Improving mental health facilities in Gisborne, New Zealand through a focus on biophilic and recovery-focused design

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A new mental health inpatient facility at Hauora Tairāwhiti Gisborne Hospital is set to improve capacity and care for patients in the acute stage of mental illness. Located in Gisborne, New Zealand, Te Whare Awhiora will accommodate 10 new patient beds, whare, activity therapy and sensory space, a seclusion room, and a whānau room where family can stay if required. The facility, which is being delivered by Te Whatu Ora Hauora Tairāwhiti, will replace an existing building on the hospital site, which is no longer fit for purpose.

The new facility will enable staff to deliver a safe, effective, and efficient contemporary model of care for patients who need a period of close observation or intensive investigation – this includes support and possible intervention where this cannot be safely provided in a community setting or a less acute inpatient service. It also provides flexible spaces that enable appropriate care from whānau depending on the levels of need.

AECOM has been engaged as part of a design consortium led by Mode Architects to provide building services, ICT, security and communications, acoustics consulting, and Environmentally Sustainable Design (ESD) services on this new facility.

Integrating biophilic design for connection to nature and culture

The facility embraces biophilic design principles which aim to connect patients and staff to the natural environment, and thus the landscape has been designed to provide open connection to the outdoors whilst also maintaining the security of the facility. The design considers Kaupapa Māori approaches and incorporates acoustic design that enables traditional ceremonies to take place.

  • Waharoa – the entry gateway signalling the beginning of the Ātea.
  • Ātea – a clearing, void, forecourt in front of entrance for ceremonial welcomes, providing civic and transitional space like a procession to prepare for the journey ahead. A marae Ātea is a very sacred space and is only associated with traditional Marae.
  • Mahau – the porch in front of the whare, a transitional space from ‘Te Ao Marama’ to ‘Te Po’ and in some cases a sacred space on the marae.
  • Whare Whakatau – a formal welcoming space. The key word is ‘Tau’ which is ‘to arrive’ or to ‘be settled’. A whare whakatau does not have the restrictions and sacredness associated with a whare tupuna or whare whakairo on the marae.

The acoustic design considers both reverberation time control and acoustic diffusion for these rooms, which have unique noise requirements to maintain acoustic comfort and enable recovery and healing. Careful consideration has been given to aspects including culture features, décor, and materials.

Recovery-focused design

The new Te Whare Awhiora facility has been delivered through a co-design process to integrate cultural designs and prioritise input from those with lived experience including carers, whānau, visitors and staff. Many elements identified during engagement with user groups were carried through to delivery, such as the users’ ability to control their environment with ventilation and lighting. The project sets a new bar for recovery-focused care with an emphasis on salutogenic design principles, which prioritise elements that support health and wellbeing such as circadian rhythm lighting, biophilic materials, visual and auditory privacy, and thermal comfort.

In considering the model of care for this facility, the priority has been to create a safe, homely, and secure environment which puts patients first through the implementation of patient-centric approaches and a courtyard model. This has been adopted through a strategically placed day room and semi-open courtyard. The traditional nurse station is no longer in the centre of the patient areas which promotes patients’ sense of freedom and choice. Simple way-finding and an extensive glazed facade enables clear line of sight and passive surveillance, while a private courtyard and observation areas in corridors ensures service users can feel safe, and their privacy is maintained.