues.32 For example, using a large image of a purple butterfly on a sign that refers to the bright purple butterfly image on the patient’s doorway helps associate area and directionality for wandering patients.

fig. 32

fig. 33

fig. 34

S E C U R I T Y

fig. 35

As mental health center patients are a high-risk clientele, portions of the building must be locked and closed after hours so there are fewer areas staff must supervise after hours.33 It is critical for the nursing station to be in an area where it sees everything in the wing, and can be seen by patients in distress, but must also be private enough for confidential records

to be hidden.34 As in most commercial establishments, a secure vestibule is required, with two sets of doors that lock (fig. 33). An installed security system will alert staff if a patient has escaped, but it should be atypical as security should be placed adjacent to the entry to protect and secure patients and visitors.35 Patients in facilities like these often wear a bracelet or ankle monitor that will sound an alarm if they escape the building (fig. 35).

85

When the receptionist and security are not on duty, placement of a security camera (fig. 34) and intercom by the exterior entrance can allow visitors and auxiliary medical personnel, like EMTs, to enter the building.36 This feature, however, should only be used to page the nursing station.

It should not permit the nursing station to remotely open the doors, as patients could anticipate this and escape; it is important that a staff member physically open the doors.37 An additional feature many behavioral health centers have is an area near the secure entry vestibule to store any prohibited items, like prescriptions, lighters, and in some facilities, cell phones.38

large patient room windows, need to be heavy-gauge with insulated double glazing. They are required to be operable for emergency ventilation, but they should not be operable to more than 4� of opening.40 Shading devices must not have a cord or pole, and should be recessed into the window heading. Additional resident room safety features include secure headboard and bedframe, a mattress without any springs, anchored artwork, and built-in desk and shelving (fig. 36 & 37). Resident bathroom security requires a pressure-sensitive alarm (fig 38) at the door header, as well as a continuous hinge and antiligature lever with magnetic latch.41 These features are critical, as doorways have been Skylights are excellent in used for suicide by hanging, resident rooms, as they can and bathrooms are extremely be operable to allow a breeze private areas where mistakes and ventilation, but prevent can be made.42 Another option escape or suicide.39 Major would be to cut the door and exterior windows, including door frame at a 30 degree angle 86

fig. 36

fig. 37

fig. 38 so nothing can be placed on it for hanging. Finally, patient room doors must swing outward or in both directions; this is because a patient must not be able to barricade themselves in their rooms or in their bathrooms.43 The hardware must be recessed or on the exterior so it does not become an anchor point.

Patients often show better results in therapy if they are exposed to nature.44 Thus, outdoor courtyards

are important for residents to experience fresh air and sunlight while being protected. These areas need to be visible from the nursing station, and enclosed enough for patients to not escape. The landscaping must not promote self-harm or overcrowding which can be detrimental to more sensitive patients, like those with anxiety disorders.45 A 14foot tall enclosure is preferred around the courtyard, and should not be a fence, for privacy and

fig. 39 security reasons. It should prevent climbing and not be an anchor point for hanging and egress from the courtyard should be controlled interiorly by nursing staff.46 Rocks and gravel should not be used and trees and shrubbery should remain trimmed so there are no accessible climbing branches or hiding spots. Surveillance cameras should pivot 180 degrees and furniture should be anchored into the concrete (fig. 39).47 87

U N I V E R S A L D E S I G N, A D A, & C O D E It is suggested that at least 20% of the total patient rooms and bathrooms should be ADA accessible (fig. 42).48 It is preferred for them all to be, but low-budget projects often have minimal space and only provide for 20%.

This number, however, varies widely; facilities that are more specific, like those that 88

fig. 40

fig. 41

treat mentally and physically disabled veterans, would have far more than 20% be ADA compliant.49 Generally speaking, patients with more serious physical disabilities, such as bariatric patients, should be treated in a medical or medical/psychiatric facility so the behavioral health center’s treatments can 50 remain streamlined.

As grab bars are important in bathrooms for patients in not only a toilet setting but also a shower setting as well, a horizontal panel should be welded to the underside of

fig. 42

fig. 43

fig. 45 the grab bar to prevent it from becoming an anchor point.51 In corridor areas, handrails (fig. 41 & 43) should be installed to not only protect the walls, but also to help patients steady themselves.52 As the building will house both genders, special accommodations for women need to be made for universal design purposes.53 Women are often victims of men in mental health facilities, so to promote equal opportunity of fig. 44 recovery, it is often best to have

separate gender units (fig. 40 & 45). This protects women, because it would otherwise be required for women to have locks on their doors against men in mixedgender units. Locking doors gives patients too much privacy from nursing staff.54 For security and safety purposes, nurse call buttons should be installed in both resident rooms and bathrooms, in case of emergency, as protecting the residents is the most important thing the facility does (fig. 44).

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ENDNOTES 1. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-3.

2. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-3.

3. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-14.

4. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 41.

5. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-14.

6. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-14.

7. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-15.

8. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-16.

9. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-22.

10. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-28.

11. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-30.

12. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-37.

13. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-6.

14. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-13.

15. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-13.

16. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-28.

17.Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 32.

18. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-23.

19. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-26.

20. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-23.

21. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-15 22. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-20.

23. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-20.

24. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-22.

25. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-30.

26. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 47.

27.Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 41.

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28. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-16.

29. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 42 30. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-5.

31. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 4-28.

32. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 51.

33. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 22 34. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-4.

35. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

36. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

37. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 13.

38. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

39. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 48 40. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-28.

41. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 61.

42. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

43. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

44. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-34.

45. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-36.

46. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-35.

47. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

48. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-24.

49. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 42 50. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

51. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-26.

52.Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-10.

53. Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-36.

54. Mardelle M. Shepley & Samira Pasha, “Design Research and Behavioral Health Facilities,” The Center for Health Design Behavioral Health Facilities Working Group, July 28. 2013. Page 23.

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IMAGES 1. http://buckassociates.net/images/179001235.jpg 2. http://thezilla.com/wp-content/uploads/2015/07/purplemind1.jpg 3. http://www.cfm.va.gov/til/dguide/dgmh.pdf 4. http://images.costco-static.ca/image/media/500-410253-894__1.jpg 5. http://www.navitascentre.co.uk/dir/wp-content/uploads/2012/05/IMG_1501.jpg 6. http://www.cfm.va.gov/til/dguide/dgmh.pdf 7. http://christnerinc.com/uploads/project-slideshow/Specialty-HealthcareVA-Outpatient-Mental-Health3_lobby.jpg 8. http://www.cfm.va.gov/til/dguide/dgmh.pdf 9. http://www.cadomodern.com/media/catalog/product/cache/1/image/9df78eab33525d08d6e5fb8d27136e95/c/a/cado_modern_furniture_lider_comfort_modern_ office_chair_zuo_dimensions.jpg 10. http://www.cfm.va.gov/til/dguide/dgmh.pdf 11. http://www.cfm.va.gov/til/dguide/dgmh.pdf 12. http://www.cfm.va.gov/til/dguide/dgmh.pdf 13. http://www.cfm.va.gov/til/dguide/dgmh.pdf 14. http://www.cfm.va.gov/til/dguide/dgmh.pdf 15. https://knoji.com/images/user/SamMontana/fabric1-16034ebc.jpg 16. http://neufert-cdn.archdaily.net/uploads/photo/image/16006/full_1330825847-03.jpg 17. http://www.cfm.va.gov/til/dguide/dgmh.pdf 18. http://www.millikencarpet.com/en-US/insights/blog/SiteAssets/Lists/Posts/NewPost/LVT_Wood%20-%20Rustic%20Pine%20RUS227.jpg 19. http://smartaccessproducts.com/wp-content/uploads/2013/10/Ella-acrylic-wall-liners.png 20. http://www.tilexdesign.com/photos/full/Medical-St.-Clare-Health-Center-MeetingArea1.jpg 21. http://hospitalsystems.com/products/lighting/aurora/images/aurora.jpg 22. http://www.ledalite.com/files/styles/product_banner_image/public/TruGrooveHotelLobby_IG_0.jpg?itok=jrEx73_23. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.9333346,-76.4614237,3a,75y,90t/data=!3m8!1e2!3m6!1s-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs!2e4!3e12!6s%2F%2Flh5.googleusercontent.com%2F-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs%2Fs203-k-no%2F!7i1097!8i760!4m7!1m4!3m3!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!2sPhilip+Merrill+Environmental+Center!3b1!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 24. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.9333346,-76.4614237,3a,75y,90t/data=!3m8!1e2!3m6!1s-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs!2e4!3e12!6s%2F%2Flh5.googleusercontent.com%2F-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs%2Fs203-k-no%2F!7i1097!8i760!4m7!1m4!3m3!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!2sPhilip+Merrill+Environmental+Center!3b1!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1

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IMAGES (CONTINUED) 25. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.9333 346,-76.4614237,3a,75y,90t/data=!3m8!1e2!3m6!1s-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs!2e4!3e12!6s%2F%2Flh5.googleusercontent. com%2F-Dhy9tBL7GeY%2FVVJa9qer-PI%2FAAAAAAAAACE%2FheNwSTr4AHs%2Fs203-k-n o%2F!7i1097!8i760!4m7!1m4!3m3!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!2sPhilip+Merrill+Environmental+Center!3b1!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 26. https://s-media-cache-ak0.pinimg.com/736x/a3/16/e8/a316e84ad69fe5cf8f4a47a41114b3a8.jpg 27. http://allpropainters.com/wp-content/uploads/2015/04/Acoustical-Ceiling-Tile.jpg 28. http://integrisok.com/upload/images/Edmond/nurseStation.jpg 29. http://cdn.freshome.com/wp-content/uploads/2014/02/Colourful-design-ginkgo-acoustic-panel. jpg 30. http://www.fremonthealthyfuture.com/wp-content/uploads/2013/04/Fremont_NS_cam01_04_09. jpg 31. http://cartlidgelevene.co.uk/work/wayfinding-and-signage/barbican-arts-centre 32. https://s-media-cache-ak0.pinimg.com/236x/6f/34/e5/6f34e5de057dd60b3889304a9dde5930. jpg 33. http://www.godrejsecure.com/SecuritySolutions/ProductImages/access%20control%20vestibule.jpg 34. http://definedav.com/media/security-camera-systems.jpg 35. http://www.policestateusa.com/wp-content/uploads/2014/04/Ankle-Monitor.jpg 36. http://www.behavioral.net/sites/behavioral.net/files/styles/570x360/public/Zucker%20Adolescent%20Room.jpg?itok=V_uSOJ4v 37. http://www.cfm.va.gov/til/dguide/dgmh.pdf 38. http://www.cfm.va.gov/til/dguide/dgmh.pdf 39. http://www.hdrinc.com/sites/all/files/imagecache/medium/content/projects/images/4066-santa-clara-medical-center-behavioral-health-center-3423.jpg 40. http://www.askingsmarterquestions.com/wp-content/uploads/2012/05/marketing-to-women-men.jpg 41. http://www.health.vic.gov.au/dementia/images/photos/handrail.jpg 42. http://danzza.com/ada-restaurant-bathroom-dimensions-inspiration-2-design-inspiration.html 43. http://www.wencoinc.com/commercial-construction-projects/healthcare/nursing-home-construction-troy-ohio-2-lg.jpg 44. http://media.truelocal.com.au/B/F/B0162ACC-C14D-4A91-866D-7459AC74B11F/sedco-direct-clayton-security-safety-system-installation-emergency-call-button-364d-938x704.jpg 45. http://www.tokyo-stories.com/wp-content/uploads/2011/10/20111021_062_Nine-Hours640x426.jpg

93

fig. 1

fig. 2

s e c t i o n f i v e: topical explorations

“in

society

you

will

find

not

health,

5

but

in

nature.�

-henry david thoreau-

COLOR STUDY fig. 3

CHROMOTHERAPY

The idea that color can heal dates back thousands of years; in certain countries, this practice of chromotherapy takes on its own name. In India, chromotherapy is ancient medicine – the art of Ayurveda uses energies from each color to restore balance in wayward individuals.1 The energies of the seven colors are called chakras, and they divide the body up into targeted zones for healing.

Ancient Egyptian physicians 96

used colored glass (fig. 4) to harness the sun’s rays and create colored light rooms for patients to cleanse themselves.2 It was thought that color could be used the same ways aromatherapy and hydrotherapy were to cleanse the soul. Modern chromotherapists suggest wearing clothes in colors with healing effects towards specific disabilities, or specifically surrounding yourself with foods and objects in those colors.3

fig. 4

fig. 5

D E S I G N In design, color is primarily used to draw attention to or away from something. Shade, light, and vibrancy all impact whether or not a person succeeds in their space, which goes far beyond just aesthetics.4 By using a neutral scheme in a short-term patient’s

room, to be used for only a week or two at a time, a comfortable environment is created. However, a patient who has a longer stay would not be as happy with a neutral room as it would become boring and impersonal.5 It is suggested that long-term care facilities, such as mental health centers, use a balance of color and contrast with subtle texture (fig. 5). This keeps it

classic and warm but also able to use color as a defining visual cue.

The effect of color on light deeply affects how a patient thrives in the space. Using very cool, fluorescent lighting feels too institutional, and has a tendency to make patients anxiety and blood pressure raise.6 Similarly, using very warm lighting 97

fig. 6 creates a sickly glow to spaces that does not promote healing.

Natural lighting is considered most beneficial, but in areas where artificial lighting is needed, a neutral white LED is preferred to lights with any give to either side of the color temperature spectrum.7 Using highly contrasting color schemes allow those with memory or other mental health issues find where they are going. Rooms and areas that are defined by color are easier to comprehend than spaces defined only by sign or furniture layout. Contrast helps to create depth perception and is more successful at creating 98

memory cues than patterns are; patterns are discouraged in sensitive environments, as they create confusion for people with Alzheimer’s, schizophrenia, and like diseases.8

that in interiors, using a dark floor, medium wall, and light ceiling forms the most natural balance, as man is accustomed to the darkness of earth, varying tones of what lies on the horizon, and the lightness of sky.10 While each color has its own definition and spirituality (fig. 8), it is suggested to never overdo color and to find a balance, as color can It is widely considered a perfect be as unpleasant as it is beautiful11 harmony for red, blue, yellow, for people with delicate needs. and green to all be in a space to restore health. This is because Red is a high-energy color, they form an essential balance, used to care for people with and throughout history they have anemia, fatigue, paralysis, and been placed together to form exhaustion. It is a color with a an interior landscape much like lot of security and grounding, nature itself.9 It has been suggested but has also been known to

COLOR DEFINITIONS

have too much energy to be healing to those with severe mental disabilities.12 Orange is full of vitality and targets the kidneys, urinary tract, and reproductive organs. It is a very therapeutic color to those with sexual issues, including domestically abused woman, rape victims, sex addicts, and those with general intimacy issues. It should be used sparingly in areas where the oppressors are, such as environments that are treating rapists and criminals, as the color has a high impact on emotions and sexuality.

fig. 7

Yellow is an energetic color that aids in digestion and in intestinal processes.

It is a good color for recovering drug and alcohol addicts, and is thought to be a natural decongestant and reliever of arthritis. It focuses on the core of the body, where energy and vitality are born.

Green creates both balance and harmony as it is the most natural of all colors. Often associated with wealth in the United States, green is widely considered to be a generous color, one that stimulates love, hope, and compassion. It targets the heart and the blood, but does great things for all muscles and cells, as it is truly the central color of life.

fig. 8 99

fig. 10

fig. 9 100

Blue, which is widely considered the most beautiful of colors, blue’s soothing characteristics aid in the alleviation of stress, tension, and immune system issues. It also relieves insomnia, anxiety, high blood pressure, migraines, and skin irritation.

Surrounding oneself with water and sky is the best combination of blues, but in the interior (fig. 9 & 10), having access to both windows (fig.

12) and interior water features creates a healing environment.

Blue is thought to be a trustworthy color that stimulates

communication and creativity.

Purple is often ssociated with wisdom, and thus influences the eyes, ears, nose, and mouth, and is thought to be calming to the nervous system. It is mysterious, and is associated with witchcraft and clairvoyance due to its depth and splendor. An unusual color, purple should be used sparingly, as it is often too moody and explicitly feminine in healing environments.

Violets and purples with a lot of pink in them are thought to be the most godly of colors;

fig. 11 they are the colors of enlightenment and understanding, as well as of connections to the heavens. They are also unusual in healing environments due to their explicit cosmism.13 Overall, colors have different effects on different people, but their general properties and meanings remain the same throughout different cultures and different races. Color is perceived by the brain, which can associate it with certain memories, but general emotions, unclouded by experience, have been shown to be similar. fig. 12 101

fig. 13 102

HUMAN BEHAVIOR fig. 14

INTERACTION

There is a growing trend toward creating healthy urban environments because people desire to be around other people. The idea of creating an isolated asylum without being close to nature and to a city is outdated; in fact, health professionals have related diabetes, heart disease, obesity, and mental illness to poor urban environments.14 It is normal for people to desire social interaction, but high density is adverse to healing.

There are many stressors that come from poor design, such as crowding and noise (fig. 15), both of which can be avoided by creating a more open floor plan.15 Designating spaces for supervised social interaction is important for mental health facilities as they should be free to enjoy each other’s company, but mental illnesses vary so widely that there should be no private spaces. People with more aggressive mental illnesses, such as schizophrenia, need to be monitored during social interaction, as they can become very upset very quickly.16

fig. 15 103

fig. 16

L I G H T, S P A C E, AND MATERIAL As mentioned previously, using colors and textures as healing tools as opposed to rash design choices can be very successful for the mentally ill. Monochromatic spaces and rooms that are all 104

dark or all light colors can be very frustrating to people with anxiety or personality disorders, as they are disconcerting and lack contrast.17 Natural lighting is still preferable to artificil lighting (fig.

16). Small bedrooms, especially shared rooms, are known to be detrimental to mental health as they cause claustrophobia and lack of privacy. However,

mental illnesses such as eating disorders and neurosis often do better in shared environments to discuss personal experiences. It is suggested that shared rooms are available for people who feed off of each others’ positivity.18 Having highly textured (fig. 17) materials is good for those who need sensory stimulation, but the textures need to be soft and smooth enough

fig. 17 that they do not become dangerous.

For example, in sensory museums, it is typical to create contrast between smooth and sharp, but sharp surfaces are obviously too dangerous for a mental health facility. Smooth edges on furniture and soft, neutral lighting causes a sense of physical comfort in a space, which does nothing to hinder the success of a mentally ill patient.19 In fact, they assist it, as people typically feel more comfortable in softer spaces with bright, natural lighting, access to beautiful views, and enough personal privacy so that they do not hurt themselves or others. This way, they are are able to thrive and feel important in their area of a large facility.

N A T U R E Famed eco-activist and founder of the Sierra Club, John Muir was one of the first experts to write about how nature in design positively impacts the mental and physical health of people. In his book, Ecotherapy: Healing with Nature in Mind, he wrote “that only in homes and

hotels were colds caught, that nobody ever was known to take cold camping in these [Yosemite] woods, that there was not a single cough of sneeze in all the Sierra.�20 He went on to discuss how only in interiors with a strong relationship to the outdoors did he notice people feel105

ing healthy all of the time. His biggest claim was that on a broad level, nature could be used as a method of psychological healing for the mentally ill. Previously, Henry David Thoreau theorized about how nature was man’s only true home and how suffocating in an urban environment would come to hurt us all.21 Doug Peacock, a veteran of the Vietnam war, wrote in his twin autobiographies about how he suffered from permanent post-traumatic stress disorder. He said that the only way he found solace and mental health again was by embracing the wilderness of the American West through hiking in the deserts and mountains.22 But these ideas are not new; an old Native American saying, “We do not inherit the earth from our ancestors, we borrow it from our children” is still true, as 78% of people feel that they are at an increased health due to poor urban environments.23 Access to nature and abundant daylight are two of the leading trends in healthcare design, through an evidence-based design approach.24 Through studying project outcomes and post-occupancy surveying, it has been noted that people consistently do better in healthcare facilities where there are images of nature, access to nature, and cues taken from 106

fig. 18

fig. 20

fig. 19

nature.25 Abundance of windows and skylights for natural lighting, as well as plants and filtration systems for indoor air quality are the two primary things a designer can do to improve the health of patients. However, as a mental health facility is a delicate space, outdoor courtyards must be designed for patients to get the maximum benefits from nature without putting themselves or others at risk.26 Daylight has been shown to improve depression, agitation, sleep issues, circadian rhythm issues, and length of stay in dementia

and seasonal affective disorder.27 While all designs should strive to be sensitive to diminishing natural resources and to the environment, it is especially important in healthcare settings as nature is free and can be both calming and nurturing.28

107

IMAGES 1. http://www.scoopquest.com/essential-tips-for-landscape-photographers-to-capture-the-best-photos.html/landscape-photographer-ansel-adams 2. https://s-media-cache-ak0.pinimg.com/736x/4d/c5/6d/4dc56d87e8d979637216101bbee9abca.jpg 3. http://www.arttherapyblog.com/uimages/2011/01/color-therapy-healing.jpg 4. http://www.metmuseum.org/toah/images/h2/h2_93.26.3,4.jpg 5.http://sikhco.com/wp-content/uploads/2014/09/Bright-Living-Room-Decor-with-Yellow-Couch-as-well-as-White-Pillow-and-Desk-lamp-970x649.jpg 6. http://img03.deviantart.net/b12c/i/2011/119/3/7/color_spectrum_by_garvandule-d3f5hvs.jpg 7. https://www.pinterest.com/pin/49610033370610910/ 8. https://s-media-cache-ak0.pinimg.com/originals/af/2b/78/af2b78a4c446e05b70581cbb98d67967.jpg 9. https://www.pinterest.com/pin/49610033371956363/ 10. https://www.fraunhofer.de/content/dam/zv/en/Research%20Topics/Health/hospital-engineering-laboratory/ISST13_HospitalEngineering%2003.jpg 11. https://color.adobe.com/build2.0.0-buildNo/resource/img/kuler/color_wheel_730.png 12. http://www.hgtv.com/design/decorating/design-101/19-feng-shui-secrets-to-attract-love-and-money-pictures 13. http://i.stack.imgur.com/VXlcE.jpg 14. https://0.s3.envato.com/files/130256071/21-image.jpg 15. https://c2.staticflickr.com/4/3518/3273136114_c590fba9df_b.jpg 16. http://www.wallcoo.net/photography/home_space_02_1600/images/Interior_Photography_GK105.jpg 17. https://media.restorationhardware.com/is/image/rhis/prod2420133?$l-pd1$ 18. http://phandroid.s3.amazonaws.com/wp-content/uploads/2014/10/mountains.jpg 19. https://www.pinterest.com/pin/49610033373336461/ 20. https://www.pinterest.com/pin/49610033372981797/

ENDNOTES 1. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 1.

2. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 1.

3. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 2.

4. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 2.

5. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 3.

108

6. Ruth Brent-Tofle, “Color in Healthcare Environments - A Research Report,” CHEResearch, July 2004. Page 19.

7. Ruth Brent-Tofle, “Color in Healthcare Environments - A Research Report,” CHEResearch, July 2004. Page 21.

8. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 4.

9. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 5.

10. Ruth Brent-Tofle, “Color in Healthcare Environments - A Research Report,” CHEResearch, July 2004. Page 8.

11. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 5.

12. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 6.

13. “The Psychology of Color in Healthcare,” Paralyzed Veterans Association, January 2014. Page 7.

14. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 3.

15. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 4.

16. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 4.

17. Ruth Brent-Tofle, “Color in Healthcare Environments - A Research Report,” CHEResearch, July 2004. Page 12.

18. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 5.

19. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 5.

20. John Muir, “Ecotherapy: Healing with Nature in Mind,” Sierra Club Books, 2009. Page 21.

21. Sean Ireton, “Nature as Therapy...” Pacific Coast Philology, 2011. Page 123.

22. Sean Ireton, “Nature as Therapy...” Pacific Coast Philology, 2011. Page 123.

23. Louise Jones, “Environmentally Responsible Design,” John Wiley & Sons, Inc, 2008. Page 83.

24.Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 1.

25. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 2.

26. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 3.

27. Megan Reading, “Future Directions in Design for Mental Health Facilities,” Hassell Studio, July 2014, http://hassellstudio.com/docs/final_futuredirections_designformentalhealth_2014.pdf. Page 4.

28. Louise Jones, “Environmentally Responsible Design,” John Wiley & Sons, Inc, 2008. Page 89.

109

fig. 1

fig. 2

s e c t i o n

six:

s i t e e v a l u a t i o n

“greater

things

are

still

to

be

done

6 in

this

city.�

-christian tomlin-

ANNAPOLIS fig. 3

H I S T O R Y

Annapolis began in the early 1600s as Ann Arundel Town.

Located in Ann Arundel county, it simply took the namesake until it was renamed Annapolis in 1702 after the English Princess Anne. Royal Governor Francis Nicholson chose this name in hopes of creating a grand city much like the great capitals in Europe.1 Thus, the street planning for Annapolis began – the main streets radiated from a circle 112

which contained the capital building and King William’s School, currently called St. John’s College, and the second circle contained an old Anglican church. Only the wealthy could live in the tightest circle around the capital building (fig 3) – this area was for prosperous families, for artisans, and for working men and their families.2 The historical architecture is baroque, with a distinctly “maritime” feel, although many buildings feature Georgian (fig. 4), Federal, and Annapolis Vernacular style.3

fig. 4

fig. 5

P L A N N I N G & CHARACTERISTICS The streets were meant to mimic the grandiose, baroque streets of great European capitals (fig 5); Annapolis shortly became the social, political, and economic hub of Maryland, containing

the best shopping and eating destinations. The town’s citizens would wear elegant clothes and attend balls at mansions. But after the Revolutionary War, Baltimore became a bigger city, with a fuller economy and Annapolis became a military center. Annapolis created Fort Severn, built on Windmill Point, which eventually became the US Naval Academy in 1850.

The Academy and local college, St. John’s, were used to rehabilitate injured soldiers during the Civil War. Its strong military presence remains as one of Annapolis’ featured attractions, as people often come to see the large Navy ships docked as well as to see off loved ones in the service. As Annapolis is on the Chesapeake Bay, the area has always been a major trade 113

fig. 6 area. Its primary exports were tobacco and wheat until well into the nineteenth century. After the Civil War, it being a major trade port declined, as the thriving economy of the city boosted it to using the coast for yacht clubs, the US Navy (fig 9) and Coast Guard facilities, and beach resorts (fig 6).4

Washington International Airport, it is a thriving naval and governmental center as well as tourist destination for its upscale, historical appeal. The median household income in Annapolis in 2013 was $71,467, which is well above the poverty line. The overall cost of living index is 110.1, with the average in the United States being 100, which indicates its status as a more upscale town (fig 7).5 Out of the 38,722 people, it has an average resident age of 36.3 and a nearly 50-50 population of both men and women, with As Annapolis features a bridge 53.5% of households being white to the Delmarva Peninsula and alone. 25.7% of households are the site of the late Baltimore- black alone, followed by 16.8%

DEMOGRAPHICS & CRIME RATES 114

fig. 7 of people living in Hispaniconly households. Only 1.6% of households are mixed-race, making it very different from other large US cities like Philadelphia, which has many mixed-race homes.6 It features a large amount of educated people: 89.2% of people 25 years and older have graduated from high school, and 45.1% have a Bachelor’s degree or higher. Only 3.4% of people are unemployed; everyone else travels approximately 24.3 minutes to work. Nearly 42% of people have never married, and only 39.5% of people are currently married.

11.8% of people are divorced.

5,984 people are foreign-born, with most of them being Latin American.7 The crime rate is relatively low in Annapolis, as well – in 2012, only 2 murders were committed, along with 4 rapes, 54 robberies, and 117 assaults. Property crimes are the highest, which is typical in wealthier towns.

There were 185 burglaries, 775 thefts, 82 auto thefts, and 8 accounts of arson.8

fig. 8

fig. 9 115

BAY RIDGE fig. 10

D I S T R I C T The Phillip Merill Environmental Center is located in the Bay Ridge district of Annapolis. Surrounded by water, the building sits on a beach in the Chesapeake Bay, is adjacent to the Blackwalnut Creek, and is near the Severn River and Lake Ogleton to the south, east, and north. The area is also surrounded by thick forest which is preserved by the Chesapeake Bay Foundation.9 In 1879, Bay Ridge became 116

an official district, and was a Victorian summer resort area with a large hotel. Located on the bluff, Tolly Point (fig 11), the hotel and area drew thousands of daily visitors to the all-day concerts, excellent waterfront dining, games, picnic grounds, and a 2-mile long electric trolley ride along the rivers and lakes.

The resorts and hotels burned down in the early 1900s, but it only took about 5 years for people to rebuild the area with the lavish mansions and beach homes (fig 10) that exist today.10

fig. 11

fig. 13

M I L I T A R Y During World War II, the area’s homes served as living spaces for members of the military, and the wealthy citizens adopted second homes elsewhere until the war ended. Afterward, a memorial was erected (fig 13) and the area was repopulated with the original owners, who chose to stay there permanently after.11

N O T A B L I T Y fig. 12

There are a few notable things in the surrounding area, which

include the Anne Arundel Medical Center (fig 12) and the Bay Ridge recreational center on the adjacent property. It features a pool, yoga, and private parties, and much of the noise is muffled by the forest between the two properties. The Anne Arundel Medical Center is a fifteen minute drive away, and the area also features a MedStar Health Center, a Spa Creek Center, and the US Naval Academy. There is no public transportation anywhere near the facility; it all ends nearly 2 miles away from the facility, inside the boundaries of downtown Annapolis.12 117

H E R N D O N A V E. fig. 14 entrance, but the climate is so calm that there has never been any flooding, hurricane damage, The building (fig 14) is located or storm damage.14 The speed off of Herndon Avenue, an limit on Herndon Avenue is artery to Bay Ridge Road, which 30 and it is strictly enforced. leads straight into downtown Annapolis. The entrance to the site is visible when nearing the end of Herndon Avenue, which turns left and becomes Bay The Philip Merill Drive.13 Large homes, designed Environmental Center is zoned in the Annapolis Vernacular C2 as a commercial zone for style, line Bay Drive and overlook Conservation Businesses (fig the Chesapeake Bay. There is 15). The surrounding area about 700 feet of shoreline is zoned OS, or conserved leading up to the Philip Merrill open space, and residential.15 Environmental Center’s back 118

S T R E E T

Z O N I N G

fig. 15

119

KESSLER INSTITUTE FOR REHAB

ANNE ARUNDEL MEDICAL CENTER

MEDSTAR HEALTH

JOHNS HOPKINS COMMUNITY PHYSICIANS

HOSPITALS AND MEDICAL TREATMENT CENTERS LOCAL TO THE BUILDING 120

ENDNOTES

IMAGES

1. “Annapolis: History,” City-Data. Web. Page 1.

fig 1. http://traveladdictsnet.c.presscdn.com/wp-content/uploads/2015/08/Annapolis-Maryland-sailing-schooner-Woodwind-sunset.jpg

2. “Annapolis: History,” City-Data. Web. Page 2.

3. “Discover Dining, Shopping,..” Annapolis Downtown. Web. April 2015.

Page 2.

4. “Annapolis: History,” City-Data. Web. Pages 2-4.

5. “Annapolis, Maryland,” City-Data. Web. Page 1.

6. “Annapolis, Maryland,” City-Data. Web. Page 3.

7. “Annapolis, Maryland,” City-Data. Web. Page 11.

8. “Annapolis, Maryland,” City-Data. Web. Page 6.

9. “History of Bay Ridge,” Bay Ridge. Web. Page 1.

10. “History of Bay Ridge,” Bay Ridge. Web. Page 3.

fig 2. http://pre12.deviantart.net/eee0/th/pre/f/2011/040/d/6/skyline_eve_by_sugarscream-d395zum.jpg fig 3. http://www.ocallaghanhotels-us.com/d/annapolis/media/annapolis_1600/ OCH_Annap_Home/OCHAnnapHome-MainStreetDaytime.jpg fig 4. http://www.annapolisexperience.com/blog/wp-content/uploads/2013/08/1920sGeorgianRevivalStyleResidenceMurrayHillAugust27th2013. jpg fig 5. http://www.bohlarchitects.com/annapolisarchitectureguide/images/annapoliscityplan1695.jpg fig 6. http://www.dellabarba.com/flying/viewabove/view_DSC_2791_1.JPG fig 7. http://waterfrontstealsanddeals.com/category/waterfront-real-estate/

11. “History of Bay Ridge,” Bay Ridge. Web. Page 5.

fig 8. http://www.chezamis.com/sites/chezamis.com/files/slide_shows/show1/2annapolis_0.jpg

12. “History of Bay Ridge,” Bay Ridge. Web. Page 1.

fig 9. http://www.baltimoresun.com/business/federal-workplace/bs-md-naval-academy-foia-20150203-story.html

13. “Bay Ridge - Philip Merrill Environmental Center,” Google Maps, Web. Page 1,

fig 10. http://www.homes-database.com/wp-content/uploads/2010/08/g.jpg

14. “Annapolis, Maryland,” City-Data. Web. Page 9

fig 11. http://cutterloose.com/wp-content/uploads/2015/10/Thomas-Pt-light.jpg

15. “Zoning,” Annapolis Government, July 2015. Web. Page 1-7.

fig 12. http://www.zephyraluminum.com/sitebuildercontent/sitebuilderpictures/ large1.jpg fig 13. http://lh5.ggpht.com/_HgxEQJE8K88/SmzjNiIq8gI/AAAAAAAADU8/kih_RagaN5c/s640/P1000688.JPG fig 14. http://www.bee-inc.com/blog/wp-content/uploads/2012/09/The-Philip-Merrill-Environmental-Center-First-Ever-LEED-Building.jpg

121

fig. 1

fig. 2

section seven: p r o g r a m d e v e l o p m e nt

“great

design

is

making

something

memorable

7 and

meaningful.�

-dieter rams-

PROGRAM E N T R Y S E Q U E N C E

Entry Vestibule: The entrance to the building is already defined by a long ramp. The vestibule should be 50 +/- s.f., allowing turnaround for a wheelchair, and have a list of visitation rules on the wall. This is important, because anyone entering the building will have to pass through a metal detector and security next.

124

Reception, Security, & Waiting: This should be a high impact area as it is the first true taste of the building that visitors receive. The desk itself needs to be able to hide patient charts, and having an enclosed portion is good for phone calls. It needs computers and the security portion needs an area to secure prohibited items during visitations. The waiting area should have 4+ soft seats and be comfortable.

It should be 200 +/- sf. fig. 3

Admin Offices: At least 4 offices should be provided for the administration. at 90 +/- sf each, they can be smaller, just to accommodate a desk, chair, and some storage. Each should have 12 linear ft. of shelving.

Discovery Room: A 100 +/discovery room should include soft seating and decoration. It should be a welcoming space, as it is where future inpatients go with their families to discuss treatment options and discuss what the facility has to offer.

Medicine Control Room: A highly secure area, this room should be 200 +/- sf to accommodate tons of shelving and a desk with a computer. This space is similar to a pharmacy, but with extremely high security measures. It is where doctors store perscriptions.

Medical Supply Room: A storage space for medical supplies, like emergency equipment and needles, gloves, face masks,

oxygen tanks, etc. Should be Two exam rooms at 100 +/- sf each artificially lit only. Needs to be should accommodate a patient 100 +/- sf and highly secure. table, a counter and sink, and chair for guest and doctor. There Medical Waste Room: A small, should be one for men and one 50 +/- sf room adjacent to the for women, with one shared, small other medical rooms should bathroom for discreet access include a dumpster on wheels to urine samples. Area should for medical waste personnell to include small space for height, come and professionally remove. weight, and blood pressure testing.

Needs to be highly secure.

Chart Room: A 100 +/- sf Service Corridor: The total sf chart room should be located may vary, but the service corridor around all previous areas for should connect to a freight easy access to patient records. elevator and be a minimum of It should not be accessible by 8’ wide for food, medical, and patients, and should have filing other deliveries. It should only cabinets or shelves for storage. be accessible with a card swipe.

Cannot be used as a patient fire exit. Meeting Room: This 100 +/sf room is where families will Labratory: The lab should have discuss patient progress with 12 linear feet of shelving with a doctors. It should have a table and sink, and plenty of storage for chairs and be a comforting space. microscopes, testing machines for samples, and storage of Counseling Office: Room where urine and blood.

It should future inpatients are screened be highly secure and 120+/- sf. before admission. Should include soft seating for patient and Patient Medical Exam Rooms: chair for doctor and be 90 +/- sf.

125

fig. 4 Staff & Guest ADA Restrooms: At 60 +/- sf each, these restrooms should both feature suicide-preventatitive hardware and toilet/sink, in case the guest one is out of order. Second Vestibule: A second 50 +/- sf vestibule should lead Staff Lounge: An at least to the internal spaces and be 180 +/- sf staff lounge should accessible only with a securityinclude tables and seating, a assigned swipe card after one is tv, lockers, and a kitchenette. checked for prohibited items and is logged into the system. This Housekeeping & Maintenence: second vestibule serves to protect Can be a shared room with just residents from outside harm. a divider, or two separate rooms totaling 250 +/- sf. Should be Secondary Reception & Waiting: near the service corridor. Must A second reception area after include shelving, storage, a the second vestibule, this is a safe washer, a dryer, and work table. area for patients to greet their

THE INTERNAL D E S I G N

126

fig. 5 families after security clearance.

It should be welcoming and secure, with a variety of seating options that includes bariatric seating. It should be 200 +/- sf.

Admin round of each are nursing, etc to be

Offices: Another 4 offices at 90 +/- sf used for the head of director of activities, closer to the patients.

Conference Room: A conference room at 250 +/- sf should have a large table for 10-15 people.

It needs A/V capabilities.

Secondary Staff & Guest ADA Restrooms: At 60 +/- sf each,

these restrooms should both feature suicidepreventatitive hardware and toilet/sink, in case the guest one is ever out of order.

cafeteria should be adjacent to the kitchen and feature tables, chairs, and a buffet. It should also feature a juice bar and cafe for varied dining experiences.

Group Counseling Rooms: Two 400 +/- sf rooms should be used as flexible therapy spaces. They should have soft seating and A/V capabilities and be calming spaces.

Kitchen: A 400 +/- sf full commercial kitchen should accommodate large meal prep and food storage. Must be adjacent to the service corridor.

Women’s and Men’s Therapy Rooms: At 250 +/- sf each, these therapy rooms should be warm and safe spaces for gender-based discussions. Should include soft seating and be flexible.

Activity Room: A large activity room at 400 +/- sf should be flexible for varied, noncounseling based activities, such as video games and lounge activities. Should be supervised at all times.

Art & Gardening Room: Located in a place where it is adjacent to an outdoor garden will help this room be an inviting and functional space. Should include tables, chairs, sinks, counters, and cabinet storage. This 300 +/sf room should be supervised.

Private Counseling Rooms: 4 private rooms for 1-on1 counseling should be appealing and safe at 90 +/- sf each. They should include a therapy couch, desk, soft seating, and Cafeteria: A large 700 +/- sf task chair for the doctor.

fig. 6 127

F I R S T 128

L E V E L

D I A G R A M M A T I C

P L A N

S E C O N D

L E V E L

D I A G R A M M A T I C

P L A N 129

fig. 11 130

Public Full Bathroom: One 100 +/- sf public bathroom is to be adjacent to both the bedrooms and the nursing station. It must include a shower, toilet, and sink, as well as a small seating area for a nurse. This bathroom is to be used for patients who are too high a risk to bathe alone.

Fitness Room: A massive 2000 +/- sf fitness room should be used only under strict supervision, as it will include workout equipment, a dance and yoga area, a pool, and a lifeguard stand. It needs to have sport flooring and nonslip tile around the wet areas.

Should also include 2 small ADA bathrooms for changing.

and use computers while being chairs, computers, and storage. monitored. Needs counter space for computers, chairs, and soft Small Med Room: 2 small med seating, as well as bookshelves. rooms, 100 +/- sf each with one at each nursing station, should be Soft Seclusion Room: A 150 +/- safe and secure areas for nurses seclusion room should be full to administer medicine and of soft furniture and a nice view store small medical equipment. of the outdoors. it should be private and highly soundproofed. Storage: 2 large 300 +/- sf This room should be a larger storage rooms should include size so an agitated patient shelving and large items. doesn’t feel claustrophobic. It is where they will be sent to calm Data Room: One 100 +/- sf data room down if they are feeling upset. should have shelving and counters.

Salon: A 250 +/- salon should include two hairstylist chairs, counters, and a small manicure area where trained professionals will style the patients. It should Bookstore: A 300 +/- sf bookstore be relaxing and not too feminine, should include storage and and be highly secure to be displays for purchase, and a operated only when supervised. checkout area for patients to purchase permitted items. Nursing Stations: Two 150 +/nursing stations should have a Library: A large, 1400 +/- sf view of each corridor of patient library will serve as a space rooms. Should include a desk for patients to relax and read that shields patient charts,

Mech Room: 250 +/- sf with shelving and HVAC equipment.

Janitor Closet: Two at 70 +/- sf each; should be near restrooms.

Needs sink, shelves, and hooks.

Patient Bedrooms: See security section for full bedroom needs.

Approx. 40 at 200 +/- sf each, should feel personal and cozy and be located near the nursing stations. Must include a small bathroom and clothing storage.

131

fig. 7 Elevator: Two 70 +/- elevators should be conveniently located. One should be for freight, and the other for guests and patients.

direct

access

to

outside.

Circulation: The program takes up an estimated 21,000 sf, and 30% circulation adds another 6,300 sf, making the Stair: A grand staircase 32,000 sf building use about should consider suicide 27,300 sf. This a conservative risks highly when it comes estimate, not including a to railings and guardrails. potentially lofted portion.

Square footage will vary.

Fire Escape: Two fire escape stairs will vary in square footage but need to be 2-hour fire rated and have 132

fig. 8

NAME

QTY.

S.F.

TOTAL S.F.

ADJACENCIES

PRIVACY

LIGHTING

FF&E

FINISHES

ACOUSTICS

PERCEPTION

REMARKS

DURABLE FINISHES, WALK-OFF MAT

N/A

BRANDING TO ADD PLEASANTRY TO THE SPACE

INCLUDE VISITATION RULES

ENTRY VESTIBULE

1 50 +/-

50 +/-

RECEPTION

N/A

NATURAL DAYLIGHT, MIN. ARTIFICIAL LIGHT

SECURITY CAMERA, CARD SWIPE. METAL DETECTOR.

RECEPTION, SECURITY, & WAITING

1 200 +/-

200 +/-

DISCOVERY RM, ENTRY, ADMIN, CHART RM

RECEPTION DESK SHOULD BE ABLE TO HIDE PATIENT CHARTS

NATURAL & ARTIFICIAL, DECORATIVE LIGHTING OVER DESK

RECEPTION SOFT SEATING, VINYL DESK, FLOORING COMPUTERS, SEATING FOR 4+. SECURE STORAGE AREA FOR PROHIBITED ITEMS

MIN. CONFIDENTIAL INFO SHOULD BE DISCUSSED IN PRIV. ROOM

WELCOMING, BEAUTIFUL, PEACEFUL

CAN BE MORE DECORATIVE AND WORRY A BIT LESS ABOUT SUICIDE

ADMIN OFFICES

4 90 +/-

360 +/-

RECEPTION

MEDIUM

ARTIFICIAL & NATURAL

DESKING, 12 LINEAR FT. OF SHELVING

CARPET

MEDIUM

N/A

N/A

DISCOVERY RM

1 100 +/-

100 +/-

RECEPTION

HIGH

ARTIFICIAL & SOFT SEATING NATURAL. SOFT & DECORATIVE

CARPET, VINYL WC

HIGH

WELCOMING, FRIENDLY

WHERE PATIENTS/FAM. DISCUSS ADMITTANCE

MEDICINE CONTROL ROOM

1 200 +/-

200 +/-

RECEPTION, CHART ROOM, SERVICE CORRIDOR

HIGH

ARTIFICIAL ONLY

TONS OF SHELVING, COUNTER SPACE, & TASK CHAIR

VINYL FLOORING, PAINT, P-LAM

HIGH

SHOULD NOT BE SEEN BY PATIENTS

SIMILAR TO A PHARMACY, BUT WITH EXTREME SECURITY

MEDICAL SUPPLY ROOM

1 100 +/-

100 +/-

MEDICINE CONTROL ROOM

HIGH

ARTIFICIAL ONLY

SHELVING

VINYL FLOORING, PAINT, P-LAM

HIGH

SHOULD NOT BE SEEN BY PATIENTS

MEDICAL STORAGE FOR EQUIP. & EMERGENCIES

MEDICAL WASTE

1 50 +/-

50 +/-

MEDICINE CONTROL ROOM, SERVICE CORRIDOR

HIGH

ARTIFICIAL ONLY

LARGE “DUMPSTER” ON WHEELS

VINYL FLOORING, PAINT

HIGH

SHOULD NOT BE SEEN BY PATIENTS

EMPTY ROOM WITH JUST A MOVABLE DUMPSTER. HIGH SECURITY

SERVICE CORRDOR

1 TOTAL SF. CAN VARIES VARY, BUT MUST BE MIN. 8’ WIDE.

MEDICAL ROOMS

HIGH - STAFF & ARTIFICIAL DELIVERY ONLY ONLY

SECURITY CAMERA, CARD SWIPE

VINYL FLOORING, PAINT, ACT

N/A

SHOULD NOT BE SEEN BY PATIENTS

SECURE ENTRY BUT SHOULD NOT BE USED AS PATIENT FIRE EXIT

LABRATORY

1 120 +/-

120 +/-

MEDICAL HIGH ROOMS, CHART ROOM

ARTIFICIAL ONLY

12 LINEAR FT. OF SHELVING, SINK, MICROSCOPES & TESTING EQUIPMENT

VINYL FLOORING, PAINT, P-LAM, ACT

HIGH

SHOULD NOT BE SEEN BY PATIENTS

PURELY FUNCTIONAL SPACE

PATIENT MEDICAL EXAM ROOM - ONE MALE, ONE FEMALE. ONE SMALL ADA BATHROOM ATTACHED.

2 100 +/-

200 +/-

MEDICAL HIGH ROOMS, CHART ROOM, RECEPTION

ARTIFICIAL ONLY

COUNTER SPACE WITH SINK & TRASH CAN, RECLINING TABLE, CABINETS.

VCT OR LVT, PAINT, P-LAM, ACT

HIGH

FRIENDLY, NOT TOO INSTITUTIONAL. PLEASANT ART.

WEIGHT, HEIGHT, BLOOD PRESSURE, URINE SAMPLES, GENERAL BLOOD WORK & MINOR ILLNESS TREATMENT

133

NAME

QTY.

S.F.

TOTAL S.F.

ADJACENCIES

PRIVACY

LIGHTING

FF&E

FINISHES

ACOUSTICS

PERCEPTION

REMARKS

VINYL FLOORING, PAINT, P-LAM

HIGH

SHOULD NOT BE SEEN BY PATIENTS

N/A

CHART ROOM

1 100 +/-

100 +/-

RECEPTION, PATIENT MEDICAL EXAM ROOM

HIGH - STAFF ONLY

ARTIFICIAL ONLY

FILING CABINETS OR SHELVING

MEETING ROOM

1 100 +/-

100 +/-

DISCOVERY RM, ENTRY, ADMIN, CHART RM, COUNSELING OFFICE

MEDIUM - HIGH

ARTIFICIAL & NATURAL

SMALL ROOM CARPET, WITH TABLE CALMING AND CHAIRS TO COLORS DISCUSS PATIENT PROGRESS

HIGH

POSITIVE, COMFORTING, SAFE

N/A

COUNSELING OFFICE

1 90 +/-

90 +/-

RECEPTION, PATIENT MEDICAL EXAM ROOM, MEETING ROOM

HIGH

ARTIFICIAL & NATURAL

SOFT SEATING, DOCTOR/ EXAMINER CHAIR & DESK

CARPET, WC, CAN BE SLIGHTLY DECORATIVE

HIGH

FAMILIAR, WARM, INVITING, SAFE

WHERE FUTURE ADMISSIONS ARE SCREENED BEFORE ADMIT.

STAFF & GUEST ADA RESTROOMS

2 60 +/-

120 +/-

RECEPTION

HIGH

ARTIFICIAL

TOILET & SINK. BOTH SHOULD BE SUICIDE PREVENT. IN CASE GUEST ONE IS OUT OF ORDER

TILE FLOORING, PAINT

HIGH

CLEAN, SAFE

N/A

STAFF LOUNGE

1 180 +/-

180 +/-

STAFF RESTROOM

MEDIUM - HIGH. ARTIFICIAL & STAFF ONLY. NATURAL

TABLE & CHAIRS FOR DINING. KITCHENETTE.

LVT, PAINT, PLAM

MEDIUM - HIGH

A WELCOMING SPACE FOR STAFF TO UNWIND

TV & LOCKERS

HOUSEKEEP & MAINTENENCE

1 250 +/-

250 +/-

SERVICE CORRIDOR, KITCHEN

HIGH - STAFF ONLY

SHELVING/ CABINETRY, WASHING & DRYING, SINKS

VINYL FLOORING, PAINT, P-LAM

MEDIUM

SHOULD NOT BE SEEN BY PATIENTS

CAN BE COMBINED AND SEPARATED BY DIVIDER WALL

SECOND VESTIBULE TO INPATIENT AREA

1 50 +/-

50 +/-

RECEPTION

MEDIUM - HIGH. ARTIFICIAL ENTRY ONLY UPON SECURITY CLEARANCE AT PRIMARY RECEPTION.

N/A

LVT, GLASS ENCLOSURE

LOW

N/A

HIGH SECURITY. ONLY ALLOWED ADMITTANCE AFTER RECEIVING VISITOR BADGE WITH SCAN CODE.

SECONDARY RECEPTION & WAITING

1 200 +/-

200 +/-

SECOND VESTIBULE

HIGH

ARTIFICIAL & NATURAL

DESK, TASK CHAIR, COMFORTABLE SEATING & TV.

CARPET, WARM WOOD, CAN BE SOMEWHAT DECORATIVE

MEDIUM - HIGH

WELCOMING AND SECURE

PROVIDE BARIATRIC SEATING

ADMIN OFFICES

4 90 +/-

360 +/-

SECONDARY RECEPTION

MEDIUM

ARTIFICIAL & NATURAL

DESK, CHAIR, STORAGE

CARPET, PAINT

MEDIUM - HIGH

N/A

N/A

CONFERENCE

1 250 +/-

250 +/-

ADMIN OFFICES, SECONDARY RECEPTION

MEDIUM - HIGH

ARTIFICIAL & NATURAL

LARGE TABLE & CARPET, PAINT SEATING FOR 10-15

MEDIUM - HIGH

N/A

AV CAPABILITIES

134

ARTIFICIAL

NAME

QTY.

S.F.

TOTAL S.F.

ADJACENCIES

PRIVACY

LIGHTING

FF&E

FINISHES

ACOUSTICS

PERCEPTION

REMARKS

SECONDARY STAFF & GUEST ADA RESTROOMS

2 60 +/-

120 +/-

SECONDARY RECEPTION

HIGH

ARTIFICIAL

TOILET & SINK. BOTH SHOULD BE SUICIDE PREVENT. IN CASE GUEST ONE IS OUT OF ORDER

TILE FLOORING, PAINT

HIGH

CLEAN, SAFE

N/A

GROUP COUNSELING ROOMS

2 400 +/-

800 +/-

SHOULD BE CENTRALIZED

HIGH

ARTIFICIAL & NATURAL

SOFT SEATING, FLEX SPACE. STACKING CHAIRS, A/V CAPABILITIES

CARPET & LVT MIX, P-LAM, CALMING

HIGH

POSITIVE, COMFORTING, SAFE

SHOULD BE FLEXIBLE

WOMEN’S THERAPY SPACE

1 250 +/-

250 +/-

GROUP COUNSELING

HIGH

ARTIFICIAL & NATURAL

SOFT SEATING, A/V, CABINETS

CARPET, WC, DECORATIVE

HIGH

FAMILIAR, WARM, INVITING, SAFE

WOMEN ONLY FOR SAFE GENDERBASED DISCUSSION

MEN’S THERAPY SPACE

1 250 +/-

250 +/-

GROUP COUNSELING

HIGH

ARTIFICIAL & NATURAL

SOFT SEATING, A/V, CABINETS

CARPET, WC, DECORATIVE

HIGH

FAMILIAR, WARM, INVITING, SAFE

MEN ONLY FOR SAFE GENDERBASED DISCUSSION

ACTIVITY ROOM

1 400 +/-

400 +/-

GROUP COUNSELING, GENDERED THERAPY RMS

MEDIUM - LOW

ARTIFICIAL & NATURAL

SOFT SEATING, FLEX SPACE. STACKING CHAIRS, A/V CAPABILITIES

LVT, WC

HIGH

EXCITING, MOTIVATIONAL, FUN

FLEXIBLE ROOM FOR VARIED ACTIVITIES

CAFETERIA

1 700 +/-

700 +/-

KITCHEN

LOW

ARTIFICIAL & NATURAL

CHAIRS, TABLES, BUFFET, JUICE BAR & CAFE

LVT, WC, PAINT

MEDIUM - LOW

PLEASANT & UPBEAT, HEALTHY

N/A

KITCHEN

1 400 +/-

400 +/-

CAFETERIA, SERVICE CORRIDOR

HIGH

ARTIFICIAL

FULL COMMERCIAL KITCHEN

STANDARD KITCHEN FINISHES

HIGH

SHOULD NOT BE SEEN BY PATIENTS

N/A

ART & GARDENING ROOM

1 300 +/-

300 +/-

ACTIVITY ROOM, OUTDOOR AREA

LOW

NATURAL & ARTIFICIAL

TABLES AND CHAIRS, COUNTERS, SINKS, STORAGE

LVT, PAINT, WET MEDIUM - LOW WALL FINISHES

INVITING AND EARTHY

ACCESSIBLE ONLY UNDER SUPERVISION

PRIVATE COUNSELING

4 90 +/-

360 +/-

GROUP COUNSELING, GENDERED THERAPY RMS

HIGH

NATURAL & ARTIFICIAL

COUCH, DESK, SOFT SEATING, TASK CHAIR

SHOULD BE APPEALING & WARM

HIGH

COMFORTABLE AND SAFE

N/A

PUBLIC FULL BATHROOM

1 100 +/-

100 +/-

NURSING STATION, BEDROOMS

HIGH

ARTIFICIAL

SHOWER, SINK, TILE TOILET FLOORING, PAINT

HIGH

WARM AND COMFORTING

FOR PATIENTS WHO ARE TOO HIGH A RISK TO BATHE ALONE

P R O G R A M

O U T L I N E

A N D

S P A T I A L

N E E D S 135

NAME

QTY.

S.F.

TOTAL S.F.

ADJACENCIES

PRIVACY

LIGHTING

FF&E

FINISHES

ACOUSTICS

PERCEPTION

REMARKS

FITNESS ROOM

1 2000 +/-

2000 +/-

N/A

LOW

ARTIFICIAL & NATURAL

POOL, LIFEGUARD STAND, FIRST AID AREA, WORKOUT EQUIP., YOGA/ DANCE AREA

SPORT FLOORING, PAINT, NONSLIP TILE AROUND POOL

LOW

EXCITING AND ENERGETIC

INCLUDE 2 SMALL ADA BATHROOMS FOR CHANGING. FITNESS AREA ONLY IN USE WHEN SUPERVISED

BOOKSTORE

1 300 +/-

300 +/-

SECONDARY RECEPTION

LOW

ARTIFICIAL & NATURAL

STORAGE AND DISPLAYS FOR PURCHASES, CHECKOUT AREA

LVT, PAINT, WC

MEDIUM - LOW

FUN, CLEAN, EASY TO NAVIGATE

SMALL STORE FOR INPATIENTS TO PURCHASE BOOKS, PERMITTED SNACKS, ETC.

LIBRARY

1 1400 +/-

1400 +/-

BOOKSTORE, SECONDARY RECEPTION, THERAPY ROOMS

LOW

ARTIFICIAL & NATURAL

TABLES AND CARPET, LVT, WC, SOFT CHAIRS, SOFT SEATING, SURFACES BOOKSHELVES, COMPUTERS

HIGH

PEACEFUL, RELAXING

N/A

SOFT SECLUSION ROOM

1 150 +/-

150 +/-

THERAPY ROOMS

HIGH BUT ABLE TO BE MONITORED

ARTIFICIAL & NATURAL

SOFT SEATING AND SURFACES, NO EDGES

LVT, PAINT

HIGH

RELAXING

SPACE FOR INPATIENTS TO CALM DOWN

SALON

1 250 +/-

250 +/-

N/A

MEDIUM - LOW

ARTIFICIAL & NATURAL

COUNTERS, HAIRSTYLIST CHAIRS, MANICURE STATION

LVT, PAINT

MEDIUM

ENJOYABLE

ONLY TO BE USED UNDER STRICT SUPERVISION

NURSING STATION

2 150 +/-

300 +/-

RECEPTION, BEDROOMS

MEDIUM - LOW

ARTIFICIAL & NATURAL

DESK, STORAGE, CHAIRS, COMPUTERS

SOLID SURFACE, LVT, PAINT, PANELING

MEDIUM

FRIENDLY

SHOULD HAVE DIRECT LINE OF SIGHT TO PATIENT ROOM CORRIDORS

SMALL MED. ROOM

2 100 +/-

200 +/-

NURSING STATION

MEDIUM - HIGH

ARTIFICIAL

PATIENT TABLE, LVT, PAINT, CHAIR, NICE ART COUNTER

HIGH

SAFE, SECURE

FOR PATIENTS TO BE ADMINISTERED MEDICATION

STORAGE

2 300 +/-

600 +/-

ONE SHOULD BE NEAR SERVICE CORRIDOR

HIGH

ARTIFICIAL

SHELVING, COUNTER SPACE

VCT, PAINT

N/A

SHOULD NOT BE SEEN OR ACCESSED BY PATIENTS

N/A

DATA ROOM

1 100 +/-

100 +/-

MECH ROOM

HIGH

ARTIFICIAL

SHELVING, COUNTER SPACE

VCT, PAINT

N/A

SHOULD NOT BE SEEN OR ACCESSED BY PATIENTS

N/A

MECH ROOM

1 250 +/-

250 +/-

DATA ROOM

HIGH

ARTIFICIAL

SHELVING, HVAC EQUIP.

VCT, PAINT

N/A

SHOULD NOT BE SEEN OR ACCESSED BY PATIENTS

N/A

JANITOR

2 70 +/-

140 +/-

ONE ON EACH FLOOR

HIGH

ARTIFICIAL

SINK, SHELF, HOOKS

VCT, WET WALL MATERIAL

N/A

HIGHLY SECURE

N/A

136

NAME ELEVATOR

PATIENT BEDROOMS + BATHROOM

QTY.

S.F. 2 70 +/-

40 200 +/-

TOTAL S.F.

ADJACENCIES

PRIVACY

LIGHTING

FF&E

FINISHES

ACOUSTICS

PERCEPTION

REMARKS

140 +/-

RECEPTION, SERVICE CORRIDOR

N/A

ARTIFICIAL

N/A

NATURAL STONE, WOOD, GLASS

N/A

N/A

SECURITY MEASURES INSTALLED

8,000 +/-

NURSING STATION

HIGH

ARTIFICIAL & NATURAL

BED AND ALL FURNITURE SHOULD BE BUILT-IN AND SECURED.

CARPET, LVT, HIGH STANDARD BATHROOM FINISHES, SOFT SURFACES

PERSONAL, COZY

SEE SECURITY CHAPTER ON BEDROOM SAFETY

STAIR

1 VARIES

VARIES

N/A

N/A

N/A

N/A

WOOD, SOLID SURFACE

N/A

GRAND, BEAUTIFUL

SHOULD CONSIDER SUICIDE HIGHLY

FIRE ESCAPE

2 VARIES

VARIES

N/A

N/A

N/A

N/A

N/A

N/A

N/A

2 HOUR FIRE RATED

BUILDING TOTAL SQ FT: APPROX 32,000

TOTAL EST: ADDED 30% APPROX. 21,000 CIRCULATION: 6,300 + 21,000 = 27,300

*THIS ESTIMATION DOES NOT INCLUDE AREAS WHICH -VARY- SUCH AS FIRE ESCAPE, STAIR, AND SERVICE CORRIDOR, WHICH DEPEND ON FLOOR TO CEILING HEIGHTS AND CODE.

fig. 9 137

fig. 10 138

IMAGES fig 1. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.931752,-76.462821,3a,75y,90t/data=!3m8!

1e2!3m6!1s47703461!2e1!3e10!6s%2F%2Fstorage.googleapis. com%2Fstatic.panoramio.com%2Fphotos%2Fsmall%2F47703461. jpg!7i1024!8i768!4m2!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 fig 2. http://www.bobbiandmike.com/blog/wp-content/uploads/2012/02/03_ eyeballe.jpg fig 3. http://assets.inhabitat.com/wp-content/blogs.dir/1/files/2010/08/ CBF-Merrill-Environmental-Center-12.jpg fig 4. http://s3.amazonaws.com/smithgroup/project_images/images/000/000/888/normal/PhilipMerrillEnvironmentalCenter-5. jpg?1366311797 fig 5. http://www.berkeley.edu/news/media/releases/2007/10/images/livable-merrill.jpg fig 6. http://s3.amazonaws.com/smithgroup/project_images/images/000/000/887/normal/PhilipMerrillEnvironmentalCenter-4. jpg?1366311795 fig 7. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.931752,-76.462821,3a,75y,90t/data=!3m8!

1e2!3m6!1s47703461!2e1!3e10!6s%2F%2Fstorage.googleapis. com%2Fstatic.panoramio.com%2Fphotos%2Fsmall%2F47703461. jpg!7i1024!8i768!4m2!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 fig 8. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.931752,-76.462821,3a,75y,90t/data=!3m8!

1e2!3m6!1s47703461!2e1!3e10!6s%2F%2Fstorage.googleapis. com%2Fstatic.panoramio.com%2Fphotos%2Fsmall%2F47703461. jpg!7i1024!8i768!4m2!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 fig 9. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.931752,-76.462821,3a,75y,90t/data=!3m8!

1e2!3m6!1s47703461!2e1!3e10!6s%2F%2Fstorage.googleapis. com%2Fstatic.panoramio.com%2Fphotos%2Fsmall%2F47703461. jpg!7i1024!8i768!4m2!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1 fig 10. https://www.google.com/maps/place/Philip+Merrill+Environmental+Center/@38.931752,-76.462821,3a,75y,90t/data=!3m 8!1e2!3m6!1s47703461!2e1!3e10!6s%2F%2Fstorage.googleapis. com%2Fstatic.panoramio.com%2Fphotos%2Fsmall%2F47703461. jpg!7i1024!8i768!4m2!3m1!1s0x89b7f5fa5b5219bd:0x5263da34075a3024!6m1!1e1

139

fig. 1

fig. 2

s e c t i o n e i g h t: building analysis & code

8

“design is not just what it looks like - design is how it works.�

-steve jobs-

BUILDING *ALL INFORMATION WAS GATHERED DURING A PRIVATE TOUR OF THE BUILDING.

P A S T & P R E S E N T

Used by the Chesapeake Bay Foundation, this LEED Platinum building creates a presence on the coast of Annapolis undone by other neighboring buildings. Prior to the land’s development into the environmental center, the building’s land served as a public pool and inn. The community of Bay Ridge valued 142

these spaces and thus moved the public pool onto a neighboring plot of land which is now a recreational center for youth.

The site, encompassing 31 acres, was considered conservation land (categorized as C2 Zoning) and only 4.5 acres could be developed. The architects, SmithGroup, had to consider this when building, and were permitted to encroach upon the conserved land as long as the building achieved a high level of sustainability. They were required to keep much of the

fig. 3

site intact, and thus the building is located right atop the area where the old pool used to be. The footprint is only slightly larger.

the bay by the second building.

The views are stunning, as it is surrounded by forest and by the bay. Large south-facing windows allow plenty of natural light into the space and feature some remote controlled, as well as manual, screens to be used for sun shading.

only does it permit sustainability, but it also allows workers to have a great view of the bay, which creates a healthy workplace.

Both the interior and the exterior expose most of the structure to create an industrial look. Minimal ductwork is exposed and left raw There are three rainwater storage to decrease waste of materials for tanks at the north side of the aesthetic purposes. Many surfaces The building mediates humankind building where the roof slopes down are eco-friendly, such as cork, and the bay through its poetic to catch it and use it for flushing engineered wood, and coconut. wooden structure that creates a toilets and running the washing nautical and natural vibe. It does machines. These tanks are eyenot dig down into the ground with catching and serve as a reminder a basement, nor does it sit upon to guests that this facility stands the fragile sands of the beach for conservation of resources.

Much of the building is created which are prone to erosion. There are two separate structures, both Currently, the plan is divided into from recycled or repurposed with shed roofs. One is long and four areas. Each floor is divided materials. The building’s siding narrow, facing the bay, with the similarly, with two on either side is galvanized metal, created from reception area and offices inside. of the centralized lobby and cans, cars, and guns, and much The second is off to the south and staircase. The four areas are all of the interior wood flooring is is equal in height, but is smaller open workstation areas as well as cork, which comes from a tree that and square. It has a conference a few closed offices and private permits the bark to be harvested room, lunchroom, and kitchen. spaces. Most is open, though, as it every 7-9 years without harming The deck is somewhat enclosed by is more sustainable to have fewer the tree. The entry mat is made the structural wood beams outside, walls, allowing natural light and from coconut shells, which are and is semi-blocked to the face of ventilation into the space. Not fuzzy and natural and thus easy

RELATIONSHIP T O N A T U R E

CONSTRUCTION

143

fig. 5

fig. 4 144

fig. 6

fig. 7

fig. 8

fig. 9 145

fig. 10 to clean and great for traction.

When the original pool building was demoed, all of the materials were sold or salvaged to make new things. The foundation was broken apart and used as filler in the new road’s base. All debris was recycled and kept off of the site as much as possible, as erosion is common on beachy areas.

146

fig. 11

fig. 12 fig. 5

E X T E R I O R A N A L Y S I S Fenestration: As the building has tons of south-facing windows, serious sun shading is needed to control the fenestration (natural light). There is a continuous 10’ porch in the front of the south side with sun-shading louvers.

They were created from recycled pickle barrels, donated by a local business. As the angle of the sun is different during winter and summer, the shading is tilted such that an excess of winter sunlight can come in, warming the space, but not a lot of summer sunlight, keeping the space cool. It allows the building to have its beautiful views and also to prevent solar heat gain.

Southern Exposure: Facing the south allows the building to need minimal artificial lighting during operating hours and also to take advantage of southern winds.

The architects evaluated the site

to understand the wind patterns and sun patterns, and having it face south permits a wealth of natural heat and natural light.

from both galvanized metal and Hardipanel, which is fiber cement mixed with sand, 20% post-consumer recycled cellulose fiber, and water. It is resistant Geothermal Wells: There are 48 to moisture and is a structural large geothermal wells beneath material. The galvanized metal the building’s gravel parking lot. siding, also used on the roof, They extend 300’ underground is unpainted so it can be easily and naturally heat and cool the recycled in the future, if need be. building with the Earth’s internal temperature of 54 degrees F. Northern Exposure: Dormer windows and a continuous Cisterns: Rainwater is collected clerestory, as well as some smaller in cisterns that water run into off windows, allows some light of the sloped roof. The cisterns to come in on the north side. each hold 7,000 gallons of rainwater which are used for all Parking: Parking can be found non-potable water functions the beneath the building, as it sits building needs, such as washing on stilts. There is also a small clothing and flushing toilets. lot out front, made of gravel, for water to sink back into the Solar Water Heat: There are earth instead of creating filthy solar tubes on top of the roof’s runoff like asphalt. There are dormers heat all domestic hot also two parking spots where water for coffee and cooking and electric vehicles can be charged. laundry. These save 120 kilowatthours of electricity each day. Gravel: Gravel is used instead of asphalt, as well as reclaimed Siding: The siding is made concrete, on the north side of 147

fig. 13 the building by the entry. They are pervious, so rain does not sink into it and stay there. They allow rain to go back into the earth. They also reflect the sun’s heat instead of absorbing it.

Bioretention: There are ponds for bioretention in the parking lot, where stormwater is treated and captured. They filter the water and remove oil before the water evaporates or runs off into the bay 148

or creek. The landscape architect consultants selected plants that could make use of the high nutrient content in the water and also hold back the land from erosion.

diversity

in

native

creatures.

Plants: Again, the plants selected are great for preventing erosion and need minimal water, so the CBF does not need to irrigate the land. The plants only need to be mowed once a year and are native to the area, restoring

Wetlands: The area features both natural and manmade wetlands, which filter storm water before it enters the creek and allows aquatic life to thrive.

Green Roof: The small green roof features downspouts that filter water into two irrigation barrels.

fig. 14 149

I N T E R I O R A N A L Y S I S Plan: The building is currently an open office with few enclosed spaces. Having an open floor plan allows for minimal artificial ventilation and lighting to be needed, because of all the light and air coming in, unobstructed, from the windows.

Fenestration: With the large, south-facing windows, the building experiences plentiful daylight. It receives more even northern sunlight too from the clerestory. The interior finishes are light and airy, reflecting light and keeping the space cool.

Cisterns: Water is conserved due to the cisterns that produce water for laundry, sinks, and toilets.

They also installed water-efficient shower heads and faucets with sensors to prevent overuse of water. The toilets also compost 150

human waste and turn it into recycled wood, make up a large topsoil for the area’s landscaping. part of the interior scheme and are all sustainable materials.

Operable windows: There are many operable windows in the Kitchen: The kitchen is a sunny building, which have sensors on area perfect for eating and cooking. them that alert the user to open It is a social spot in the facility and them up when exterior weather alleviates the need for people to conditions are good. This allows go drive somewhere, contributing them to use natural ventilation to air pollution, to get food. alone for over 30% of the year.

Structure: All structure and Materiality: The contractor HVAC is exposed, eliminating suggested that they use structural waste of unnecessary materials insulated panels to keep the and creating a raw look. building’s temperature even throughout the year. These panels eliminate the need for typical framing, drywall, and insulation, as the thick foam inside is structural. Bamboo, cork, and Parallam are all used and are all rapidly renewable materials. All woods used were certified by the Forest Stewardship Council.

MDF: Medium density fiberboard, made from reused sawdust and eco-friendly resin, along with ceiling tiles that are 80%

PROJECT DATA Project Name: The Doe Foundation Address: 6 Herndon Drive, Annapolis MD 21403 Owner: The Doe Foundation for Behavioral and Mental Health Treatment Architect: SmithGroupJJR Date of Completion: 2001 Number of stories: Two (2) at +/- 16,000 sf each, approximately 57’x211’ with multiple column bays Total gross sf: 32,000

commercial building) Fire Code: International Fire Code 2012 Building Code & Date: International Building Code 2012 Elevator Code (if applicable): N/A

ZONING CODE REQUIREMENTS Land Use Zoning: Institutional Max. allowable height: Two stories Existing parking: Yes

USE GROUP CLASSIFICATION

Zoning Ord.: C2 (Conservational

Mixed Use: A-2, A-3, B, I-2

R E G U L A T I O N S

All means of egress should be fully sprinklered.

Dead end limit for all means of egress: 50’-0”.

All floors need a minimum of 2 means of egress.

Energy Code: N/A

APPLICABLE BUILDING CODE INFORMATION

C O D E

MEANS OF EGRESS

A N D

A-2:Assembly Cafeteria Total Gross SF: 700 +/SF per Occupant: 15 net Number of Occupants: 44 Min. Corridor Width: 72” (in case of medical emergency in cafeteria) Exit Access Travel Distance: 250’0” A-3:Assembly Fitness Center Total Gross SF: 2,500 +/SF per Occupant: 50 gross Number of Occupants: 50

S T A N D A R D S 151

Min. Corridor Width: 72” (in case of medical emergency in fitness center) Exit Access Travel Distance: 250’-0”

of medical emergency in group counseling) Exit Access Travel Distance: 250’0”

Library Total Gross SF: 1,400 +/SF per Occupant: 50 gross Number of Occupants: 28 Min. Corridor Width: 72” (in case of medical emergency in library) Exit Access Travel Distance: 250’0”

Activity Room Total Gross SF: 400 SF per Occupant: 15 net Number of Occupants: 23 Min. Corridor Width: 72” (in case of medical emergency in activity room) Exit Access Travel Distance: 250’0”

Conference Total Gross SF: 250 +/SF per Occupant: 15 net Number of Occupants: 14 Min. Corridor Width: 36” Exit Access Travel Distance: 250’0” Group Counseling Rooms Total Gross SF: 400 +/SF per Occupant: 7 net Number of Occupants: 54 Min. Corridor Width: 72” (in case

C O D E 152

B: Business Office Total Gross SF: 90 +/SF per Occupant: 150 gross Number of Occupants: 1 Min. Corridor Width: 36” Exit Access Travel Distance: 300’0” Laboratory Total Gross SF: 120 +/SF per Occupant: 100 gross

R E G U L A T I O N S

A N D

Number of Occupants: 2 Min. Corridor Width: 36” Exit Access Travel Distance: 300’0” Medicine Control Room Total Gross SF: 200 +/SF per Occupant: 100 gross Number of Occupants: 2 Min. Corridor Width: 36” Exit Access Travel Distance: 300’0” Patient Medical Exam Room Total Gross SF: 120 +/SF per Occupant: 100 gross Number of Occupants: 2 Min. Corridor Width: 72” (in case of medical emergency in exam room) Exit Access Travel Distance: 250’0” I-2: Institutional Resident Rooms Total Gross SF: 200 +/SF per Occupant: 200 gross Number of Occupants: 1

S T A N D A R D S

Min. Corridor Width: 36” Exit Access Travel Distance: 250’0”

SANITATION Within each classification group, the space with the largest square footage & occupancy load was used.

A-2: Assembly Cafeteria 1 W.C for males 1 W.C. for females 1 lavatory 1 drinking fountain A-3: Assembly Fitness Center 1 W.C for males 1 W.C for females 1 lavatory 1 drinking fountain B: Business

C O D E

Medicine Control Room 1 W.C for males 1 W.C for females 1 lavatory 1 drinking fountain

minutes Corridor Fire Resistance Rating: 0 hours for classification groups

I-2: Institutional Resident Rooms 1 W.C. per room 1 lavatory per room 1 shower/bathtub per 15 people (each wing then needs 2 shower/ bathtubs) 1 drinking fountain

FIRE PROTECTION REQUIREMENTS

Incidental Use Areas: 1 hour rated for all I-2 areas

BUILDING LIMITATIONS National Historic Registry: No Health Department/Food Services: No Urban Redevelopment Requirements: No

Fire Exit Enclosures: 2 hours Shafts and Elevator Hoistways: 2 hours Tenant Space Separations: 2 hours Smoke Barriers: Assume 30

R E G U L A T I O N S

A N D

S T A N D A R D S 153

fig. 15 154

IMAGES fig 1. http://media3.washingtonpost.com/wp-srv/photo/gallery/101230/ GAL-10Dec30-6900/media/PHO-10Dec30-279764.jpg fig 2. https://hiromuotsuka.files.wordpress.com/2013/01/img_3909.jpg fig 3. http://s3.amazonaws.com/smithgroup/project_images/images/000/000/885/normal/PhilipMerrillEnvironmentalCenter-2. jpg?1366311792 fig 4. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 5. http://www.cbf.org/image/area---join-us/more-things-you-can-do/Merrill-Center_MidAtlanticAerial_695x352.png fig 6. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 7.http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 8. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 9. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 10. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 11. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 12. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 13. http://www.cbf.org/image/area---about-cbf/offices-operations/maryland/Merrill-Center-brochure-sketch-New_695x352.jpg fig 14. http://www.cbe.berkeley.edu/livablebuildings/pdfs2007/submittal_philip_merrill.pdf fig 15. https://www.tradelineinc.com/sites/default/files/styles/popup/public/ article/74628/Rainwater_Cisterns.jpg?itok=fmhJOEDq

155

fig. 1

fig. 2

s e c t i o n n i n e: executive summary

“quiet

the

mind

and

the

soul

9 will

speak.�

-ma jaya sati bhagavati-

SUMMARY C L O S I N G T H O U G H T S

Successful designs begin with thorough research. By understanding a user group, both their mental and physical needs, and by understanding what the existing building has to offer, a solid basis for truly creating something special exists. It is the responsibility of the designer to create something that matters for the community; something that 158

answers the question “what do these people truly need?�

Needs are different from wants.

People want entertainment and shopping destinations, but one intrinsic need of all people is simple: health. Statistics presented in the first section proved how desperately people want to be mentally healthy, and the lengths they will go to in order to achieve it. Sometimes they become misguided, by turning to substance abuse, by becoming workaholics, or by withdrawing from intimate

fig. 3

and

meaningful

relationships. they can recover. Both working at and visiting ManorCare over the By studying the history of mental past four years has revealed the illness and the barbaric means truth that people with no access of treatment, it became obvious to nature, with shared bedrooms, that compassion was the missing and with few gathering spaces link. Treating people as patients, have very little success in recovery. or worse, as prisoners, is simply a means to an end; people often Studying ergonomics and died in asylums because they were technical criteria was perhaps the not treated with compassion and most critical part of this research. therapy, but rather with torture. As the residents in this facility Society has come to a brave are at an extremely high risk, conclusion that people must both to themselves and to others, support each other to overcome understanding security and other the terrors of mental illness. factors like visual and acoustic control was paramount. The needs Three of the case studies revealed of mental health patients are the successes of treating people so different from other types of with this compassion; The patients that understanding this Abramson Center, The Mayerhof allows a designer to create a safe Care Campus, and the SK Yee facility for a sensitive demographic.

Healthy Life Center all prove how sunlight and intimate gathering By learning the effects and spaces benefit individuals who implications of color, human are receiving care. Access to behavior, and nature, it became nature, pleasant interior finishes, easier to grasp the effects of and simple circulation all help interior design upon a patient. patients feel less like they are Knowing how small the ticks are institutionalized, and more like that set people off, and how small

the design decisions can be to create a healthy space has created a well-rounded understanding of sensitivities amongst people.

Analysis of the site of the Philip Merrill Environmental Center, as well as the area of Annapolis taught that the US Naval Base’s proximity creates a high population of veterans in the city. As discussed in section one, veterans have an extremely high suicide rate, as many of them suffer from PTSD (post-traumatic stress disorder). The need for this facility in Annapolis is critical, as it could save many veterans’ lives.

Developing a program this early on was difficult, because pulling together a concise list of the spaces the mentally ill need to heal is a nearly impossible task.

A building could never be big enough to house all of their needs; however, multi-use spaces like an activity room that can be used for arts and crafts, for light physical activities, and for watching 159

fig. 4

fig. 5

movies allows the building to be fragile people from giving up. a space flexible enough to cater Finally, it saves the saviors, to all needs at different times. because the people dedicated to caring for the mentally ill Finally, understanding the bigger never have to wonder if they picture – codes, the interior, are changing lives. They are. and the exterior of the existing building, allows the designer Thank you for coming on to use what exists in a way that this journey.

Thank you best serves not only the user for having compassion. group, but also the environment.

This research was conducted with the intention of changing the world for a sensitive group of people, but it does not stop there.

Saving the mentally ill saves their families, loved ones, and friends.

It saves the community. It saves 160

fig. 6

IMAGES fig 1. http://s5.favim.com/orig/53/beach-beautiful-girl-hair-Favim.com488759.jpg fig 2. http://orig09.deviantart.net/f8d7/f/2013/356/1/0/glowing_eye_by_asherah32-d6yvfy8.jpg fig 3. http://img15.deviantart.net/88b1/i/2010/245/7/4/letting_go_by_latoday-d2xtzi9.jpg fig 4. http://41.media.tumblr.com/058d0dd86f93b6968621a3cde6d435b0/ tumblr_nlw09clqeu1ssite1o1_500.jpg fig 5. http://static1.squarespace.com/static/52eb329be4b0803827f294ae/52ede5a6e4b0b3cb082ab695/55c51d25e4b0ddda27f47 5b0/1438981519057/Letting-Go_Web.jpg?format=500w fig 6. http://40.media.tumblr.com/4f76da276d30381996e946cfd147d5bc/ tumblr_n8qc5v1tTb1r0o3jvo1_500.jpg

161

fig. 1

fig. 2

s e c t i o n

t e n:

b i b l i o g r a p h y

“the

eyes

are

the

window

10 to

the

soul.�

-traditional proverb-

“Annapolis, Maryland,” City-Data. Web. January 10, 2014. Accessed November 2, 2015. Page 3.

“Annapolis: History,” City-Data. Web, 2012. Pages 1-3.

“From Bethlehem to Bedlam - England’s First Mental Institution.” Historic England.

2015. Accessed September 9, 2015.

Augustin, Sally. Place Advantage: Applied Psychology for Interior Architecture.

Hoboken, NJ: John Wiley & Sons, 2009. Print.

Furlong, Maggie. “’Perception’ On TNT: Eric McCormack On His Schizophrenic New Role And Getting Away From ‘Will & Grace’” The Huffington Post.TheHuffingtonPost.com, 9 July 2012. Web. 31 Aug. 2015.

“Bay Ridge - Philip Merrill Environmental Center,” Google Maps, Web. Page 1,

“Health - Bethlem.” Victorian London. 2012. Accessed September 9, 2015. http:// www.victorianlondon.org/health/bethlem.gif.

“Discover Dining, Shopping,..” Annapolis Downtown. Web. April 2015. Page 2.

Dr. Bradley Carlin, “Mental Health Facilities Design Guide,” United States of America, Department of Veterans Affairs, August 1, 2014. Page 3-14.

“Health and Education.” NIMH: National Institute of Mental Health. 1 Jan. 2015. Web. 22 Aug. 2015.

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-Meyer Design, Inc; Senior Living Team of 10 people, as well as various employees who provided excellent advice throughout.

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Additional image sources: -cover page: http://www.awesomeinventions.com/wp-content/uploads/2015/05/double-exposure-deer-trees.jpg -back cover: http://orig02.deviantart.net/c792/f/2014/095/0/a/img_5389_copy1_by_crazygirl44-d7d4iya.jpg Your and kindness throughout has helped to make this book not only a meaningful -table of advice, contentsguidance, 1: http://2.bp.blogspot.com/-QTRYxFQnZhs/Uk34VDbihsI/AAAAAAAADG4/SxYNXmzD8Mk/s320/ ChristianHopkins9.jpg part of my life and collge experience, but also a great source for the upcoming semester. It could not -table of been contents 2: http://41.media.tumblr.com/efbb26044e15da824d1585670b54ec79/tumblr_nudrtjKs8x1r0tytoo1_1280.jpg have completed without you.

-section 10 cover 1: http://images.fineartamerica.com/images/artworkimages/mediumlarge/1/heavens-light-black-and-white-garybrandes.jpg -section 10 cover 2: http://img06.deviantart.net/0bf3/i/2012/083/b/1/black_and_white_eye_by_pacificrush27-d4ttvqs.jpg

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a m y l e i g h h u f f o r d capstone research & programming f a l l 2 0 1 5 amyleighhufford@gmail.com b e h a n c e . n e t / a my l e i g h hu f f o r d