Engineering a hospital with mental health in mind

In helping to design a mental health hospital, engineers face the challenge of representing therapeutic needs in built form

Concerning the impact of architecture in the world of healthcare, ‘there is more research than you can “throw a stick” at in terms of the impact on patients, but there is very little research of the impact on staff,’ says Garry Banks, a chartered electrical engineer at Arup and Partners. It’s why the study the company originally did for the newly opened Clock View hospital in Liverpool was potentially significant in making it a successful space both for healthcare workers and patients 

The Clock View has been described as a £25 million state-of-the-art mental health hospital. The building was a collaboration between The Mersey Care NHS Trust, Medical Architecture and Arup, each bringing a different kind of knowledge about people, healthcare, space and materials to the project. 

The Arup organization has a unique combination of knowledge at the origins of the organization through its founder, Anglo-Danish philosopher and engineer Ove Arup. Set up in 1946, Arup’s reputation as an engineering company stretches back to its pioneering work on Sydney Opera House and its pre-cast concrete shells, and also to its work on the ‘inside-out’ structure of the Centre Pompidou in Paris. Arup is an unusual organization, each employee receives a share of the firm’s operating profit each year and it’s owned in trust ‘for the benefit of its employees and their dependents’. The company’s philosophy of extending knowledge through its practice is reflected in the company journey of the Clock View hospital Project Director Garry Banks. He left school at 16 served an apprenticeship as an electrician, worked on site for 8 years, then joined Arup in the late 80s, who then sent him back to college, then onto university for 4 years (Salford University), where he graduated in 1991.

Pilot study

When in 2005 Mersey Care approached Arup, and Medical Architecture and Art Projects – as the company was then known – Banks and his consultancy team which included behavioural psychologists wanted to do some research around the impact on staff of mental health facilities. ‘We invested some of our own Research and Development money to do a pilot study,’ explains Banks, ‘which we took to Mersey Care and showed them. They were really interested and they appointed us to do a formal piece of work for them.’ It was an extensive study as the Arup psychologists worked at five of their existing units, shadowing the staff around 188 wards. ‘We interviewed all the staff and from that we aware able to plot some key issues that were relevant that would then inform the design of the new facilities.’ The four key areas they focused on were, Safety, Work Processes, Comfort, and Organisational Aims and Objectives. 

The results of the study then fed into Mersey Care’s design brief for Medical Architecture and Arup. ‘Medical Architecture had a key role in creating something that was interesting but functional and responded to the brief,’ says Banks. ‘Our responsibility in engineering the solutions was then – particularly around the comfort and safety pieces – to make sure that we designed systems that enabled the patients and staff to be safe but also have access to significant improved levels of daylight, to not overheat in summers, to have great access and safe access to outdoors. It was all those things we picked up in that initial piece of research that our behavioural psychologists did that then were translated into a physical building.’

Therapeutic environment

The resulting structure has 80 rooms with bathrooms. The building maximises natural light, has safe inner garden courtyards and therapeutic areas. There were different materials and systems at work in different parts of the building, some unique to the demands of a mental health building. ‘Parts of the building were timber, other parts were reinforced concrete,’ explains Banks. ‘As many of the areas as possible were naturally ventilated, we did some very detailed analysis of the patient bedrooms to understand that the patients were going to be comfortable enough given that they weren’t going to be able to control much – as you know everything has got to be anti-ligature so they can’t self-harm in the bedroom. There is very little stuff they can do. That put a massive emphasis on the window design. A lot of time and effort was spent with Medical Architecture and the Trust trying to create the best window design in terms of daylight, in terms of ventilation but also created something that was safe for patients.’ 

The issue of the therapeutic or healing environment is used a lot but as Banks reflects, it’s not always easy to represent in built form, and engineers engage with such projects in many different ways. ‘The skills that go into this are transferable to a whole host of project types,’ says Banks. ‘We also had Acousticians and Fire Engineers working with us. Acoustics are a big issue, you have to get the acoustic separation right between rooms because you don’t want patients who are already trying to cope with some serious issues being disturbed.’ 

The building has already been nominated for a number of awards, and as Banks says the initial feedback we are getting from the staff is that it’s great. ‘A full post-occupancy evaluation is to be done,’ says Banks, ‘it will be interesting to see the feedback and align that with some of the work we did back in 2005.’