Integrated treatment facility: An alternative care setting for adult patients with mental illness Greenville, South Carolina

Currently, mental health patients when first admitted for care, or committed by a court, are isolated from society in institutional settings that provide immediate, stabilizing treatment. These settings are unpleasant, sometimes rough environments that are focused on acute treatment and rarely address the longer term therapeutic needs of the patient, let alone provide a place of refuge. When discharged from the hospital, patients are released into the world at large without any setting anchors and limited access to the services they need. Group homes, or halfway houses, offer patients minimal care and sporadic services with more independence than many patients are ready to assume. Unlike the settings for hospitals and group homes, a more comprehensive therapeutic community, one which is located within the community at large and has immediate access to support and services, can provide a more stable infrastructure for transitioning patients from institutionalized isolation and segregation to an integrated form of care that enhances patient and community interaction.; This thesis studies how architecture can help create a setting that arrives at a balance between supervision, medical treatment, and patient freedom while providing both integration into the community and refuge from the world at large. It is designed to meet the specific residential and therapy needs of patients that are discharged from the hospital but are not ready for independent living on their own or in a group home. Historically, mental health facilities warehoused and mistreated patients, taking away the freedom, comfort and control over their environment. Today relatively barren and untherapeutic settings focus more on acute care, stabilizing and quickly discharging the patient, thanks to medical technological advances and more specific medications. Due to this rapid treatment and discharge process, patients become lost in their unsupportive environment and unfortunately, wind up back in the hospital again.; In order to establish a platform of information to work from, literature reviews were conducted on topics such as the current trends in the delivery of care to mental and behavioral patients, a historical survey of mental and behavioral health facilities focusing on their immediate environment, healthcare facilities with similar programmatic treatment plans, and the sociological position of the mental health community. An extensive amount of time was spent at Marshall I. Pickens Behavioral Hospital observing and diagramming the daily routine of activities at the facility to understand the environment and its restrictions. To compliment the literature and observation studies, a series of interviews with administrators, nurse managers, nurse technicians, and some casual conversations with patients were conducted to understand the perspectives of everyone involved.; Based on the research conducted, a series of design principles were created in order to guide the design of an intermediate care mental health facility that is integrated into the community and promotes multiple levels of positive social interaction. In a broad sense, architecture must balance the need for both connections and retreat from the life of its neighborhood and the community at large. The facility must serve as a retreat/safe haven for residents where patients have a sense of control over their personal and communal space. When located within a mixed use walkable neighborhood, community oriented retail business can act as filters to the larger community by providing buffering zones and activities between life within the facility and life in the larger community. The form and scale of the facility should not stand out as an institution, but should be physically integrated into and respect the scale, articulation and general character of its surrounding context and neighborhood. Within the facility, institutional corridors should be avoided and circulation spaces should be used as con...