INPATIENT UNITS (WARDS): VIDYA SAGAR INSTITUTE OF MENTAL HEALTH, AMRITSAR
Architect: Sarbjit Singh Bahga, Chandigarh ---
Patient units or wards form a major component of a mental hospital because contrary to the general hospitals, the average stay of a patient in such a hospital is much longer. There are broadly three types of activities involved in the in-patients units. Firstly, the patients stay in a congenial environment together performing their daily-routine chores. Secondly, the service of meals, done three times a day, requires trolley movement between the Kitchen Block and the Wards. Thirdly, the replacement of dirty clothes with fresh laundry which takes place at least once a day also requires trolley-movement between the Laundry Block and the Wards. Apart from this circulation, the patients’ movement from the Wards to the Occupational Therapy/Rehabilitation Unit and the doctors’/staff’s movement from OPD/Administration Block to the Wards are also involved. The layout has thus been planned keeping in view the above activities and the easy flow of pedestrian movement between different activity-zones.
The design of various Ward blocks is governed by the Client’s/User-Group’s Brief provided to the Architect. Among other things, it stipulates that the Wards must be such that the patients feel secured. The feeling of security is the first prerequisite for rehabilitating the patient’s normal relations with his environment, because a sense of insecurity engenders anxiety, which is the root-cause of much disturbed behaviour. Most of the Ward blocks, like Intermediate/Improved Patients Units, Acute Care and Voluntary Units, should have dormitories with six beds each. The other units like Chronic Stay and Forensic Units should have dormitories for 10-12 patients each. The Nursing Stations should have a central location in the Ward so that the patients remain under constant vigil. Each Ward should have a separate dining space, which can also serve the purpose of social interaction amongst the patients. Provisions for lounge and recreation room should also be made since psychiatric patients often have to stay for long periods. Adequate open area should be provided with each Ward for various group-activities of the patients. While designing the Ward blocks of different types, concerted efforts have been made pursuing the rationale that was drawn from a logical interpretation of the Client’s Brief. As a result, each block is an architectural manifestation of function, truthfulness, and aesthetics.
INTERMEDIATE/IMPROVED PATIENTS’ UNIT
The Intermediate/Improved Patients’ Unit, as the name denotes, is meant for the patients who have either improved after a long treatment or their treatment involves shorter period of hospitalisation, and are likely to be relieved within a few weeks or months. Since the condition of this category of patients is comparatively better their Wards are designed to be two-and three-storey. In the Male Section this block is three-storey high, and accommodates 100 patients. It has a covered area of 3240 square metres. In the Female Section this block is double-storey and houses 60 beds. Its covered area is 2160 square metres. Each floor of these blocks has an identical plan, which accommodates six-bed dormitories, a recreation-room, lounge, interview-room, dining-room, wash-room, store, toilets, and nursing station. The comprehensive nursing station is designed to have a built-in counter, record-room, retiring-room, toilet, utility, and store. To provide security to the nursing staff, it is warded off from the patients’ area by a mild-steel grill. The station is juxtaposed in such a way that the nurse can keep a direct eye on each dormitory. To avoid the patients playing mischief with the electric points, all the control-panels/switch-boards have been centrally located in the nursing station. The dormitories are designed as semi-open. The front wall of each dormitory, which faces the nursing station, has a six-foot-wide opening without door. On either side of this opening is a six-foot-high panel wall. This arrangement ensures requisite privacy to patients, visual check on patients, and adequate cross-ventilation in the dormitory. Circulation areas/day-spaces have been kept large for the patients to move about freely.
Acute-Care Units accommodate those mentally-ill patients who are acutely serious, and need longer stay and special care in the hospitals. Since these patients are not expected to move upstairs, their Wards are designed as single-storey. Two units of 20-bed capacity each have been provided in the Male and the Female Sections. Each Unit has a covered area of 790 square metres, and the plan-form is almost identical to the typical floor plan of Intermediate/Improved Patients’ Unit, which has been discussed above.
The Forensic Ward is planned to house mentally-ill offenders or criminals who are admitted to the hospital under law. Separate Ward blocks were required for such patients to safeguard the interests of other patients, and to ensure adequate security provided by the police. In the Male Section, the Forensic Unit is designed and constructed as double-storey structure with a covered area of 2660 square metres accommodating 80 patients. In the Female Section only a single-storey part of the Block has been constructed to house 20 patients for the time being. However, this Block can be expanded as and when required in future. The scope of work provided to the Architect, incorporated Nightingale-type Wards/Dormitories accommodating 10-12 beds each, police attendants rooms and provision for direct watch by the nursing staff, besides other requirements like dining hall, recreation space, doctor’s rooms, interview-rooms, attendants’ rooms, etc. In consonance with the peculiar requirements of this category of patients, the juxtaposition of Wards, Nursing Station and Recreation Space has been so planned as to facilitate the supervisory staff to monitor the patients’ activities constantly and easily. The typical floor plan contains two independent units of 20 beds each. The units are mirror-imaged and joined together, resulting in a highly-disciplined symmetrical structure encompassing enclosed and semi-enclosed courts. These courts are ideal places for patients’ outdoor activities. They also afford the much-needed cross-ventilation in the building. The twin-unit draws access through a single entry point at the fag end of the vaulted corridor where one enters in a small stairs-lobby. From here the access corridor bifurcates to provide independent approach to each unit. The U-shaped staircase provides vertical access to the upper floor, and the two units at first floor are also similarly approachable.
The Form of this unit is a pleasant synthesis of fulfilment of functional needs of forensic patients and visually pleasing architectonics. This building thus portrays the Architect’s firm belief in the dictum: “Form Follows Function”.
Chronic Stay Units have been designed to house those chronically-ill patients who are unable to sustain lifestyle on their own, and, therefore, need external help to perform their daily chores. Majority of these patients are unlikely to be recovered and hence need hospitalisation throughout the remaining part of their life. The User-Group’s Brief given to the Architect for designing Wards for these patients includes single-storey dormitory-type accommodation with 10-12 beds each together with Nursing Station located strategically to keep direct watch on the patients. Furthermore, it was required to provide the patients their exclusive open space/court for outdoor activities. To translate Client’s Brief into blueprint, cross-shaped twin units have been designed to accommodate 50 beds. These Units are juxtaposed in such a way that they enclose an adequate open space in between. Nursing Stations of both the Units are judiciously located to enable the attendants to keep an eye not only on the dormitories but also the central court. Each Unit has a covered area of 1180 square metres and it comprises, apart from two dormitories, a nursing station, a dinning hall, wash-room, recreation hall, doctor-room, interview-room, isolation-room, store, etc. Separate entries have been provided to both the Units for better management and control of chronic patients. The low-height buildings of Chronic Stay Units set amidst sprawling lawns are ideal homes away from the original homes of these under-privileged, pitiable persons.