American society has had a difficult time finding the appropriate care for the mentally ill. Today in some jails, up to half of the inmates have a diagnosable DSM disorder. This phenomenon of treating mental health in prisons and conventional hospitals is known as trans-institutionalization and has proven to be quite unsuccessful. About a quarter of the homeless population suffers from a mental health disorder (as opposed to 6% of the general U.S. population). And these statistics came after large-scale, inhumane institutions closed around the country beginning in the 1950’s. With the disproval of large institutions and trans-institutionalization as effective means for healing, as well as the low resources and ineffective implementation of community-based healthcare, there is a need for a new, innovative solution.

 

My conception of this solution is through the re-institutionalization of mental healthcare. This approach means sensitively hearkening back to the days where mental health was treated in brick-and-mortar institutions, albeit with extreme readjustments. The modern institution needs to become a place of community, not isolation. It needs to become a place of healing, not condemnation. And it needs to become a place of promise, not of despair.

 

Affiliated with the University of Virginia Health System, my in-patient mental health facility will be located in Foxhaven Farm in Charlottesville, VA. This facility will have a focus on engagement within the facility and engagement with the surrounding community. Nursing staff will plan recreational programming such as yoga, gardening, and art displays, bringing in local experts as needed. Chaperoned trips to downtown (for farmers markets, dining, shopping, and other reasons) will encourage normality and engagement with the community while providing needed supervision and guidance. The complex will have 6 residence buildings (“cloisters”), consisting of 6 patients and 1 nurse. Three cloisters are organized around a central communal core with living room, dining, and treatment spaces. This enforces the idea of fractals of privacy. Each person will have their own room, and each residence will have shared common spaces as well. The other facilities will consist of treatment spaces, offices, recreational spaces, and dining.

 

My sample residential building emphasizes order, comfort, privacy, communal living, and integration with the outdoors. The central arrangement around a cloister brings in fresh air and natural light. The rooms have sleeping space and living spaces, with private porches and shared bathrooms. The living room is big enough for people to either socially engage or sit separately. The nurse has a two story suite, and there is room for a psychiatrist office and treatment room on the second floor of the central core. The materials of soft stone masonry and wood cladding evoke comfort, nature, and warmth. The scale of the building emphasizes horizontality to make sure it is not an oppressing feature in the landscape.