Design Manual
設計手冊
Neighbourhood strategies for Beijing’s urban psychiatric care.
生活中的都市策略 Cameron Clarke Student Number: 170175 Urbanism and Societal Change
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Cameron Clarke 170175
Unit Urbanism and Societal Change Institute IBBL Tutor Christine Bjerke Unit Directors Charles Bessard & Deane Simpson Spring 2019
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Institute of Mental Health Law of the People’s Republic of China
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contents
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global context project synopsis china’s mental health law a prototype project a prototype site desheng subdistrict design principles therapeutic cabinet therapeutic matrix urban acupuncture urban clinic digital layer program journey urban acupuncture pocket garden community kitchen garden rooftop kitchen garden community exercise space car-park roof garden meditative walking routes silent meditation spaces tower group therapy space street-side talking space mental wellness and recovery clinic emotional support line group meeting space professional consultation psychotherapy innovative therapy spaces communal kitchen and dining
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global context
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UN Sustainable Development Goals
The project will address the following UN Sustainable Development Goals: Good Health and Well-being Goal 3.4 “By 2030, reduce by one third premature mortality from noncommunicable diseases through provention & treatment & promote mental health and wellbeing.” (United Nations, 2015)
Reduced Inequalities Goal 10.2 “By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.” (United Nations, 2015)
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project synopsis
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Today, almost 180 million Chinese citizens suffer from a mental health illness, almost 1 in 5 of the population. Of these 180 million people living with a mental illness, 160 Million have not had any psychological treatment or care. This lack of treatment is a crisis in-waiting, and the economic and social consequences are yet to be fully comprehended. Can answers to China’s urban mental health crisis be found close to home? In this project I argue that answers may be found within existing community and neighbourhood structures. This is achieved by proposing a preventative & rehabilitational focused psychiatric care model based upon a urban acupuncture of care facilities across the city fabric, rather than the current model of reactive centralised institutions. Architectural spaces and interventions are networked together by a digital layer of communication technology, bringing mental healthcare physically, and virtually, closer to each of the city’s citizens, and in doing so increasing communal and neighbourly interaction and reducing stigma and fear of illness, which is integral for good mental health. 9
china’s mental health law
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2012 Mental Health Law
2015 - 2020 Mental Health Working Plan
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2012 Mental Health Law
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2015 - 2020 Mental Health Working Plan
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a prototype project Internet Enabled Social Networks Diagnostic & Treatment Apps
Community Support Groups
Urban Community Networks
Technological Innovation Intelligent patient monitoring, security & space utilisation
Educational Spaces
Community Treatment & Care Facilities
Architectural Spatial Intervention
VR Spaces created for Diagnostics & Treatment
Remote access to hospital consultations & specialists
Rehabilitation Facities
National Strategy & Policy
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The publication of the National Mental Health Work Plan of China (2015 - 2020) expanded upon the 2012 National Mental Health Law and set out a series of goals to be achieved by 2020 to deliver on the overall agenda, which aims to create a comprehensive and holistic mental healthcare system:
The policy aims to maximise integration with local communities, simultaneously enabling care to take place closer to patients existing social networks, while improving the wider public’s understanding of mental healthcare. The policy states that local governments:
“[To] build a social milieu of understanding, acceptance, and caring for individuals with mental illnesses; raise community awareness of the importance of mental health; promote the psychological well-being of the public; and enhance the harmonious development of the society”
“...should vigorously promote a comprehensive, community-based, open model of rehabilitation for individuals with mental illnesses that effectively links medical rehabilitation and social rehabilitation and that strengthens the technical support provided from specialised mental health institutions to community-based rehabilitation facilities”
The Work Plan also seeks to spread the responsibility of mental healthcare into the private sector, away from solely being provided by state funded primary health services. As part of wider reforms being brought to healthcare more generally, the policy encourages private commercial and community organisations to develop services, products and treatmenta which can contribute to the overall mental health policy goals. There is a clear encouragement on the adoption of new technologies and in learning from new practices in the international community so that “successful experiences from international sources… should be rapidly applied in the practice of mental health work.”
Thus, it is possible to assess the strategies outlined in both the 2012 National Mental Health Law and the National Mental Health Work Plan of China (2015 - 2020) through the lense of three interconnected thematics: Firstly, the role of existing urban community and neighbourhood networks play in both increasing understanding, controlling stigma, opening access to diagnosis, treatment and rehabilitation. Secondly, how rapid technological innovations are changing the methods of treatment for mental healthcare across the globe, and are enabling a move away from institutionalised care, to treatment in local neighbourhoods and in the home.
Finally, there is a particular emphasis on strengthening community care, treatment and rehabilitation facilities which“involves the collaborative participation of specialised mental health facilities, community rehabilitation centres, social organisations, and families.” . One way that this policy is to be achieved is by the opening of a new type of architectural intervention:“public community-based rehabilitation facilities.”
And lastly, there is an oppportunity for a new unique series of spatial, achitectural and planning strategies to be proposed as prototype projects at local neighbourhood scales, which can then be networked together to form the built landscape of a new mentalhealthcare infrastructure
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A Prototype Site
This project proposes a series of interventions which form the basis of a Design Manual for a Prototype Project, speculating on a possible alternative trajectory for Chinese urban mental healthcare. The project focuses on a prototype site for proposals, offering programs which are largely absent from the current mental healthcare system. These interventions will support community awareness, early diagnosis and also recovery support and community reintegration for patients. I will be basing my investigations at the edge of the central Beijing’s oldest district: Xicheng. Xicheng contains the broadest spectrum of urban typologies in the city and is home to central Beijing’s last remaining psychiatric hospital. The population of the district is 1.3 Million , over twice that of Copenhagen. Xicheng is further subdivided into 15 neighbourhoods, these proposals will focus on the Desheng Subdistrict. Desheng is a 4.14 km2 neighbourhood, with a residential population of 116,199 and an additional transient population of 25,50 0. This site has been selected for investigation as it crosses the 2nd ring-road boundary which de-marks the typological change from traditional hutong neighbourhoods, danwei work unit housing to the ultra high density gated community housing schemes which has begun to dominate the Beijing sk yline.
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Desheng Subdistrict
Typical Megablock Plan, Beijing
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Tectonic massing of typical Megablock
Tectonic massing of typical Danwei Typical Danwei Plan, Beijing
Typical Hutong Plan, Beijing
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Tectonic massing of typical Hutong
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Three Neighbourhood Sites within Desheng Subdistrict, Xicheng, Beijing Source: Baidu, 2019
See photos in Site Journey, overleaf
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Desheng Subdistrict Hutong 花 园
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Desheng Subdistrict, Beijing 1 : 2000 22
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Desheng mental wellness & recovery clinic
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listening pavilion
和 平
peaceful space
花 园
reflective garden
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meditative route
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Desheng subdistrict hospital
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design principles
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Light
It is well documented that daylight, artificial light and sunlight can all provide significant health benefits for the general population, as well as mental health patients in particular. There is research to suggest that bright light—natural or artificial— can improve health outcomes such as depression, agitation, sleep, circadian rest-activity rhythms, and length of stay in dementia and bipolar seasonal affective disorder (SAD) patients. Further to this, studies show that exposure to morning light is more effective than exposure to evening light in reducing depression. Using light to reduce depression is a relatively inexpensive intervention that has been shown to yield consistently positive results. While artificial lighting can be manipulated throughout the design process, the initial layout of rooms to face east, allowing natural daylight in patient rooms in the morning, can make a significant contribution to patient wellbeing.
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Elimination of Environmental Stressors
In the pursuit of recovery, mental health patients must first be comfortable. Noise, glare, and air quality are among the many environmental variables that must be considered in the design of healthcare facilities. Noise is a major cause of sleep disturbance, and there is evidence to suggest that noise increases stress in patients, inducing high blood pressure and increased heart rates. Design interventions that minimise or eliminate noise throughout the facility are important. While natural light has been identified as crucial in maximising recovery potential, flooding rooms with too much light in inappropriate locations is likely to cause discomfort, as is poor indoor air quality. Way finding is also a critical element in the elimination of stress for both patients and their visitors, who may be unfamiliar with the facility. Way finding systems should use external cues, local information and graphical clarity.
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Safety & Security
Safety specifically addresses the need to keep staff and patients out of harm’s way through physical elements in design, while security allows the freedom of movement for patients within the facility without compromising treatment and the safety of the patients, staff, and the community. Good security design allows the freedom of movement for patients within the limits of their condition. The more serious the illness, the more overt will be measures to ensure patients do not harm themselves. Design must also consider the protection of staff, other patients, visitors and members of the public.
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Observation
Closely related to security is the issue of observation, which is ideally achieved through passive surveillance. Innovative ways to increase the potential for staff to check on patients can be seen in a number of new facilities. Providing secure courtyards is succesful approach, but there are other ways of maximising observation without intruding the patients. Wide corridors with regular gathering spaces enable a low key approach to observation, and single loaded corridors with uninterrupted views to external spaces also allow staff to continue with their work while keeping an eye on activities throughout the facility.
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Avoidance of visual disturbance
Visual disturbance can take many forms, but mental health facility planners generally strive to provide a calm environment with ample space and minimal clutter – through colour, light, furniture and art. Evidence indicates that a calm environment free of technological distractions allows patients time and space to reflect. Art selection can contribute to a calm atmosphere: studies on art in hospitals suggest that, in addition to benefits from access to nature, patients respond positively to art depicting nature and negatively to chaotic abstract art. There is also evidence that inappropriate art styles can increase stress and worsen other conditions.
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Colour
The colour most beneficial in making people feel calm is blue. Studies have shown that brighter colours: (whites, light grey, and lighter colours) are found to be less arousing, and less dominant than darker colours, grey and black. However, the calming effect is not the only benefit of astute colour selection– colour coding the environment can greatly assist in orientation and can be used as part of the way finding strategy.
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Group Interaction
The value of social interaction for psychiatric patients is well researched, and varies according to the type of illness and the demographic of the patients. There are two aspects to socialisation – with other patients, and with visitors. Culture has a large bearing on how people behave in mental health settings - privacy with and for family are critical. Social interaction with family and friends is an important element in many treatment programs, and research indicates that single rooms are significantly better than multi-bed rooms for accommodating visitors. Multi-bed rooms may even deter family presence because they greatly reduce privacy and restrict visiting hours. While some patients sharing the same bedroom provide each other with social support, research shows that the presence of a roommate is more likely to be a source of stress rather than support.
There is also strong evidence that where single bed rooms are provided, patient to patient interaction can be increased, and stress levels lowered, by providing lounges with comfortable furniture arranged in small flexible groupings. Access to outdoor spaces that are large enough for different social and cultural groups to inhabit is also important.
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Access to Nature
Many recently designed mental health facilities focus strongly on links to nature, through both views and physical interaction. A significant body of research consistently finds that viewing nature induces positive emotional and physiological changes and diminishes negative emotions through changes in blood pressure and heart activity. Post-occupancy evaluation where the mental health facility is based on the courtyard model, is indicating that patient stay has been reduced significantly as well as the incidence of violence. Other studies indicate that patients and family who use hospital gardens report positive mood change and reduced stress. As an added bonus, staff in facilities with gardens can benefit from nature. Gardens in the workplace can reduce stress and improve outcomes through fostering social connection and providing opportunities for positive escape from stressful clinical settings.
The impact of smell on well-being is also identified in research relating to design in mental healthcare settings in which commonalities across the literature suggest that ‘pleasing aromas may reduce blood pressure, slow respiration, and lower pain perception levels; unpleasant odours stimulate anxiety, fear and stress.
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therapeutic cabinet
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therapeutic matrix Mental Wellness
Theraputic Goal
Prevention
Awar
Self Awareness Privacy Social Interaction Physical Activity Stress Reduction Diet Unpolluted Environment Access to Nature Community Connection Social Purpose Self Help Mindfulness Listening Support Talking Therapy Peer Support Groups Clinical Assessment Observation Psychotherapy Pharmacotherapy Family & Carer Support Supported Housing
Urban Acupunctural Elements
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Tower Group Therapy Space
Silent Meditation Space
Medative Walking Routes
Community Carpark Roof
Community Exercise Space
Rooftop Kitchen Garden
Community Kitchen Garden
Pocket Garden
Inpatient Care
Digital Layer
Mental Wellness and Recovery Clinic
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Infrastructure for Awareness, Diagnosis & Treatment
Urban Acupunctural Elements
Pocket Garden
Treatment
Community Kitchen Garden
Rooftop Kitchen Garden
Community Exercise Space
Community Carpark Roof
Medative Walking Routes
Silent Meditation Space
Tower Group Therapy Space
Diagnosis
Streetside Talking Space
Inpatient Care
Communial kitchen & dining
Innovative therapy spaces
Psychothrerapy
Professional Consultation
reness
Group Meeting Space
Emotional Support Line
Streetside Talking Space
Mental Illness Recovery
Remission
digital layer
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digital layer
the intervention the clinic institution
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1. Computerised Cognitive Behavioural Therapy (CCBT) Utilizing patients familiarity with smartphone devices and applications to deliver programmes of self directed talking therapy in their home environment. 2. Telepsychiatry Enabling therapists to connect and communicate remotely with patients, to operate over large distances and provide cheaper therapeutic treatment that traditional face to face consultations. 3. Healthcare Provider Tools Creating tools and software which enables healthcare providers to communicate with each other, and maximise efficiency and to create flexible, contextual and responsive treatment programmes. 4. Patient Mobile Tools Building mobile tools which allow patients to track their treatments, or to communicate with other patients in their local or wider network, enabling and facilitating self run support groups 5. Hardware Using connected hardware such as VR headsets and motion trackers to deliver immersive virtual treatments, change perceived spatial conditions or utilise virtual environments to test and diagnose patients. 6. Applied Artificial Intelligence Connecting patient data with artificially intelligent machine learning to analyse patient conditions, treatment efficacy & to assist with diagnosis or prevention.
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program journey A Community Mental Health System based upon the recovery approach which resonates strongly with traditional Chinese culture and is consistant with the government’s 686 Project, paying more attention to the patient’s level of functioning and their strengths, rather than their disabilities and psychopathology. The recovery approach emphasises self-confidence 自信, self-help 自助 & self-sufficiency 自給自足. The programme will address the treatment gap found between diagnosis and hospital inpatient acute care or medication and will open up awareness of mental illness and wellness for those undiagnosed in the commununity 42 62
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the proposals
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pocket garden Mental Mental Wellness Wellness
Theraputic Theraputic Goal Goal
Mental Mental Illness Illness
Prevention Prevention
Awareness Awareness Diagnosis Diagnosis
Treatme Tre
Self Awareness Self Awareness PrivacyPrivacy Social Interaction Social Interaction Physical Physical ActivityActivity Stress Stress Reduction Reduction Diet
Diet
Unpolluted Unpolluted Environment Environment AccessAccess to Nature to Nature Community Community Connection Connection Social Purpose Social Purpose Self Help Self Help Mindfulness Mindfulness Listening Listening SupportSupport TalkingTalking Therapy Therapy Peer Support Peer Support GroupsGroups ClinicalClinical Assessment Assessment Observation Observation Psychotherapy Psychotherapy Pharmacotherapy Pharmacotherapy Carer Support Family Family & Carer&Support Supported Housing Supported Housing
de Talking Space
t Care
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ve therapy spaces
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editation Space
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e Walking Routes
Schematic Neighbourhood Plan
ity Carpark Roof e Walking Routes
ity Exercise Space ity Carpark Roof
Kitchen Garden ity Exercise Space
ity Kitchen Garden Kitchen Garden
Garden
Therapeutic Matrix
Garden ity Kitchen Garden
Inpatient Inpatient Care Care
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community kitchen garden Mental Wellness
Theraputic Goal
Mental Illness
Prevention
Awareness
Diagnosis
Treatme
Self Awareness Privacy Social Interaction Physical Activity Stress Reduction Diet Unpolluted Environment Access to Nature Community Connection Social Purpose Self Help Mindfulness Listening Support Talking Therapy Peer Support Groups Clinical Assessment Observation Psychotherapy Pharmacotherapy Family & Carer Support Supported Housing
de Talking Space
t Care
ve therapy spaces
hrerapy
ional Consultation
eeting Space
al Support Line
ial kitchen & dining
roup Therapy Space
de Talking Space
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editation Space
Schematic Neighbourhood Plan
e Walking Routes
ity Carpark Roof
ity Exercise Space
Kitchen Garden
Garden
Therapeutic Matrix
ity Kitchen Garden
Inpatient Care
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retractable ETFE roofing insulates the garden, allowing for the creation of various different microclimates, giving the potential for crops from all over china to be successfully grown.
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garden an be opened to the hutong street to allow passersby to visit, but can be secured at night when no in use
Gardening takes place within existing building structure
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carpark roof garden Mental Wellness Mental Wellness
heraputic Goal
Awareness
Theraputic Goal
Prevention
Mental Illness
Prevention Awareness
Diagnosis Awareness
Mental Illness
Diagnosis
Treatment
Treatme
Self Awareness
acy
Privacy
al Interaction
Social Interaction
sical Activity
Physical Activity
ss Reduction
Stress Reduction Diet
olluted Environment
Unpolluted Environment
ess to Nature
Access to Nature
mmunity Connection
Community Connection
al Purpose
Social Purpose
Help
Self Help
dfulness
Mindfulness
ening Support
Listening Support
ing Therapy
Talking Therapy
r Support Groups
Peer Support Groups
cal Assessment
Clinical Assessment
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Observation
chotherapy
Psychotherapy Pharmacotherapy
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ional Consultation ial kitchen & dining
roup Consultation Therapy Space ional
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Schematic Neighbourhood Plan al Support Line
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Kitchen Garden
ity Kitchen Garden
Garden
Therapeutic Matrix
roup Therapy Space ity Carpark Roof
Inpatient Care
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Supported Housing
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Garden eKitchen Walking Routes
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ity Kitchen Carpark Garden Roof ity
Family & Carer Support
ity Exercise Space Garden
rmacotherapy
mily & Carer Support
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rooftop kitchen garden Mental Mental Wellness Wellness
Theraputic Theraputic Goal Goal
Mental Mental Illness Illness
Prevention Prevention
Awareness Awareness Diagnosis Diagnosis
Treatment Treatme
Self Awareness Self Awareness Privacy Privacy Social Interaction Social Interaction PhysicalPhysical Activity Activity Stress Reduction Stress Reduction Diet
Diet
Unpolluted Unpolluted Environment Environment Access Access to Nature to Nature Community Community Connection Connection Social Purpose Social Purpose Self Help Self Help Mindfulness Mindfulness Listening Listening SupportSupport Talking Therapy Talking Therapy Peer Support Peer Support Groups Groups Clinical Assessment Clinical Assessment Observation Observation Psychotherapy Psychotherapy Pharmacotherapy Pharmacotherapy Family &Family Carer & Support Carer Support Supported HousingHousing Supported
roup Therapy Space de Talking Space
de Talking Space
t Care
t Care
ve therapy spaces
ve therapy spaces hrerapy
ional Consultation hrerapy
ional Consultation eeting Space
eeting Space al Support Line
de Talking Space al Support Line
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ial kitchen & dining
ial kitchen & dining
roup Therapy Space editation Space
de Talking Space roup Therapy Space
Schematic Neighbourhood Plan
e Walking Routes editation Space
ity Carpark Roof e Walking Routes
ity Exercise Space ity Carpark Roof
Kitchen Garden ity Exercise Space
Kitchen Garden ity Kitchen Garden
Garden
Therapeutic Matrix
ity Kitchen Garden Garden
InpatientInpatient Care Care
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located against the existing lift overun, a lean-to roof creates an idea suntrap for the planting of seeds and saplings, before they are potted untill they are ready to be replanted outside
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Entrance from lift core directly into rooftop ‘potting shed’
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rooftop planting benefits from being free from overshadowing by other buildings, escape from the worst of the street level pollution
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while allowing a reconnection to nature, gardening can be a very sociable activity, so space is provided for groups and individuals to share knowledge and hold group gardening therapy meetings
Simple light weight folded structures shelter the garden from adverse weather
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community exercise space Mental Wellness Mental Wellness
Theraputic Goal Theraputic Goal
Prevention
Mental Illness Mental Illness
Prevention
Awareness
Awareness Diagnosis
Diagnosis
Treatment
Treatme
Self Awareness Self Awareness Privacy
Privacy
Social Interaction Social Interaction Physical Activity Physical Activity Stress Reduction Stress Reduction Diet
Diet
Unpolluted Environment Unpolluted Environment Access to Nature Access to Nature Community Connection Community Connection Social Purpose
Social Purpose
Self Help
Self Help
Mindfulness
Mindfulness
Listening Support Listening Support Talking Therapy
Talking Therapy
Peer Support Groups Peer Support Groups Clinical Assessment Clinical Assessment Observation
Observation
Psychotherapy
Psychotherapy
Pharmacotherapy Pharmacotherapy Family & Carer Support Family & Carer Support Supported Housing Supported Housing
editation Space
de Talking Space
t Care roup Therapy Space
ve therapy spaces
ve therapy spaces ional Consultation
al Support Line
hrerapy eeting Space
ional Consultation
eeting Space de Talking Space
editation Space
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de Talking Space
Schematic Neighbourhood Plan
de Talking Space
t Care ial kitchen & dining
hrerapy ial kitchen & dining
al Support Line roup Therapy Space
Therapy Space eroup Walking Routes
ity Carpark Roof editation Space
Exercise Space eityWalking Routes
Kitchen Garden ity Carpark Roof
ity Kitchen ExerciseGarden Space ity
ity Kitchen Garden
Garden
Therapeutic Matrix
Kitchen Garden
Inpatient Care
Garden
Inpatient Care
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meditative walking routes Mental Wellness
tic Goal
ss
Mental Wellness
Theraputic GoalPrevention
Mental Illness
PreAwareness vention
Diagnosis Awareness
Mental Illness
Diagnosis
Treatment
Treatme
Self Awareness Privacy
ction
Social Interaction
vity
Physical Activity
tion
Stress Reduction Diet
nvironment
Unpolluted Environment
ture
Access to Nature
Connection
Community Connection
se
Social Purpose Self Help Mindfulness
pport
Listening Support
py
Talking Therapy
Clinical Assessment Observation
de Talking Space
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ional Consultation
roup Therapy Space ial kitchen & dining
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roup Therapy Space hrerapy
alking Space de ve Ttherapy spaces
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ity Carpark Roof
Schematic Neighbourhood Plan
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Inpatient Care
Kitchen Garden editation Space
Supported Housing
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Kitchen Garden
ousing
ity Kitchen Garden
Pharmacotherapy Family & Carer Support
Garden
rapy
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eityWalking KitchenRoutes Garden
Psychotherapy
ity Carpark Roof Garden
py
Peer Support Groups
ity Exercise Space
Groups
ssment
和 平 听
和 平
花 园
和 平
听
花 园
听
听 道
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meditative route
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App user is guided through a route with accompanying medative audio
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Therapeutic Matrix
ional Consultation e Walking Routes
ity Carpark Roof eeting Space
al Support Line
ity Exercise Space
de Talking Space
roup Therapy Space Kitchen Garden
Schematic Neighbourhood Plan
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roup Therapy Space
de Talking Space
DiagnosisTreatment
ity Exercise Space
ity Carpark Roof t Care
e Walking Routes
ial kitchen & dining
editation Space
ve therapy spaces roup Therapy Space
Mental Illness
hrerapy de Talking Space
ional Consultation
Awareness
eeting Space t Care
al Support Line
de Talking Space ial kitchen & dining
Awareness Prevention Diagnosis
editation Space ve therapy spaces
Mental Wellness
hrerapy
Theraputic Prevention Goal
editation Space ity Kitchen Garden
Mental Wellness
Garden
e Walking Routes
ity Carpark Roof
ity Exercise Space
Kitchen Garden
t
ity Kitchen Garden
Garden
silent meditation spaces Mental Illness
Treatme
Self Awareness
Privacy
Social Interaction
Physical Activity
Stress Reduction
Diet
Unpolluted Environment
Access to Nature
Community Connection
Social Purpose
Self Help
Mindfulness
Listening Support
Talking Therapy
Peer Support Groups
Clinical Assessment
Observation
Psychotherapy
Family & Carer Support
Pharmacotherapy
Supported Housing
Inpatient Care
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Simple curved seating creates a private moment where thoughts can be heard
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Therapeutic Matrix
ity Carpark Roof ional Consultation
eeting Space
al Support Line ity Exercise Space
de Talking Space Kitchen Garden
Schematic Neighbourhood Plan
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de Talking Space
Diagnosis Treatment
Kitchen Garden
Exercise Space tity Care
ity Carpark Roof
e Walking Routes ial kitchen & dining
Mental Illness
ve therapy spaces editation Space
hrerapy roup Therapy Space
ional Consultation de Talking Space
eeting Space
Awareness
al Support Line t Care
de Talking Space
Awareness Prevention Diagnosis
roup Therapy Space ial kitchen & dining
editation Space
ve therapy spaces
Mental Wellness
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Theraputic Prevention Goal
roup Therapy Space ity Kitchen Garden
Mental Wellness
Garden editation Space
e Walking Routes
ity Carpark Roof
ity Exercise Space
Kitchen Garden
ity Kitchen Garden
Garden
tower group therapy space Mental Illness
Treatme
Self Awareness
Privacy
Social Interaction
Physical Activity
Stress Reduction
Diet
Unpolluted Environment
Access to Nature
Community Connection
Social Purpose
Self Help
Mindfulness
Listening Support
Talking Therapy
Peer Support Groups
Clinical Assessment
Observation
Psychotherapy
Family & Carer Support
Pharmacotherapy
Supported Housing
Inpatient Care
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By interconnecting 4 apartments, enough space is created for a range of activities
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ity Kitchen Garden
Garden
Therapeutic Matrix
Schematic Neighbourhood Plan
74 Mental Illness
Diagnosis Treatment
ity Kitchen Garden de Talking Space
t Care Kitchen Garden
ity Exercise Space
ial kitchen & dining ity Carpark Roof
e Walking Routes
Mental Illness
hrerapy editation Space ve therapy spaces
roup Therapy Space
de Talking Space ional Consultation
Awareness
eeting Space
t Care al Support Line
de Talking Space
PreDiagnosis vention
editation Space ial kitchen & dining roup Therapy Space
e Walking Routes ve therapy spaces
Mental Wellness
hrerapy
ity Carpark Roof
ional Consultation
eeting Space ity Exercise Space
Awareness
Kitchen Garden al Support Line
Prevention Theraputic Goal
alking Space de ityTKitchen Garden
Mental Wellness
Garden roup Therapy Space
editation Space
e Walking Routes
ity Carpark Roof
ity Exercise Space
Kitchen Garden
street-side talking space Rec
Treatme Rem
Self Awareness
Privacy
Social Interaction
Physical Activity
Stress Reduction
Diet
Unpolluted Environment
Access to Nature
Community Connection
Social Purpose
Self Help
Mindfulness
Listening Support
Talking Therapy
Peer Support Groups
Clinical Assessment
Observation
Psychotherapy
Family & Carer Support
Pharmacotherapy
Supported Housing
Inpatient Care
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Passers-by can share a moment of stillness on the busy street
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Lightweight timber and fabric construction can be easily folded up and relocated
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Open to the sky, the space helps take the mind off the surrounding chaotic city
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ity Carpark Roof
ity Exercise Space
Therapeutic Matrix
ity Carpark Roof
ial kitchen & dining
ity Exercise Space
Schematic Neighbourhood Plan
80 Remission
de Talking Space
t Care
Diagnosis
Garden
ity Kitchen Garden ial kitchen & dining
ve therapy spaces Kitchen Garden
Mental Mental Wellness Illness
ity Exercise Space hrerapy
ional Consultation ity Carpark Roof
Treatment Awareness
e Walking Routes eeting Space
al Support Line
editation Space
roup Therapy Space de Talking Space
de Talking Space roup Therapy Space
Prevention
editation Space
e Walking Routes t Care
Diagnosis
Kitchen Garden ve therapy spaces
ity Kitchen Garden hrerapy
Garden ional Consultation
Theraputic Awareness Goal
eeting Space
al Support Line
de Talking Space
roup Therapy Space
editation Space
ention
e Walking Routes
ess
Self Awareness
mental welless and recovery clinic Mental Illness Recovery
Treatme
Privacy
Social Interaction
Physical Activity
Stress Reduction
Diet
Unpolluted Environment
Access to Nature
Community Connection
Social Purpose
Self Help
Mindfulness
Listening Support
Talking Therapy
Peer Support Groups
Clinical Assessment
Observation
Psychotherapy
Family & Carer Support
Pharmacotherapy
Supported Housing
Inpatient Care
A
Roof Plan 1:100
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Existing Building
Existing
30m
Building
Existing Building 25m
Site
Programme Strategy
Programme Sequence
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Layers of Privacy
Thresholds
Vertical Circulation
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ground floor
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botanical lab
pharmacy staff & inpatient entrance
consultation
consultation
medicinal garden
activity space
community activity space
kitchen
nurse station
community living room
fruit and vegetable garden
dining
vr classroom
covered market space
entrance
streetside respite & phone line
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first floor
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acupuncture clinic
bedroom
consultation room
bedroom
consultation room
consultation room
consultation room
bedroom
bedroom
waiting room
group room emotional support line
First Floor Plan 1:100
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roof plan
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A
A
Roof Plan 1:100
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structural plan
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structural section 3 group room
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Sect 1
1. Existing structure foundations underpinned to form pad support for steel / timber structure insert to take new structure 2. Painted steel ring-beam, bolted through existing brickwork to support during removal of roof and new sitting of CLT first floor structure 3. Reglit glazing system between primary timber structure, with internal curtains and acoustic plasterboard ceiling.
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emotional support line
2 entrance
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tion AA 1:50
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section detail 1. Primary crosslaminated timber structure, secured with bolted connections for expedient assembly and disassembly.
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2. Corrugated galvanised steel facade panel, in-filled with woodfibre insulation on a Met-sec framing system, between primary and secondary timber structure
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3. Large format, ALU. framed triple glazed window system, with inward opening side vent and concealed internal blinds 4. Crosslaminated timber panel flooring system spanning between primary structure, with rigid thermal insulation and acoustic plasterboard internally 5. Openable rooflights, with internal remotely operated blinds
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6. Acoustic plasterboard internally between primary timber roof structure, below 200mm acoustic plenum
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group room
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wayfinding 1. The clinic is graphically identified by use of the Chinese character 天 ‘tian’ meaning ‘sky’, ‘above the head’ and refering to ‘nature’
oof Plan
2. Entrance to the clinic is subtly suggested by floor painted patterns which guide patients into the clinic and towards treatment, inspired by the green line which leads patients from the Old Street tube station in London to the nearby eye hospital
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entrance
botanical lab
pharmacy staff & inpatient entrance
consultation
consultation
medicinal garden
activity space
community activity space
kitchen
nurse station
community living room
fruit and vegetable garden
dining
vr classroom
covered market space
entrance
streetside respite & phone line
Ground Floor
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Ground Floor Plan 1:100
kitchen
fruit and vegetable garden
dining
covered market space
entrance
stre
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facade of corrugated aluminium panels subtly reflects the sky down into the hutong. the panel system is easily replaceable and modifiable throughout the building’s life
staff and patients have control over visibility from street level into the building as good levels of natural lighting are ensured via large roof-lights above all first floor spaces
sheltered space at street level can be used by patients and locals for social events, markets and community engagement and awareness
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View showing clinic’s interaction with street-life and existing architecture
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entrance is identified by simple neon light for chinese character ‘tian’ meaning ‘sky’, 天
always open entrance to street-side respite space, where visitors can rest from the noise and bustle of the street, or make a direct call to the emotional support line above.
points of entry to the building are indicated by textures pained onto the street surface
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Clinic entrance and respite space located within existing hutong building fabric
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on entry there is a direct sight-line into the centre of the clinic, its courtyard garden from which all ground floor programmes can be directly accessed
communal spaces such as dining room, activity rooms are located on the ground floor patients who have appointments with a consultant arrive and proceed to the first floor
appointments are notified via the app for each patient, removing the need for stressful queue systems that are commonly found in larger hospitals
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Entrance subtly shown by blue floor painting leading through to courtyard garden
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emotional support line acupuncture clinic acupuncture clinic
bedroom bedroom
consultation room consultation room
bedroom bedroom
consultation room consultation room
consultation room consultation room
consultation room consultation room
bedroom bedroom
bedroom bedroom
waiting room waiting room
group room group room emotional support line emotional support line
First Floor Plan First Floor Plan 1:100 1:100
First Floor
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consultation room
community living room
fruit and vegetable garden
st Floor Plan
waiting room
emotional support line
entrance
streetside respite & phone line
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workers in the emotional support line have passive surveillance over the external respite space below and circulation up to the consultation rooms
the confidentiality of a support-line depends upon anonymity of both caller and volunteer, and so the volunteer desks are situated on first floor behind a reglit glazing system. their presence can be felt from street level, but cannot be individually identified the welfare of volunteers is vital, and so space is provided to rest and drink tea between taking calls
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Behind frosted glass the anonymous emotional support line takes calls from locals
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respite space in the form of an enclave between the existing building structure and the new insertion of the clinic
a pocket garden fills the space, creating a calm atmosphere by mitigating the stressful environmental conditions of the city. noise, visual chaos and the smell of fumes are replaced by natural stimuli and a moment of peace
within the respite space is seating and a direct phone connection to the emotional support line which is located above.
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A direct line exists from the respite space at street level, free from surveillance
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group meeting space acupuncture clinic
bedroom
consultation room
bedroom
consultation room
consultation room
consultation room
bedroom
bedroom
waiting room
group room emotional support line
First Floor Plan 1:100
First Floor
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bedroom
bedroom
group room
emotio
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First Floor Plan
roof-lights in all first floor spaces give good qualities of soft natural light, which can be controlled via internal blinds. all first floor circulation routed are located under the highest section of the ceiling, directly under views of the sky above
the buildings timber structure is clearly expressed through the building, brining with it its positive spatial, visual and acoustic qualities to each space.
larger flexible spaces are simply divided by curtains which are hung just above the finished floor level, so as to maintain the consistency of being within one larger volume, while being appropriately divided for specific function
throughout the building furniture is integrated into the construction as much as possible. this allows for specifically customised spaces to be created at a low cost, makes spaces easier to maintain and safer for staff and patients.
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Local support groups make use of flexible space located above the hutong street-life
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professional consultation acupuncture clinic
bedroom
consultation room
bedroom
consultation room
consultation room
consultation room
bedroom
bedroom
waiting room
group room emotional support line
First Floor Plan 1:100
First Floor
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consultation room
consultation room
consultation room
waiting room
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generous yet simple built-in furniture provides ample space for patients and their families to wait for consultations while enjoying the peaceful views over the courtyard garden or out above the roof level of the surrounding hutong
textured floor surface guides patients through the waiting room and towards individual consultation rooms
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A patient checks in via the App., connecting directly to her consultant
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soft natural light is filtered into the consultation room from the roof-lights to the east and dappled light through the courtyard trees in the afternoon and evening intensity of light can be controlled via external timber louvres and internal fabric blinds
inbuilt furniture provides the consultant with a generous desk-space and patient sofa where they can sit or lay down during the consultation minimised use of moveable furniture reduces cost and improves the safety for patient and consultant
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Consultation room, with dual aspect lighting at a level with courtyard trees
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psychotherapy clinic botanical lab
pharmacy staff & inpatient entrance
consultation
consultation
medicinal garden
activity space
community activity space
kitchen
nurse station
community living room
fruit and vegetable garden
dining
vr classroom
covered market space
entrance
streetside respite & phone line
Ground Floor
122
Ground Floor Plan 1:100
botanical lab
staff & inpatient entrance
consultation
consultation
medicinal garden
kitchen
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psychiatrist offices are located on ground floor, adjacent to the botanical therapeutic garden where many traditional chinese medicines are grown a calm backdrop to the space is created, where patients can watch their treatments being grown and developed while also providing ‘western’ medicine in combination with traditional herbal techniques, the direct relationship to the garden allows patients and therapists to walk around the garden while discussing treatment plans
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Consultation with Psychiatrist against a backdrop of therapeutic botanical garden
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traditional therapy spaces acupuncture clinic clinic acupuncture
bedroom bedroom
consultation consultation room room
bedroom bedroom
consultation room room consultation
consultation room room consultation
consultation room room consultation
bedroom bedroom
bedroom bedroom
waiting room room waiting
group group room room emotional emotional support support line line
First Floor Plan First Floor Plan 1:100 1:100
First Floor
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acupuncture clinic
bedroom
bedroom
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innovative therapy spaces botanical lab
pharmacy staff & inpatient entrance
consultation
consultation
medicinal garden
activity space
community activity space
kitchen
nurse station
community living room
fruit and vegetable garden
dining
vr classroom
covered market space
entrance
streetside respite & phone line
Ground Floor
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Ground Floor Plan 1:100
kitchen
nurse station
dining
vr classroom
covered market space
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the nurse station provides a space for staff to monitor patients as they move between residential facilities on the first floor, communal spaces such as the kitchen, garden and dining room, and the treatment spaces a centralised location reduces distance travelled by the nurses, and thus reduces staff fatigue
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View from Nurse’s Station at the heart of the treatment & social spaces
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the adjoining existing building fabric is retained, supported by a simple steel ring-beam and timber internal wall structure allows for the space to be opened up for maximum flexibility and future adaptability
generous activity spaces either side of the nurse station are equipt with facilities to allow use of the latest VR therapeutic techniques, as well as staff training and community events
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Patients undergo VR assessment & treatment within renovated hutong building
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communal kitchen & dining botanical lab
pharmacy staff & inpatient entrance
consultation
consultation
medicinal garden
activity space
community activity space
kitchen
nurse station
community living room
fruit and vegetable garden
dining
vr classroom
covered market space
entrance
streetside respite & phone line
Ground Floor
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Ground Floor Plan 1:100
kitchen
fruit and vegetable garden
dining
covered market space
entrance
135
the centre of any hutong home, the kitchen also forms the heart of the clinic diet plays a critical role in mental health, and also in the wide diversity of chinese culture here patients and staff can learn to cook together beijing’s citizens come from all over china and often this relocation disassociates them from their specific traditional cuisine here they can re-engage with growing and cooking of familiar dishes in a communal shared environment
the sense of smell is vital to the stimulation of appetite, which is often lost during mental illness and treatment an open double height space above the kitchen allows the smell of cooking to travel through the communal circulation, helping patients to build their daily routines around the simple tasks of cooking and eating
direct access to the garden where many of the ingredients can be cultivated in a range of micro-climates, reflecting the diversity of chinese produce
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Patients and staff cook together, using food grown in the courtyard garden
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in the warmer months all the windows of the dining space can be fully opened, allowing for a sheltered but highly open space to be created the dining room is located alongside the vegetable produce area of the courtyard garden
dining is traditionally a highly social activity, but due the increased time burden on many chinese citizens it is now often a more solitary activity this can have a profoundly negative impact on mental well-being, and is particularly the case for those suffering or recovering from a mental illness thus, the kitchen is directly adjoined by a generous dining space, comprising of one large communal table which is shared by staff, patients and their families
it is common in hutong streets for dining and cooking spaces to have a direct relationship with the street, and here that possibility is maintained with access and visual connection to the sheltered external space and adjacent to the entrance to the facility from here events can spill out onto the street-side, for example a produce market or community dining or food sale
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Communal dining room adjoins kitchen, garden and connection to the street
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Institute of Mental Health Law of the People’s Republic of China 144