Stephanie Edwards, who is currently studying at The Architectural Association, UK (2nd year, RIBA part 1), was shortlisted in the Architects for Health’s First Student Health Design Award (2007) for the following submission. For contact please email: firstname.lastname@example.org
Reconfiguring St Clements Hospital (East London and The City Mental Health NHS Trust)
Are hospitals the ultimate ecologies? Can the collision of healthcare and architecture really be analysed? Who are we to challenge the delicate processes of the institution?
Scientific research on the treatment of the mentally ill continually excludes spatial parameters. The project should instigate change within a mental health hospital in London. The year long experiment should shape the unit’s manifesto: to alter the spatial, psychological and organizational systems that defines life within the healthcare environment.
Project and proposal: Reconfiguring St Clements Hospital
Can the collision of healthcare and architecture really be analyzed? As students we were posed with this question at the start of the project. This provoked me to go beyond a formal study and to probe all aspects of the hospital environment, including the dark, but very real, details of everyday life in a mental ward -subjects such as suicide prevention and patient restraint. Throughout the year a host of professionals were consulted and corresponded with. These consisted of National Health Service psychiatrists, ward managers, estates and facilities staff, architects specializing in healthcare buildings, and potential users, in order to craft their individual research and responses. Drawings were then used as tools to reveal the relationship of how people interact with one another or how components make up an environment, where a specific visual representation was invented.
This project defines the conditions for the staff and patients who live and work in St Clement’s hospital, a former workhouse or ‘prison by a milder name’. It explores whether the 1849-era hierarchy extends throughout the hospital today. At the outset, the operational and behavioural aspects on one particular ward were analysed. The intended timetable initiated by the staff was compared with the actual timetable followed by the patients. This displayed the many physical and non-physical restrictions within the ward and its constant fluctuation throughout the day. The initial study probed efforts to flatten the hierarchy, for example through the removal of a formal uniform, and challenged the system within the ward as well as the relationships between staff, patient and visitor. In response to the insight gained, architectural, organizational and urban propositions were made. The process from admission to discharge was scrutinized and redirected to facilitate speedy recovery. The services located at St Clements are gradually being moved to purpose built sites. As areas are abandoned, an urban proposal aims to integrate the community through shared use.
The Architects for Health
First Student Health Design Award
was sponsored by