Completed Sycamore mental health facility promotes patient choice

Designed by Medical Architecture and built by Sir Robert McAlpine for NTW Solutions – Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, the recently completed Sycamore was delivered through Cohort 1 of the NHS New Hospital Programme. The £60m facility provides inpatient accommodation for 72 male patients with a range of forensic mental health needs, including patients with complex personality disorders and/or learning disabilities. It is also the catalyst to allow all secure services across the Trust to be brought together from previously dispersed sites, consolidated in a single, integrated secure centre of excellence.

It is well recognised that in secure mental health inpatient units, boredom leads to challenging behaviours and poor physical health. The building has therefore been designed to provide a range of settings which offer opportunities for mitigating boredom, from bedrooms to living spaces, and sheltered gardens to open courtyards. These spaces can be accessed autonomously and provide opportunities for both structured and unstructured sports and activities.

Six patient wards are paired together and arranged around a large recreation courtyard. This forms a secure boundary without the need for high fences and the feeling of confinement they can create. With rich landscaping and integrated security measures, this shared space does not feel like a typical forensic mental health facility. To be inclusive of patient needs, the courtyard is separated into two distinct character zones, ‘Passive’ and ‘Active’. The ‘Passive’ zone provides opportunities for refuge, with restful places to sit amongst plants and grasses. The ‘Active’ zone includes a 200m jogging/walking loop, activity spaces and a fitness ‘trim trail’ to promote physical activity and the associated wellbeing benefits.

In addition to the large, shared recreation space, at the centre of each ward, a private landscaped courtyard for relaxation is provided, and between each ward pair is a designated activity courtyard, with sports court markings. This arrangement provides choice, with safe access to a variety of different outdoor areas.

The majority of the day activity and living space is at the centre of the ward with direct access into the courtyards. Abundant daylighting, attractive views and a sense of spaciousness contribute to the therapeutic qualities of the environment and play an important role in patient rehabilitation.

Whilst use of the common spaces is actively encouraged, it was acknowledged that this patient group may choose to spend time in their own room, particularly in the morning and evening. To promote personal wellbeing, bedrooms are arranged to face outwards, with views to the surrounding mature woodland. To maximise the opportunity for activity, the bespoke fitted furniture has been designed to assist with a personal workout outside of scheduled recreation time.

The transition from private bedroom to shared circulation and day spaces has been considered to provide a reassuring path into more stimulating environments. The bedroom corridors are single-sided, with immediate views to the landscaped ward courtyards from each bedroom door, providing orientation, good observation and balancing circadian rhythms.

The exterior appearance of the new facility is extremely important and has a major role to play in reducing the stigma surrounding mental illness, as well as engendering pride in the building as a workplace. A visible and publicly accessible café with integrated artwork provides a welcoming space for visitors and staff working across the site. A consistent and controlled palette of materials and architectural styles has been developed to integrate the building with existing buildings and to present a positive image for visitors and new arrivals.