Challenging stigma through design

The forward-thinking design of a new psychiatric facilityis helping to challenge the stigma attached to mentalill health as well as creating a more-therapeuticsetting for recovery.

Blossom Court at St Ann’s Hospital in Enfield, northLondon, is a new inpatient facility comprising three adultacute wards and an eating disorders ward, with shared accommodation including visiting space, staff rest areas, and a multi-faith room.The building is part of wider development of the entire hospital site in an effort to create a people-focused healthcare campus, master planned by Medical Architecture. At the time of project inception, over half the buildings lay empty and maintaining this surplus estate was diverting vital spending away from frontline healthcare.



At the same time, Care Quality Commission reports identified that the trust’s existing inpatient facilities, which date back tothe 1930s, were no longer fit for purpose.Over recent years Medical Architecture has worked closely with Enfield and Haringey Mental Health NHS Trust, which runs the hospital, to develop plans for the new mental health inpatient building. And this will be one of the first phases of the overhaul of the wider hospital site. Challenging stigma through design Images by Medical Architecture/Tim Crocker6

The campus masterplan prioritises people, with roads and parking organised around the perimeter. Buildings are located along a boulevard, creating an activated street scene. And the new inpatient building is prominently located, promoting the hospital’s mental health services and challenging any stigma that surrounds them. The four wards are arranged around two private two-storey courtyards, each with a ward on its ground and first floor.This offers private views,  abundant daylight, and a positive focal point for patients.


The ward plan forms a simple loop, providing two choices of route and giving staff and patients the opportunity to back away from challenging situations.The arrangement also allows sub division for separating patient groups and the creation of one-way circulation routes to aid social distancing. Providing easy access to good-quality outdoor space is one of the building’s fundamental design principles so both storeys are configured to provide direct access to outdoorspace without the need for direct staff supervision. And the generous ground-floor courtyard features a deep overhang in front of its dining and activity rooms for shadeand shelter. While, on the first floor, this overhang creates a terrace bordered by glazing. Ruairi Reeves, director of Medical Architecture, said: “Amember of the clinical team made a comment early in the design process that patients commonly left mental healthwards in worse physical health than when they arrived.


“This helped inform the approach to physical and mentalwellbeing throughout the scheme, to ensure that both aspects were addressed.”Exercise equipment is provided in the courtyards andgardens and the interiors have been designed to create calm,organic environments, with natural oak finishes creating avisual connection to the outside space.”The facade features a simple palette of high-qualitybrickwork that will age well, is robust, and integrates with thematerials of neighbouring residential buildings.Large Britplas ‘Safevent’ windows – some of thelargest the supplier has ever installed at 2.1m high –address ligature risk and can be opened wide to reveala fine perforated steel mesh to improve ventilation whilepreventing the passing of contraband.


Sustainability also played a key role in the development,with the building designed to be as flexible and adaptable aspossible for future use.Each ward is designed to a standard template and thestacked wards share risers.And it is designed with passive measures, including tallceilings, high window vents, and exposure of the building’sthermal mass to reduce overheating in the summer, alongwith a high level of insulation to retain heat in the winter.This is supplemented by air source heat pumps and aroof covered with photovoltaic cells to provide a renewablesource of energy.Jinjer Kandola, chief executive and a consultant clinicalpsychologist at the trust, said: “Blossom Court sets the barhigh – this is how all mental health care should look andwe are committed to improving the rest of our estate overthe coming years so all our patients can enjoy the quality ofenvironment that Blossom Court now provides.” 

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