Green Theatre Seminars

Completed in 2020, the Blossom Court inpatient building at St Ann’s Hospital in London represents a new approach to design for mental health within a constrained site. The unique two-storey arrangement sees four wards stacked around two terraced courtyards, creating a positive focal point for patients, and an abundance of natural light. A calming interior with views to nature enhances the therapeutic environment, promoting patient wellbeing and recovery, and improving the working lives of NHS staff.

The courtyard layout provides private and discretely secure space for patients without the need for fences or walls around the building’s perimeter. In doing so, demanding functional requirements are incorporated inconspicuously to create a normalised environment. With a simple palette of good quality brickwork, the building is designed to integrate with the surrounding community, to foster pride and de-stigmatise the mental health services being provided.

Initial feedback following completion was that seclusion and rapid tranquilisation of patients had significantly reduced, while physical restraint almost entirely stopped, allowing better focus on the recovery of patients compared to previous accommodation. This presentation will look at a more comprehensive body of evidence gathered during the building’s first five years of operation, from its general arrangement to details and selection of materials, and explore lessons that can be learnt to inform future developments of its kind.

Woodland View, opened in Spring 2016, is a purpose-built facility on the Ayrshire Central Hospital site, consolidating NHS Ayrshire and Arran’s mental health services into one integrated location.

The 206-bedroom hospital spans 16,100 m2, offering adult inpatient services, dementia care, psychiatric rehabilitation, and forensic services and from 2024 a new mental health assessment unit delivers care for emergency admissions. The design prioritised sustainability, community integration, and non-institutional environments to foster recovery and rehabilitation.

Inspired by the surrounding coastal landscape, Woodland View was purposefully designed to support service users’ journeys toward recovery building confidence, offering choice and paving the way for their transition home and into the community. Features like direct access to green spaces from wards have been transformative, significantly reducing incidents of restraint and violence. Patients can step into landscaped areas, connect with nature, and de-escalate distressing situations – sometimes lying on the grass to view the sky.

As with every aspect of the built environment, changes in regulations, standards and social evolution mean architectural solutions need to be resilient. Specifically in mental healthcare, changes in the human condition versus models of care can quickly impact the way, we as architects need to continuously challenge our approach to these types of facilities and how staff need to adapt their care plans.

In November 2024 Arcadis revisited this award-winning building as part of a Post Occupancy Evaluation to gain valuable insights into what design approaches continue to work well, whilst highlighting lessons learned for future projects. In 2026 Woodland View will be 10 years old – this talk will cover the POE in 2024 highlighting how the building has adapted to change with an update on the use of the mental health assessment suite and how that has impacted the community and staff.

Water Meadow View is Lancashire and South Cumbria NHS Foundation Trust’s new £32M, 14 bed mental health support facility for adults with Learning Disabilities. Located on a 50-acre rural site within the grounds of Guild Park, the new facility has been co-designed with Service users, Experts by experience, Peer support workers, Clinical champions, Nursing leads, and families creating a true person-centred design. The new environments created support and facilitate the Trust’s Trauma informed care approach, least restrictive practices and Neurodiversity awareness.
From the outset, the aspiration and vision for the facility was to challenge the norm of inpatient MH building, create a holistic LD focused environment that responds to real service user need and want, and is unashamedly ambitious in its goal of creating an inspiring, therapeutic and restorative setting with a real sense of ‘place’. This manifests itself in a number of ways, from its idyllic rural, hillside location taking in breath-taking views of the surrounding Lancashire countryside, to its functional content including a mixture of traditional ES bedrooms and single occupancy flats promoting service user choice, empowerment and independent living.

One of the key drivers of the project was to imbed the new building into a supportive Community setting and help Service users stay connected with their homes, communities and loved ones. The site chosen, albeit rural, is on the periphery of a major new Housing development that includes new community infrastructure, civic investment and public amenities. The Master planning involved close liaison and consultation with Homes England and the local authority to embed this MH build symbiotically within the local plan.

The connection with nature and the landscape is a huge feature of the WMV project and design. This holistic approach went beyond minimizing environmental impact and looked to actively regenerate ecosystems and enrich the green context, revitalizing and strengthening community links and restoring balance and wellbeing between building users and the natural world.
Sensory design themes, when developed in partnership with service users, can create environments that not only meet clinical needs but also enhance wellbeing, safety, and autonomy. Landscape, setting, views out and connection to nature were key themes developed from our EBE/SU engagement workshops, and this informed the final landscape design. The question of ‘look and feel’ was also driven by the engagement workshops with the final approach to the massing, detailing and form directly influenced by this. Ie a non-institutional, intentionally ambiguous design aesthetic. The impact of co-production was significant, influencing both the

Healthcare leaders often approach psychiatric emergency unit design with preconceived notions about what works, leading to costly missteps that compromise patient care. This session examines the critical intersection between architectural decisions and clinical outcomes in psychiatric emergency settings.

An emergency psychiatrist and a healthcare design architect will address common misconceptions that drive design decisions, such as the appeal of "hybrid" units that blend EmPATH and traditional psychiatric ER models. Through real-world case studies, they'll reveal the unintended consequences of mixing design elements without understanding their operational implications—from Joint Commission compliance challenges to altered nursing responsibilities that can compromise patient safety.

Drawing from extensive consultation work, case studies like the University of Iowa HealthCare EmPATH Emergency Department project – which had its disadvantages, the presenters will demonstrate how seemingly minor design choices—room configurations, observation protocols, and spatial relationships—directly influence treatment approaches, staffing requirements, and patient outcomes.

The presentation highlights a collaborative approach that integrates clinical expertise with lived experience perspectives. Peer support specialists' input fundamentally shifted design priorities from purely clinical efficiency to environments that promote dignity and healing, proving that patient-centered design isn't just ethical—it's clinically effective.

Attendees will learn to recognize when their assumptions may be limiting design effectiveness, understand the operational ramifications of popular design trends, and gain tools for aligning architectural decisions with actual treatment objectives rather than theoretical ideals.

This presentation explores the vital role of Occupational Therapy in shaping mental health environments that promote healing, recovery, and meaningful engagement. Drawing on OT expertise in human occupation, sensory processing, and therapeutic use of space, we highlight how design decisions can profoundly impact well-being. Key themes include the creation of sensory-inclusive environments that support regulation and participation, the integration of biophilic design and outdoor spaces as therapeutic resources, and the importance of therapeutically adapted seclusion suites that prioritise safety while preserving dignity. We will also shine a light on overlooked spaces - such as corridors, waiting areas, and transition zones, that hold untapped potential for engagement, connection, and comfort. By embedding OT perspectives into the design process, we advocate for environments that go beyond safety and function to foster meaning, autonomy, and recovery in inpatient mental health care.

This study examines the impact of ward design on falls incidence in older adult mental health inpatient care, with a focus on Australia’s emerging shift from centralised to 'decentralised / pod' ward models. In line with national goals to reduce restrictive practices and enhance person-centred care, decentralised ward layouts—often pod-based with segmented visibility—are becoming the new standard in older adult mental health services. While these environments aim to enhance therapeutic engagement and patient satisfaction, their implications for patient safety, particularly falls, remain under-explored.
Adopting a convergent mixed methods design grounded in pragmatism, this study triangulates quantitative incident data with qualitative insights from nursing staff to gain a comprehensive understanding of how physical ward design influences falls incidence and other aspects of mental health nursing such as visual observations. Quantitative data on falls incidents, extracted from the hospital’s RISKMAN system, will be analysed pre- and post-relocation (six months either side) from a centralised to a decentralised ward. Key variables include time, location, severity, witnessed vs unwitnessed falls, and falls risk (FRASS scores).
Complementing this, semi-structured interviews with up to 12 nursing staff—each having experienced both ward layouts—will explore their perceptions of how design impacted workflow, visibility, and fall prevention practices. Analysis will use Braun and Clarke’s reflexive thematic analysis, informed by Bridges’ Transition Theory to contextualise staff adaptation to environmental change.
Findings aim to inform future ward design in mental health, bridging clinical practice, service user safety, and environmental planning.

Designed by Scott Tallon Walker Architects in association with Medical Architecture and opened in 2022, The National Forensic Mental Health Hospital in County Dublin, represented a once-in-a-generation step-change in the design of facilities for mental health services in Ireland.

Located on a 10-hectare woodland site, the 25,000m² campus replaced the existing Central Mental Hospital in Dundrum, and accommodates 170 high, medium, and low secure mental health beds. The accommodation is laid out as a series of single storey pavilion buildings around a pedestrianised ‘village green’ which contains peaceful gardens for patient amenity and therapeutic activities. Intuitive wayfinding is achieved through a site-wide narrative of colour, art, and landscaping.

The project brief and subsequent design were heavily focused around providing a safe, secure and healing environment that contributes to a patient’s recovery. This included:

• Strategic masterplanning and arrangement of accommodation to optimise the existing topology, mature woodland setting and long coastal views.
• Adopting a set of very clear planning principles to manage safety and security, while providing freedom of movement for patients
• Addressing the competing requirements of observation with the quality of space, daylight and views
• Creating high quality internal environments that will endure
• High quality landscaping and space for activity to create community, and a meaningful day for patients
• Accommodating differing services and future adaptability through standardisation of design.

In 2023, the building won International New Build Project of the Year and the Outside Space of the Year, at the DIMH Awards. The facility was hailed for setting a new standard in mental health facility design in Ireland. The presentation will look at evidence gathered during the building’s first three years of operation, and lessons that can be learnt to inform future developments of its kind.

Avon and Wiltshire Mental Health Partnership NHS Trust is developing The Kingfisher: a pioneering combined community and inpatient service tailored for people with learning disabilities and/or autism (LDA) who require acute inpatient treatment for mental health conditions.

This presentation will explore both the architectural design of the building and the development of the associated clinical model.

Providing effective support for people with LDA experiencing acute mental distress remains a significant challenge. Historically, general adult acute admission wards and psychiatric intensive care units have provided care despite not being designed to meet LDA-specific needs—often resulting in poor experiences and iatrogenic harm. While recent initiatives have aimed to offer community-based alternatives, many admissions are still prolonged and occur far from home.

The design of The Kingfisher has been led by a clinical reference group, including experts by lived experience, ensuring that the unit reflects the needs and values of those it serves.

Key Design Features Include:
• Energy Efficiency – BREEAM rated ‘Excellent’ and Carbon Net Zero
• Enhanced Bedrooms – Each with lounge, study, and dining space
• Private Gardens – Individual outdoor space for every bedroom
• Inclusive Facilities – Bariatric, accessible, and single-sex provision
• Activity Spaces – Dedicated areas for arts, crafts, domestic tasks, and exercise
• Biophilic Design – Natural artwork and living plants visible throughout
• Trauma-Informed Design
• Autism-Friendly Environments

The final building will feature art installations created by the charity Hospital Rooms, whose artists have collaborated with experts by lived experience to produce a unique and therapeutic visual environment.

The presentation will include:
• Architectural plans and visual materials
• Reference to relevant standards and evidence base
• First-hand accounts from project leaders and experts by experience

We will conclude with time for audience questions and discussion.

The SouthWest London and St George’s Mental Health NHS Trust commissioned new hospital buildings, Trinity and Shaftesbury, which opened in December 2022 and September 2023 respectively. Since opening, the new hospital buildings have been singled-out for national and international acclaim & awards. They are the centrepiece of an Estates Modernisation Programme focused on the de-stigmatization and integration of mental healthcare facilities within a large-scale development that now includes 1,200 new homes, a new 32-acre public park, retail shops and community spaces created on surplus NHS land.
Co-designed with staff, patients, carers and service users, the aim was to create therapeutic and dignified surroundings for staff and service-users using open courtyards, planted gardens, ample daylight, fresh air, safe layouts, artworks and careful attention to acoustics. The hospital’s purpose was to replace Victorian facilities with high quality inpatient and outpatient services, giving patients a chance to recover in an environment that supports the care they deserve.
The initial post-occupancy data shows serious incidents have been reduced by over 36% - an exceptional and noteworthy benefit. Energy use in the new facility is 17% below projected values.

But has the facility made working or staying in a mental health facility better? And, if so, how?

The presentation will look at how hospital spaces have been adapted after hand-over to address practical concerns about maintenance, control and security. It will look at specific features of the new hospital that are valued (or not) by service-users, clinical staff and management. Lastly the talk will examine how can designers, product manufacturers and stakeholders can uphold and deliver the vision of better, safer and therapeutic mental healthcare facilities.

This presentation explores the second phase of a sustained collaboration between the University of Lincoln and NHS Lincolnshire Partnership Foundation Trust (LPFT), led by Associate Professors Dr Steve Fossey and Rachel Baynton. The partnership brings together NHS staff, service users with lived experience, and students through a co-production model that integrates artistic practice with mental health research.

The first phase focused on mindfulness, recovery, and sensory experience, producing two large-scale artworks for the Peter Hodgkinson Acute Mental Health Centre that support grounding and de-escalation. The project was shortlisted for the 2024 Design in Mental Health Awards (‘Art Installation of the Year’) and informed the creation of an immersive 3D Matterport model that enhances understanding and accessibility of therapeutic environments.

Phase Two, now complete, expands this research into the field of de-escalation through art and visual design. As Consultant Artists-in-Residence for the new Boston Norton Lea mental health ward, Fossey and Baynton developed three permanent, co-produced artworks designed specifically to support emotional regulation and recovery. This phase drew on emerging evidence from trauma-informed care, sensory integration, and environmental psychology, combining academic inquiry with collaboration from Experts by Experience and clinical practitioners. Working closely with occupational therapists and patients, the artists investigated how, colour, form, imagery and text can function as active tools for calming, orientation, and de-escalation within clinical spaces.

For the Design in Mental Health Conference, Dr Steve Fossey and will present his and Baynton’s new findings from this phase, demonstrating how sustained co-creation and evidence-led visual design can contribute to safer, more restorative mental health environments.