• Written by Stephanie Kathleen Liddicoat, Lecturer, Architectural Design, Swinburne University of Technology
This aquarium at the Royal Children's Hospital in Melbourne helps reframe hospitals as exciting hubs of activity with things to do and friends to meet. Shannon McGrath/Advanced Aquarium Technologiess

Welcome to the next article in our Designing Hospitals series, where we explore how architecture and design shape our hospitals and medical centres. Today, we look at how good design affects mental health and well-being, particularly in young people.


Every time you take your child to the emergency department or a loved one to a mental health outpatient appointment, the very building and spaces you encounter will have been designed, for a number of reasons.

Not only will these spaces be functional, their designs encourage patients to seek help or act to relieve stress. This type of design looks at how buildings and landscapes improve mental health.


Read more: From army barracks to shopping malls: how hospital design has been a matter of life and death


Just as evidence-based medicine uses evidence to inform clinical practice, evidence-based design informs architects and other designers how to design our hospitals, surgeries and clinics to improve patient care.

So, how does this type of design influence how we plan and build spaces with mental health and well-being in mind?


Read more: Build me up: how architecture can affect emotions


Show me the evidence

Evidence-based design, which has become more popular in the past three decades, assumes an intimate connection between health-care facilities and patient well-being.

It uses a wide range of measures to assess how someone’s psychological response to a built environment influences physiological, cognitive and functional outcomes.

The aim is to provide evidence for what works and what doesn’t to improve recovery from mental ill-health, by reducing hospital stays, distress, anxiety and aggression, while promoting staff performance and retention.

This interactive gaming screen at Monash Children’s Hospital reduces the anxiety of waiting for an appointment, while encouraging socialisation. Ouva

For instance, one key piece of research found people recovered faster after surgery, and used fewer painkillers, if their hospital bed overlooked a natural scene (like a garden) rather than a brick wall.


Read more: Green for wellbeing – science tells us how to design urban spaces that heal us


Over the same time as evidence-based design has grown in popularity, there has been a growing emphasis in mental health on providing user-friendly services and improving user and carer experiences.

In Australia, this has become particularly apparent in youth mental health.


Read more: 3 in 4 people with a mental illness develop symptoms before age 25. We need a stronger focus on prevention


According to the World Health Organisation’s guidelines, quality, youth-friendly health services need to be “accessible, acceptable and appropriate”, and offered in the right place, at the right time and price. They must also be in the “right style” for young people, their supporters and the broader community.

Here are two principles of how this works when designing for mental health and well-being.

1. Involve young people and their carers early in the design process

If you include young people’s needs and perspectives when designing a mental health service, this improves their engagement in that service, the quality of care and their health.

For most young people, their relationships with family members and other primary carers also play a key role in their mental health and recovery.

So, providing appropriately designed spaces for both young people and their carers is critical.

The Royal Children’s Hospital, Melbourne: hospital or art gallery? Bates Smart

On a practical level, this might mean providing comfortable spaces for young people, their supporters and clinicians to meet; providing privacy so they can’t be overheard or seen; or designing waiting areas for small groups.

For instance, Melbourne’s Orygen youth mental health facility, which opened in 2018, consulted extensively with young people, family and carers throughout the design process.

When young people enter the facility, they are greeted by a trained concierge rather than a formal reception area, and provided with a range of seating options, both inside and out.

Meanwhile, family members can take a leisurely stroll along several landscaped walking tracks while their loved one has their appointment.

These principles have also been applied to other health facilities for children, not just those specialising in mental health.

For instance, Monash Children’s Hospital has a large interactive gaming screen, where children and parents can pass the time waiting for their appointment.

This reduces the anxiety of waiting for an appointment, while encouraging the positive effects of socialisation within and between families.

2. Change people’s expectations of care

Some people find it stigmatising to access mental health care. But the physical setting can help people reframe their expectations about what their care might entail.

So, we move away from expectations of “control” or “incarceration” to expectations of comfort, well-being and care.

This shift helps people better engage with health-care professionals, improving their experiences of care and their well-being.

Look, meerkats! Melbourne’s Royal Children’s Hospital has a permanent meerkat enclosure, much to the delight of children and their carers. Green and Dale Associates

So, the environment must be comfortable, familiar and de-institutional. It must reduce the visibility of security and safety features, while providing activities that support well-being and mindfulness, such as courtyards, communal gardens, natural environments, art-based activities and social opportunities.

These huge musical instruments are part of London’s Great Ormond Street Hospital’s ‘lullaby factory’. Studio Weave

Reframing expectations is also critical when designing more general children’s facilities.

For instance, Melbourne’s Royal Children’s Hospital has a meerkat enclosure, interactive gaming screen, sculptures, an aquarium, and a children-only activity room.

These types of features give the impression of the hospital, not as a frightening or intimidating place, but of an exciting hub of activity with things to do and friends to meet.

Likewise, London’s Great Ormond Street Hospital for Children has been transformed into a “lullaby factory”. Here, giant musical phones and instruments weave their way between hospital buildings, playing music to captivated children and families.

What can we expect in the future?

Despite these encouraging efforts, there is still a long way to go before the influence of evidence-based design on mental health care is truly felt.

Despite its broad adoption, it is critiqued for being too rigid, using broad or ill-defined research terms, or for claiming connections between an isolated variable in the environment and a behaviour, when such straight-forward connections are not guaranteed.

So we need to commit more time, energy, resources, and transdisciplinary collaborations in this crucial area of mental health service delivery to address these concerns.


Read more: To really fix Victoria's mental health system, we'll need to bridge the state/Commonwealth divide


In positive news, the recent interim report from Victoria’s mental health royal commission recognises the importance of appropriately designed mental health-care facilities.

It recommends new acute mental health beds that are “contemporary, co-designed with people with lived experience”.

It’s important these new facilities and services thoughtfully respond to the mental health needs of children and young people, to ensure accessible and appropriate support when they need it most.


Read other articles in our Designing Hospitals series:

From army barracks to shopping malls: how hospital design has been a matter of life and death

Stephanie Kathleen Liddicoat is affiliated with the School of Design, Swinburne University of Technology, Victoria, Australia, and the Faculty of Architecture, Building and Planning, Melbourne School of Design, The University of Melbourne, Victoria, Australia. Stephanie Kathleen Liddicoat has been engaged in research projects funded by the Australian Research Council, a University of Melbourne ECR Grant and the Barbara Dicker Brain Sciences Foundation.

Eóin Killackey is affiliated with Orygen and the Centre for Youth Mental Health at The University of Melbourne. He has received funding from the NHMRC, ARC, Norwegian Research Council, Australian Rotary Health, the BB & A Miller Foundation, The Kirby Foundation, HMS Trust and The Percy Baxter Foundation. Funding has largely pertained to functional recovery in youth mental health.

Dr. Paul Badcock is affiliated with the Centre for Youth Mental Health, The University of Melbourne; and with Orygen, The National Centre of Excellence in Youth Mental Health.

Authors: Stephanie Kathleen Liddicoat, Lecturer, Architectural Design, Swinburne University of Technology

Read more http://theconversation.com/aquariums-meerkats-and-gaming-screens-how-hospital-design-supports-children-young-people-and-their-families-122198

All You Need to Know About Trenchless Technology

For many years, the traditional sewerage lines and pipe developments were not enough due to the long wait and cracking. The traditional sewer pipe repairs involved cracking the earth to find the par...

News Company - avatar News Company

Before we rush to rebuild after fires, we need to think about where and how

A primary school in East Gippsland was burnt down in the current bushfire crisis. While Premier Daniel Andrews immediately committed to rebuilding the school as it was, media reported the local CFA ca...

Mark Maund, PhD Candidate, School of Architecture and Built Environment, University of Newcastle - avatar Mark Maund, PhD Candidate, School of Architecture and Built Environment, University of Newcastle

Australian sea lions are declining. Using drones to check their health can help us understand why

Australian sea lions (Neophoca cinerea) are one of the rarest pinnipeds in the world and they are declining. Jarrod Hodgson, CC BY-NDAustralian sea lions are in trouble. Their population has never rec...

Jarrod Hodgson, PhD Candidate, University of Adelaide - avatar Jarrod Hodgson, PhD Candidate, University of Adelaide

With costs approaching $100 billion, the fires are Australia's costliest natural disaster

It’s hard to estimate the eventual economic cost of Australia’s 2019-20 megafires, partly because they are still underway, and partly because it is hard to know the cost to attribute to de...

Paul Read, Climate Criminologist & Senior Instructor/Lecturer, Faculty of Medicine, Monash University - avatar Paul Read, Climate Criminologist & Senior Instructor/Lecturer, Faculty of Medicine, Monash University

In cases of cardiac arrest, time is everything. Community responders can save lives

Cardiac arrest can occur with little or no warning in people who were previously healthy, including young people. From shutterstock.comEach year more than 24,000 Australians experience a sudden cardia...

Bill Lord, Adjunct Associate Professor, Monash University - avatar Bill Lord, Adjunct Associate Professor, Monash University

So the government gave sports grants to marginal seats. What happens now?

When Australians pay their income tax, they assume the money is going to areas of the community that need it, rather than being used by the government to shore up votes for the next election. This is...

Maria O'Sullivan, Senior Lecturer, Faculty of Law, and Deputy Director, Castan Centre for Human Rights Law, Monash University - avatar Maria O'Sullivan, Senior Lecturer, Faculty of Law, and Deputy Director, Castan Centre for Human Rights Law, Monash University

The Olympics have always been a platform for protest. Banning hand gestures and kneeling ignores their history

It is the year of the Tokyo Olympics, and the International Olympic Committee was quickly out of the blocks with new guidelines regarding athlete protests. The IOC is worried the biggest stories of...

David Rowe, Emeritus Professor of Cultural Research, Institute for Culture and Society, Western Sydney University - avatar David Rowe, Emeritus Professor of Cultural Research, Institute for Culture and Society, Western Sydney University

Where Can You Get Weed By Ordering It Online?

Nowadays, everyone wants to get their hands on some weed. Marijuana has become legalized in a lot of countries worldwide. People wait in lines for days to buy some. You couldn’t have imagined that...

News Company - avatar News Company

Hidden women of history: Catherine Hay Thomson, the Australian undercover journalist who went inside asylums and hospitals

Catherine Hay Thomson went undercover as an assistant nurse for her series on conditions at Melbourne Hospital. A. J. Campbell Collection/National Library of AustraliaIn this series, we look at under...

Kerrie Davies, Lecturer, School of the Arts & Media, UNSW - avatar Kerrie Davies, Lecturer, School of the Arts & Media, UNSW

Sick and Tired of Your Dead End Job? Try Teaching!

Tired of the same old grind at the office? Want an opportunity to impact lives both in your community and around the world? Do you love to travel and have new experiences? Teaching English is the perfect job for you! All you need is a willingness to ...

News Company - avatar News Company

The Impact of an Aging Population in Australia

There’s an issue on the horizon that Australia needs to prepare for. The portion of elderly citizens that make up the country’s overall population is increasing, and we might not have the infrastructure in place to support this. Australians h...

News Company - avatar News Company