The principle of hierarchy is another focus area in Thorben Simonsen’s PhD thesis. The idea of hierarchy should support the patients’ return to society. It is intended to reflect a recovery process in which patients can gradually move from their protected patient room to the semi-communal corridors, and then to the larger communal areas.
“In practice, however, patients find it difficult to distinguish between the different rooms and what social behaviours belong where,” says Simonsen, who provides specific examples:
“Just outside Dueslaget is a communal area where patients can eat, drink coffee or play games. But if a patient starts talking about their medication here, it is not appropriate.” The open and transparent architecture can thus make it more difficult to decipher what you can do where. Therefore, what behaviour is appropriate in which spaces is largely left to the staff to decide, which reinforces the ‘us and them’ hierarchy, despite the fact that the ambition of the architecture is to break it down.
“Another example is the patient rooms, which in practice are not only used as the patient’s personal space. They are also used for shielding and isolation when problems arise. There’s nothing inherently strange about that. But staff intervention fundamentally changes the function of the room from personal space to institutional space, and thus the control of the room also passes from patient to staff. The notion of a spatial hierarchy that patients progressively move through in their recovery process is therefore not unproblematic.
“And then there’s the atrium courtyard, which was intended as a healing outdoor space, but which in practice has become a smoking area. What’s surprising is that the courtyard, where patients are fully visible to staff, nevertheless serves as a sheltered space where patients can speak to one another privately because staff cannot hear them.