During his own visits, Christian Karlsson has also found that the hierarchy can present challenges. The idea of patients being part of a community outside their units, for example in activity rooms or gyms, is not being fully utilised. This is particularly true in areas where hospitalisations are relatively brief.
“There’s a difference between short-term and long-term hospitalisations in the way that treatment can be organised, and thus in the use of the facility. In areas with longer hospitalisations, for example forensic psychiatry, we’re seeing to a greater extent that the treatment evolves based on knowledge of the individual patient, and that the various facilities outside the individual patient units are used by both patients and staff. And we definitely believe that the design and the new practice possibilities work, which can be seen, for example, by a decrease in the use of restraints in the high-security block at GAPS,” says Christian Karlsson.
“It’s a difficult task involving considerable dilemmas to accommodate everyone with one solution when the individual patient’s condition may change quite substantially over the course of their treatment. The ideas about healing architecture, including transparency and spatial hierarchy, present pros as well as cons. This would also be the case with any other type of design. I think that we’ve generally struck a good balance, and I can also see that a number of the design concepts have been adopted as standard elsewhere,” he says, adding:
“When I visit GAPS, I see people and dialogue. That’s not the case at most other psychiatric hospitals, where the staff are in the staff areas and the patients are in the patient rooms. Moving from the old structure to a new design requires a culture change, and it will be several years before the design principles are fully realised.”
>> Read interview with Thorben Simonsen, PhD