Building a new mental health hospital with patient experience at its heart

An initial artist's impression of inside the proposed new hospital (Eric Parry Architects)

As a clinical lead for the Warneford Park development, I have been able to help shape the designs for our new hospital from both a clinical and a patient experience perspective.

When it comes to a new mental health hospital, we are not just building a space in which to provide treatment. We are creating a space to help patients heal and recover, and so the designs need to fully reflect that.

We have therefore been meticulous in our approach, and this process began with the question of where on the site the new hospital should be located.

Location, location, location

Our Chief Medical Officer, Dr Karl Marlowe, recently wrote about the advantages of the Warneford site for co-locating a hospital, research facility and postgraduate college (Warneford Park will be a game-changer for mental health).

When it comes to places to locate the hospital within the grounds, there were limited options: the first was the

southeast quadrant, or the land to the west of the existing buildings was not possible due to being where the Highfield and Meadow units are situated. The second location was felt to be too small and compromised by the existing landscaping. It would also mean that the new research building could not be linked to the hospital. In practice, the southeast corner was the only practical option for an eight-ward hospital. (The northeast quadrant was out of bounds due to the historic landscape and the southwest corner had new buildings on it).

The current plot is obviously defined by the Meadow to the south, the listed wall to the north, the road to the east and the new Highfield to the west. The decision was therefore whether the hospital was in the north of the plot or to the south. The southern strip was felt to be the most appropriate, as it gave access and views over the meadow. This was felt to be both the prime location on the site, and also the most appropriate for the hospital. There was no serious consideration of an east/west split as this would have meant separate entrances for each building, one from the east and the other from the west, and there was no access from the north due to the listed wall.

In a way, the decision made itself, as the current configuration was felt to be the most practical, and gave the hospital the best location on the site. Any other layout was either impractical or less beneficial to the hospital.

“Our vision is to provide a new hospital that will endeavour to be a blueprint for how excellent mental health inpatient care can and should be provided.”

Connecting with nature

Associations between natural environments and mental health or well-being are well-established, and research findings suggest that exposure to nature can provide restorative health benefits through mediating psychological and physiological stress (Berto, 2014).

Research findings also suggest that designs which promotes exposure to natural elements may be associated with positive health outcomes, including improved mood and reduced length of stay (Iyendo et al., 2016; Joseph, 2006).

It is the benefit of the chosen position for the hospital that maximises the connection to nature and the Warneford Meadow. This position affords a variety of outdoor spaces and views. This connection to the landscape and nature is a significant element of the design and one that is readily supported by the various stakeholders engaged in the hospital design, and has been regularly cited as a major improvement to the current hospital provision.

During the times when long-stay asylums provided care for individuals with mental health challenges, immersion in nature was considered an essential part of the overall treatment programme, involving outdoor pursuits in the vast and often beautiful asylum grounds, tended by patients and staff (Cromby, Harper & Reavey, 2013).

Preserving the original Warneford approach and grounds enables a key link to the past and the identified benefits such an established outdoor space provides. The position of the new Warneford Hospital enhances access to nature with additional views and access to the meadow that are currently underused by patients and staff. Maintaining and protecting the Warneford meadow and its wildlife is of huge importance and has been significant within our plans.

Incorporating nature and natural light indoors

Access to nature and natural light is key within the new hospital design, and maximising exposure to natural light

helps regulate patients’ circadian rhythms, which can reduce depression, improve sleep quality, and lessen agitation.

Access to nature can also be incorporated into the internal design. Indoor plants, natural materials (like wood), water features, and nature-themed art help create a calming, therapeutic atmosphere that fosters a connection to the outdoors, even for those with limited mobility. This is referred to as ‘Biophilic Design’ and it is becoming increasingly recognised as a key design concept within mental health environments.

Enhancing dignity, safety and personal control 

Throughout the hospital, there are many other examples of how we can maximise dignity and promote a sense of safety and personal control:

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  An initial artist’s impression of a bedroom inside the proposed new hospital (Eric Parry Architects)

  Single-bed rooms: private rooms with en-suite bathrooms enhance a sense of dignity, safety, and personal control, which is associated with lower rates of anxiety, aggression, and self-harm.

• Personalisation: allowing patients to control aspects of their personal space (e.g., room temperature, lighting, or decorating with family photos) can improve their well-being and sense of autonomy.
• Noise control: hospitals often exceed recommended noise levels, which can disrupt sleep and increase stress. Design strategies, such as sound-absorbing materials, acoustic panels and quiet staff areas help mitigate unwanted sounds.
• Clear wayfinding: intuitive layouts, clear signage, and the use of colour-coding, instead of complex directions, help reduce patient confusion and anxiety associated with navigating an unfamiliar environment.
• Non-institutional atmosphere: using warm, homelike colours, comfortable furniture, and avoiding stark, sterile environments can make the space feel more welcoming and less intimidating, which in turn can reduce anxiety and stress.
• Visibility and layout: designing the ward with connected spaces and good lines of sight allows staff to monitor patients effectively without the need for overly intrusive measures like glass “fishbowl” nurse stations, thus improving the therapeutic alliance and sense of trust between patients and staff.

Bringing all these individual elements together will help us to create an improved environment to deliver the most effective and modern treatment options for individuals in need of inpatient care and we will provide a new Warneford that is fit for the next 200 years. Our vision is to provide a new hospital that will endeavour to be a blueprint for how excellent mental health inpatient care can and should be provided.

References:

Cromby, J., Harper, D. & Reavey, P. (2013) Psychology, Mental Health & Distress. Basingstoke: Palgrave.

Berto, R. (2014). The role of nature in coping with psycho-physiological stress: A literature review on restorativeness.

Iyendo, T. O., Uwajeh, P. C., & Ikenna, E. S. (2016). The therapeutic impacts of environmental design interventions on wellness in clinical settings: A narrative review.

Joseph, A. (2006). The impact of light on outcomes in healthcare settings. Concord, CA: The Center for Health Design.