Green environments that support rehabilitation, healing and respite, offer significant benefits to those suffering from mental illness. Long ignored and stigmatized by the design professions and society at large, landscape architects bring the expertise to design innovative therapeutic opportunities for those being treated for mental illnesses. Through a collaborative, real world, applied service learning project, LA students collaborated with therapeutic disciplines including physical, occupational, horticulture and art therapists, psychiatrists, nurses and MD's, patients and students from other disciplines to design the campus of a mental hospital for therapy and social reconnection. The success of this partnership required advocacy, long-term commitments and interdisciplinary collaboration. The design teams were interactively organized so that each team had either an architecture, planning or industrial student as a team member. Their differing perspectives and expertise enriched the rigor and depth of the design process. The resulting quality and responsiveness of the design, unique interdisciplinary and international collaboration and the charting of new frontiers for both practice and education make this project award worthy.
The creation of environments that support rehabilitation, healing and engagement, offers significant benefits to this healthcare community. Landscape architecture students collaborated with therapeutic disciplines including physical, occupational, horticulture and art therapists, psychiatrists, nurses and MD's to design the campus of a mental hospital for therapy and social reconnection. The success of this partnership required advocacy, long-term commitments and interdisciplinary collaboration. In Croatia, veterans of the 1990’s war who participated in or witnessed the horrors of genocide need treatment for multiple conditions, PTSD, addiction, and social alienation. The treatment often relies on long-term pharmaceutical therapy that renders the patient tranquilized and disoriented. The first therapeutic campus in Croatia is now addressing some of these entrenched challenges of mental health care.
From 2012 to 2016 students from seven universities and six academic departments partnered with professionals to design and build a therapeutic campus at the Rab Psychiatric Hospital located on the island of Rab, Croatia. Following a community participatory design model, students, patients, staff and medical professionals gathered to discuss short and long term goals, treatment methods, intended outcomes and the potentials the landscape might offer. Participants offered programing suggestions, described means of accessibility and safety, and expressed the importance of cultural tradition. The design tapped this deep pool of expertise to learn how properly designed spaces and structures could support their specific treatment protocols and meet the patients' broader needs. Consulting medical staff reviewed and discussed the evolving designs in regular design reviews from conceptual design through design development and construction documentation. Patients participating in vocational and horticultural work therapy programs worked together with the students during the building process. Local skilled craftspeople joined in the construction phase of the project, living with the team as they fabricated elements and instructed the students on craft techniques and methods. Over the four years, many partners evolved to become integral team members. They include a ship builder specializing in metal fabrication, a furniture maker specializing in wood joinery, an architect and an industrial designer, and a yacht manufacturer specializing in fiberglass shell construction.
The design teams were interactively organized so that each team had either an architecture, planning or industrial student as a team member. Their differing perspectives and expertise enriched the rigor and depth of the design process. The intent was not to pigeonhole the students by discipline association, but to increase the rigor of the investigation to meet the challenges ahead. The industrial design student was adept at prototyping and pushed the landscape architects to develop their furniture designs with multifunctional outcomes in mind. Her experience in ergonomic design and detailing became a resource for the landscape architectural students that enabled them to better respond to patients with physical and mobility challenges. As a result they created movable, accessible seating with flexible lying and lounging opportunities.
One architecture student brought a depth of interest in structural engineering and worked with the landscape students to better understand load calculations and sizing of members. Importantly to the design, she pushed them to preserve an elegance to the structures even while meeting requirements that included unusual wind loads for the decks, pavilions and walls. A graduate planning student, brought to the project by her passion for community participation, mentored LA students as she assisted them in developing exercises, surveys and discussion points for the participatory workshops and also guided them through data analysis. The collaboration in turn allowed landscape architecture students to influence the non-LA students. As an example the industrial designer had not thought spatially about place making, and she moved beyond object thinking into spatial organization. She as well as the architecture and planning students hadn't directed their thinking to the role the environment and nature have in the healing process. Ensuing discussions allowed the landscape architecture students to explain and demonstrate the principles of therapeutic garden design.
The student teams based their design proposals on the staff input outlining the therapeutic curricula and patient/staff needs. Additionally, they used data culled from medical literature, post occupancy studies and first-hand accounts of therapeutic gardens to create a series of proposals for review by the medical personnel/staff. The staff and patient comments were synthesized into a final proposal to serve the broadest constituency of patients. Each of the gardens was designed for specific activities and in some cases for a specific patient population, though all the gardens are open and accessible to everyone. The first to be built was the garden of performance, social engagement and sensory experience. It is used for group therapy, performance, horticultural and physical therapy and serves as an outdoor chapel and as community gathering place for the hospital. The second garden is a wandering/walking garden. Many patients express a great need for intentional walking that is both a symptom of many illnesses and one of the side effects of anxiety created by the medicines. There are small gathering spaces for visits with family and places of solitude for the less social patients. The third garden is a memory and physical therapy garden focused on the needs of dementia patients and easily accessible to their ward, but also available to the other patients. It features a cognitive therapy pavilion, reflexology path, dog therapy course, and musical instruments for performance and therapy. The final garden is a sensory garden with aromatic, textured plantings, shade giving olive trees and a rose garden. Dry stone construction, a culturally important element on this Adriatic island was used in most of the gardens.
The data that informed the designs included climate and human use patterns. On the island of Rab climate is changeable with extremes of temperature, wind and rain. The human use patterns were influenced by the symptoms of the illness, coping strategies and beneficial therapies that could be used outdoors. The information we gathered became more specific as the designs evolved. For example, several nurses and therapists spent many sessions narrowing color choices down to those that wouldn't increase anxiety or aggression. Therapists on the dementia ward closely reviewed the images for the recognition games, a central feature of the cognitive learning pavilion. Patients reviewed the designs as well and articulated what types of spaces, vegetation and activities they would like to see in each garden.
The gardens are the outcome of a collaborative design/build process involving hospital patient and staff, local crafts people and students from three universities. The two gardens that were designed and built by the team submitting this proposal are the cognitive therapy and sensory gardens. The others were built using the same collaborative process but by other student interdisciplinary teams guided by a master plan created by the student team in 2012.
8 Landscape architecture undergraduates, American
2 Landscape architecture graduates, American
13 Landscape architecture undergraduates, Croatian
4 Landscape architecture graduates Croatian
2 Landscape architecture, graduate Slovenia
1 Industrial design undergraduate American
1 Planning, graduate American
1 Community Environment and Planning undergraduate American
Multiple Croatian physical, occupational and horticultural therapists, nurses, physiatrists and doctors: Offered extensive evidence based data, descriptions and demonstration of their programs and activities, served as design reviewers and continuing consultants.