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The early and widely used lunatic asylums, the treatment of patients/inmates was brutal and
focuses mainly on containment and restraint. Psychiatric hospitals have evolved as successive waves of
reforms were introduced. However, psychiatric care in the Philippines especially in terms of facility was as
if frozen in time, based on the research methodology conducted on the previous chapter of the research.
Modern psychiatric facilities starting to introduce evidence-based treatments that emphasize on curing
with the use of combination of psychiatric drugs and psychotherapy.
Authors and professionals criticize the outdated design of the facilities. Psychiatrist Thomas
Szasz insisted that Mental Institution and Prison or any detention facilities are identical to each other,
medication and nursing staff acts as if a judge and jailers. A book entitled Madness and Civilization was
an instrument used to criticize psychiatric facilities, the author was the French historian Michel Foucault.
The three mental disabilities that will be focused by this study are Mood Disorder, Substance
Abuse Disorder and Schizophrenia.
MOOD DISORDER
A psychological disorder distinguished by the elevation or lowering of a person's temper, such as
depression or bipolar disorder.
CLASSIFICATIONS:
1. Depressive Disorder
2. Bipolar Disorder
SYMPTOMS
1. Thoughts and attempt of suicide
2. Loss of interest in activities that were pleasurable in the past
TREATMENT
1. Medication
2. Psychotherapy
3. Family Therapy
4. Elimination of environmental stressors
BEHAVIORAL CHANGES:
1. Lowering of attention in school
2. Frequently getting into trouble
3. Using substances in physically hazardous situations
4. Engaging in secretive or suspicious behavior
5. Changes in appetite or sleep patterns
6. Unexplained change in personality
7. Sudden mood swings
8. Periods of unusual hyperactivity
9. Lacking of motivation
10. Appearing fearful anxious or paranoid
PHYSICAL CHANGES:
1. Bloodshot eyes and abnormally sized pupils
2. Sudden weight loss or gain weight
3. Deterioration of physical appearance
4. Unusual smell on breath body or clothing
5. Tremors, Slurred speech, or impaired condition
SOCIAL CHANGES:
1. Sudden change in friends, hobbies and hangouts
2. Legal problems related to substance use
3. Unexplained need for money or financial problems
4. Using substances even though it causes problems in relationship
TREATMENT:
1. Rehabilitation
2. Medication
3. Support Groups
4. Talk Therapy
SCHIZOPHRENIA
Is a mental disorder often characterized by abnormal social behavior and failure to recognize what is real.
SYMPTOMS:
1. Hallucinations
2. Delusions
3. Disorganized thinking and speech
4. Social withdrawal
5. Sloppiness of dress and hygiene
6. Loss of motivation
7. Loss of judgement
8. Lack of responsiveness
9. Impairment in social cognition
10. Social isolation
11. Difficulties in long-term memories
12. Agitation
TREATMENT:
1. Medication
2. Psychosocial
3. Family therapy
4. Assertive Community treatment
5. Skills training
Maximizing the quality of medication not in a medicinal way but on the aspect of facilities
used by the patients, nurse, professionals and others involved. Research studies conclude that
environment can affect the healing process of patients.
The study will focus on the innovation of minimization of seclusion and restraints in mental
facilities, without compromising the security of other people using the same facilities. This is to maximize
the quality of healthcare getting by the patients with mental disabilities.
The study will also focus on the use of the concept of Maslows hierarchy of needs. This will be
used in the planning process of the facilities in the proposed complex. This concept will be used as a
motivational method which will help to hasten the recovery of the patients. The concept is to include the
curiosity of the persons to improve his/herself in order until he/she reaches the peak or the selfactualization.
PHYSIOLOGICAL NEEDS
These are the most basic requirements of a human body. If these are not meant, the body will not
function properly and will be broken. These are the most important and will become the foundation of a
human body.
SAFETY NEEDS
After the most important needs or the physical needs, the second group would be the safety needs, a
mind where he/she will feel safe, comfortable and free. A satisfying surrounding.
This will include:
1. Personal security
2. Financial security
3. Health and well-being
4. Safety against accidents/illness
LOVE AND BELONGING
The third stage of human needs is Love and Belogings which involves emotions and feelings. If this is not
met, it can impact the individuals relationships in general, such as: Friendship, Intimacy and Family.
ESTEEM
After getting the acceptance of other people its for the acceptance of your true self. Self-respect is vital
for every individual. Imbalance of this level may result to individuals continuous seeking for fame or
glory. Which is not the answer the feeling of what they lack, this can cause individuals depression
because the feeling of failure.
SELF-ACTUALIZATION
Self-actualization or the final stage, this is the stage where you feel contented on all aspects of your life.
You are in a good state of mind and physical.
These principles will be a big help on the healing process of the patients. Applying a much
appropriate planning and design principles using these concepts and theory, will a big leap on the
modernization of the design standards of Psychiatric Institutions, not just in the Nation but in the whole
world. First, the minimization of seclusion and restraints, this will change the image of being a detention
facility, isolation rooms will not be seen any more as a punishment room, instead it will be seen as a
room for self-reflection. The facility will also promote self-dignity and self-reliance if this concept is
applied. The use of Maslows Hierarchy will boost the motivation of patients to heal faster. This will serve
as a challenge in order to get the self-actualization or being dismissed from the institution.
One of the planning principle used on this project is to design building based on the mental
disability of the user.
Architectural Solution:
4. Neutral Colors
5. High, Unreachable windows
6. Open as much as possible
7. Small openings in doors for food and nurses monitoring
The application of minimizing seclusion and restraints without compromising the security of
others is on the designs of all facilities used by the patients and their staff. Feeling of restraints and
seclusion is not just basically on the wards or isolation rooms, the patients can feel the inability to move
freely everywhere if its not design/plan properly. This is why design techniques all throughout the
building will be applied.
Innovative design approach to maximize the quality of healthcare the patients are getting in details:
1. Therapeutic Environment
The environmental surroundings can affect greatly on the mind of a psychiatric patients. A report
from The New York Psychiatric Institute stated that a large drop in number of patients needed to
be secluded when they occupied a new facility that has this kind of environment. Using this type
of design and consideration well promote individual dignity and self-reliance.
Therapeutic Environments must have this attributes:
-
The usage of non-institutional materials which is lively, and a little bit of colors and textures. But
still keeping in mind the colors that might agitate the psyche of the patients.
Sound insulations in private rooms which discussions are held like conference room, therapy
room etc.
Giving patient own visual rights, controlling the views patients would see.
Giving the control of his own decision on his private room as much as possible.
2.
Aesthetics
A major factor on the institution public image and is a significant marketing tool. It will also
psychologically change the view of the public on metal institutions which is a detention facility.
Considerations includes:
Use modern type of lighting systems, accessibility of natural lighting, indigenous materials.
No clothes hook on shower rooms, and use of breakaway shower-rods and bars.
Elimination of all possibilities of self-injury in special features seclusion rooms,hardwares like door
knobs wil be eliminated.
4. Green
The institution is serving for the healthiness and well-being of an invidual. The institution must
not only help individuals but also extends it potential on helping the well-being of the
environment.
This can change the image of mental facilities.
The use of Maslows hierarchy in the project will be on the site planning process. The proposal
will be a Mental Rehabilitation Complex composed of different buildings. Every building will have a
different approach on the design; the design of each building will reflect the 4 stages of needs in
Maslows Hierarchy of needs. And patients will start from the fundamental needs up to obtain the goal of
self-actualization or dismissal to the outside world.
SELF-ACTUALIZATION
OR OUTSIDE WORLD
LOVE AND
BELONGING
SAFETY
NEEDS
SELF-ESTEEM
PHYSIOLOGICAL
NEEDS
The building will be design appropriate for their needs. For example physiological needs building will
focus on the fundamental needs of a patients, more on the survival needs and will be limited to that.
Physiological needs will not have special facilities only available for example safety needs building like
entertainment are and the likes.
This method will motivate patients to recover faster in order to go to another building. Based on research
a patient driven by motivation is more likely to recover faster than other patients. This will also help
professionals taking care of them and giving medication because they can specialize on the different
stages of criticality of mental stability of the patients.
Therapeutic application
The gardens will be placed all around the the property especially adjacent to patient room. Garden will be overlooking on
all the patient rooms, to expose the patient on the natural environment. There wil be also visiting area on gardens to
maximmize the use of gardens.
Mild case of Mood and Substance Abuse Disorder architectural Solution detail
-Natural Lighting in Group Therapy room and Social room, decreased of seats in group therapy room