Good psychiatric building standards
Like somatic care, there are building related factors in the area of psychiatry which have a major impact on the quality of treatment, organisation of efficient patient treatment, the patient's experience of quality and safety issues.
Building related factors and associated requirements differ in several areas from those known from somatic hospital construction. Other factors are of importance to the psychiatric patient group, such as safety issues, the need for homeliness and security and the choice of colours and art, etc.
Principles for good psychiatric building standards
Integrated hospital treatment
Where possible, psychiatric care centres should be placed in close association to a somatic hospital. This association should take into account professional cooperation between the medical specialists, the need for clinical service functions in psychiatry and other operational advantages.
Flexible interior design
Psychiatric wards should be furnished in a manner that makes it possible to remain in the same physical setting/department during the entire period of admission. This requires a flexible physical framework, such that it is possible to shield patients during certain periods of their admission. A flexible physical framework will help reduce the use of force, as it will be possible to accommodate patients in the same department, irrespective of how poor their state becomes.
The national psychiatry agreement for 2003-2006 states the objective that all psychiatric patients should have a single-occupancy room with their own toilet and bathroom. This will increase the patient's perception of quality and reduce emotional outbursts and aggressiveness, leading to a reduction in the use of force. Visitor rooms should be built in the departments so that patients' visitors do not necessarily have to enter the ward.
Access to nature
Under the Danish Psychiatric Care Act (Psykiatriloven), psychiatric inpatients must have the opportunity to go outside every day if they so wish, The physical framework needs to take this requirement into account. This means it is best to place wards on the ground floor so that patients have unimpeded access to going outside, and to minimise the use of staff resources. For patients who need to be shielded, it must also be possible to go outside in shielded outdoor areas.
Security and simplicity
It is important that patients experience a secure and manageable environment. This can be achieved by making it possible for patients to remain in the same physical setting/department during the entire period of their admission. There need to be several recreational areas in the departments, of varying sizes. It is also important that examination and treatment rooms are placed within the departments. Personnel rooms should also be visible in the departments.
Therapeutic and recreational activities
Facilities for physical training must be available in connection with the wards, and there must also be access to occupational therapy and recreational activities. Part of the treatment during admission can be training in social skills. There must therefore be access to common rooms for social activities, such as kitchens and lounge rooms. There should be computer and Internet access in wards and common areas.
Aggression prevention and tranquil design
Large, spacious rooms and passageways help prevent aggression and have a soothing effect. For psychotic patients, wards should be designed so they are easy to comprehend, with clear signs and plenty of space for everybody. The physical framework must provide opportunity for both activity and rest. Staff offices should be located such that it is easy to contact people in the offices.
There should be space enough for people to be in the building without entering the private space of patients. The common reception in the departments should provide a relaxed setting where patients, visitors and practitioners can spend time in casual niches and activity areas outside the wards.
Corridors should not provide through access to other functions or departments, to avoid patients' private rooms being adjacent to main thoroughfares.