Monday, 5 May 2014

Updated topic


"Good architecture can make a difference ... when the style and content of an institution are mutually supporting, they can produce the Architectural Placebo."

This quote is from Charles Jencks in reference to the Maggie Cancer Centers - the cancer care centres in Britain initiated by his late wife, Maggie. Jencks and others, such as the Dutch academic Cor Wagenaar, believe that modernism has created a rupture in the long relationship between architecture and health. Ancient Greek temple complexes were about healing the spirit as well as the body. During the Enlightenment, it was proposed that well designed buildings could do more for public health than the medical profession. While looking at a nicely detailed stair may not cure us, we do need our healthcare buildings to allow us to feel like people rather than just patients.
The most basic definition of a placebo is something that cures only because of a person’s belief in it.  You could say it’s a fake but I prefer to think of it as something that unlocks your body’s unique and fantastic ability to cure itself. You have to believe in a placebo or it won't work. It works in an indirect, indeterminable way, maybe through our immune system and/or our willpower. Extrapolating this to the effects architecture could have, you could imagine many ways in which it could actually be the placebo by providing a place to relax, belong, live and dwell. All impossible to explicitly measure in discrete terms but perhaps definable in terms of relationships and patterns.
There is nothing mysterious in the success of the Maggie Center designs. They all share the similar  positive qualities of  light, space, openness, intimacy, views, connectedness to nature. They  have a domestic scale, centred around the kitchen, a place where you can make yourself a cup of tea and chat - almost the opposite of many standard hospital environments. In Jencks's words,
“...they are buildings that hug you, but don't pat you on the head.”
It's  about providing relief, psychological and emotional support – things that contribute to the urge to go on living and being part of a community. There are no sets of instructions for architects as to how to achieve these goals but perhaps this thesis will provide clues in the form of a set of patterns  which may, along with other therapeutic measures, support and help restore psychological wellbeing.

The Thesis:  Science + Magic = Architectural Placebo
 Any ‘architectural placebo’ design for restoring sanity will inevitably involve science plus a little magic. The science will be represented by a healthy dose of evidence-based design while the ‘magic’ refers to the haptic, philosophical, and spiritual qualities of architecture that often cannot be defined by words but rather by experiencing it.
Patterns of evidence-based design applied in combination with the more intuitive 'magic' of sensory and phenomenological design to create places which restore psychological wellbeing.
Science + magic = the architectural placebo.

The goal of this thesis is to define these patterns as qualities and relationships that can potentially be applied to any building to enable an 'architectural placebo for mental health', using an old abandoned psychiatric hospital as a case study.

The Site
The Kingseat administration building will be the test site for this thesis. Kingseat hospital is a site of celebrity, infamous for bad memories of psychiatric care. To overcome the stigma of the ghosts of mistreatment will be no mean feat so these patterns will be robust if they prove to work here.
The building will be restored to a use similar to that for which it was first designed; its genetic code will be restored and repaired..

The Programme
The users of this space will primarily be the 'lost' population of patients with mental illness - those for whom there is no architecture, only the streets or a revolving door at the acute wards of psychiatric hospitals. The new insertion will treat these occupants like fragile humans rather than dangerous animals, people rather than patients, family rather than boarders. An architecture of normality and domesticity, but also an architecture of restoration and safety. A place to dwell.
It will not be a hospital, but will provide therapy. It will not be a chapel, but will provide space to contemplate life. It will not be a dormitory, but will provide a place to live with others.

In order for the architecture to function fully as a placebo, it will also support and care for those providing support and care: the therapists and caregivers, the support staff and caretakers. The existing fabric of the building will be restored to similar functions of the original but with important improvements to enhance and support the therapeutic aspect of the building. The existing lower levels will be used for administration, support, therapy and communal/occupational therapy activities.

 The Design Concept
The Kingseat administration building will be covered lightly with a new 'blanket' of dwellings. The ‘blanket’ will be clad with zinc or similar, so that on gray days the new structure merges into the sky and is perhaps invisible when first entering the site. Nestling up high in the rooftops, similar to the generations of pigeons nesting in the nearby palms.

The existing building below will be carefully restored to provide a contrast between the existing and the new. An exploration of phenomenology and architecture of the senses, particularly those forgotten by architecture such as smell and touch,  will emphasise the interior experience. Cultural elements will also be significant. In particular,  considerations of different cultural requirements for privacy (visual, acoustic), a sense of place or feeling of comfort in being in a particular environment.

The History
Psychiatric hospitals have a chequered past in New Zealand. Childhood threats to be 'sent off to Sunnyside/Tokanui/Carrington' conjure up images of places filled with madmen, insanity. Haunted places.  During the nineteenth century there was a move to institutionalise those who 'deviated from social norms' leading to increased construction of buildings to house these people - prisons, hospitals and asylums. Several large psychiatric hospitals were built in New Zealand during this time. All were imposing, prominent buildings with precedents from Britain. Most were self sufficient with productive gardens and farmed land out in the countryside, isolated from the cities.  They had benign names like Cherry Farm, Seaview and Sunnyside. They housed thousands of long term residents and were a culture unto themselves.
During the 1990s psychiatric hospitals gave way to community-based care for the treatment of mental illness; almost all psychiatric hospitals were closed or run down during this time which caused problems for patients who did not have appropriate community support. These patients either found themselves on the street, in prison or in a cycle of admission and discharge from acute psychiatric wards.
 The stigma of these former asylums have been enhanced by the recounting of experiences as residents by famous patients such as Janet Frame. This shadow of stigma is seen in suggestions that the former hospitals be used as prisons and in the partial redevelopment of Kingseat hospital as a horror theme park ('Spookers').

Critical Question

Using phenomenological and salutogenic design frameworks to define a set of patterns for restoring mental health,  can the stigma of an old ‘insane asylum’ be overcome and/or used to advantage to create an ‘architectural placebo’ for mental healthcare?

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