Cabangunay, Vergel ( Part 1, Part 2, Part 3 and Related Appendices)

8/10/2019 Cabangunay, Vergel ( Part 1, Part 2, Part 3 and Related Appendices)

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YOUTH MENTAL REHABILITATION COMPLEX:

PREPARING YOUTHS WITH MENTAL DISABILITY IN THE

MAINSTREAM SOCIETY THROUGH SELF-RELIANT FACILITY

A Thesis Presented to theSchool of Architecture, Industrial Design & the Built Environment

Mapua Institute of Technology

In Partial Fulfillment of the Requirements in Architectural Design 11/ AR200/ AR200Sfor the Degree of BACHELOR OF SCIENCE IN ARCHITECTURE

Presented by

Cabangunay, Vergel G.2010121904

Architect Junar Pakingan Tablan, uap, MSAEAdviser

DECEMBER 2014


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PART I

CHAPTER I.1 GENERAL OVERVIEW

I.1.1. INTRODUCTION

For the ages 10 to 24 years old, suicide is the third leading cause of death, more

than 90 percent of those are suffering from mental disabilities/disorders. Only one out of every

four of those received professional medications. Parents most common question was where to

go, which leads to the thought of just managing it on their own. Mental disability/disorder is not a

minor problem that can be solved at home. This may lead to being socially unstable, insecurity or

even death. These patients need medical attention through medication and rehabilitation. A good

environment for interaction and self-redevelopment, a place that will help them improve not only

their mental capabilities but also physical, social and spiritual.

Mental rehabilitation for adults is different from youths. Mental disorders like ADHD,

anxiety, depression and substance use disorders are much more common on youths than adults

and need different type of medication approach. Youthsage bracket is the most prone to mental

illness compared to other age bracket. Meeting the unique needs of youth is a one factor out of

many, on why they should be separated.

I.1.2. BACKGROUND OF THE STUDY

The study aims to differentiate the needs and type of facility needed by children and

adolescents from the standard mental hospital. In Philippines, has the only facility where youth

only can get medication are the 28% of outpatient community psychiatric center. There is no in-

patient facility that will solely cater the needs of children and adolescents. Not all

disabilities/disorders can be treated by regular check-up in a community center, and all of the in-

patient psychiatric hospital in the Philippines cannot provide the unique needs and environment a

youth requires. Which is why, this study aims to provide a specific design standard that will


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provide children and adolescents a residential multi-disciplinary facility, where they can get a 24/7

medical supervision. There are certain youth needs that a regular mental hospital lacks like,

education, facilities for other medication like pediatric, a space for privacy, a homey environment

and the like.

I.1.3. STATEMENT OF THE PROBLEM

Youths and adults have different needs in terms of facilities and environment. Mental hospital

in the Philippines caters all types of age bracket for in-patients. However, the design suggests

that it focuses mainly on the rehabilitation and environmental needs of an adult. Peoples image

of a mental facility is like a detention facility, which is why, relatives never thought of sending the

patient, because of the thought that they are not helping them and just locking them away. Even

though children or adolescents have a psychiatric problem, it doesnt mean we should focus solely

on the mental healing. A child needs for an education, nutrition and other health medication,

social stability, space for privacy and an environment that promotes self-reliance and interaction

should also be prioritized which the mental facilities for in-patient in the Philippines fails to

provide. Specific problems that needs to be addressed:

1.

Does the mental facility reflect an image of a detention facility?

2.

Does the environment appropriate for the specific mental disorders? Or is it just

monotonous?

3.

Does it provide a place for privacy; does the hospital promote individual dignity?

4.

Does the hospital provide facilities for the special needs of health medication for youths

like pediatrics, educational and physical needs?

5.

Does the hospital provide cognitive and physical training for youths?

6.

Does the hospital promote interaction with the outside relatives?

7.

Does the facility promote self-reliance, do patients move around independently?

8.

Does it provide physical, social and spiritual rehabilitation?

9. Does the treatment and the facility adapting to the change in terms of modernization?


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I.1.4. PROJECT GOALS

The main goal of this proposal is to promote self-reliance to the patients, while

rehabilitating mentally and physically without compromising their social, educational and family

interaction in order to prepare them for the mainstream society.

I.1.5. OBJECTIVES AND STRATEGIES

1.

A design character that feels like a home and recreational facility rather than a detention

facility.

2.

Space planning promoting freedom and individual dignity without compromising the

security.

3.

A calming room that can serve as a private room.

4.

Recreational facility that will promote moderate up to hard physical training and cognitive

skills.

5. A highly-technological research center for continuous improvement of rehabilitating

knowledge.

I.1.6. SIGNIFICANCE OF THE STUDY

Youth mental rehabilitation through self-reliance facility study focuses mainly on 2

parts, analyzing the flaws on the current designs and spatial planning of in-patient mental

facilities in the Philippines and secondly, coming-up with complimentary solutions that will be

developed and used on designing the said facility for children and adolescents.

This study will be helpful to psychiatric medication community, because of how it

addresses the flaws on current in-patient psychiatric facilities, and will also enlighten them

through addressing the issues on why adults and youths with mental disabilities must be

separated. This study will also be helpful on coming-up with a design standard that can be used


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for future psychiatric facilities development for children and adolescents, the project aims to be

the first in-patient psychiatric facility for the youths.

I.1.7. SCOPE AND LIMITATIONS

The scope of the study is children and adolescents age ranging from 8 to 20 years

old. The study will include analysis of current in-patient psychiatric facilities in the Philippines

focusing on the design and planning flaws on the design standard for mental institution.

The study does not cover any psychiatric facilities for out-patient and day treatment

psychiatric facilities. The study will also not cover the types of medicinal medication and types of

educational development program for children with mental disability, and will focus solely on the

environmental rehabilitation through architecture.

I.1.8. ASSUMPTIONS

The thesis assumes that children and adolescents undertaking in-patient medical

supervision need different type of environment and facilities than adults, in order to cope-up with

youthsunique needs.

I.1.9. TARGET MARKET

This proposal is a regional Youth mental rehabilitation Facility for both male and

female patients from at least 5 different regions in Luzon. The facility is for ages 5 to 21 years of

age, patients that has a chronic condition that significantly limits his/her social function, a patient

that cannot be treated by outpatient basis. The facility will accommodate all mental disabilities

from minor to crisis stabilization disabilities or patients that inflicts suicidal behavior. It will also

works across all interfaces like education, social care, youth justice, pediatrics and the like.

The Psychological Research Institute will be accessible to professionals on the field of

psychology in the whole country especially the ones specializing for children mental health. And

will have modern and updated facilities like laboratory examination room, observation room and

the like, that will help to improve the medications.


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Study the

facilities,gather

data,

survey, take

pictures and

get the built

plan

Analyzeand make

a report

Confer

with theadviser

I.1.10. CONCEPTUAL FRAMEWORK

Review

of

related

literature

Confer

with the

adviser

Review of

studies in the

same field

both foreign

and local

National

center for

mental health

in

Mandaluyong

site visit

Study the

facilities,

gather

data,

survey, take

pictures and

get the built

plan

Analyzeand make

a report

Cavite

Center formental

health site

visit

Seekprofessional

advise

Submitmanuscripts

to the adviser

Write the

conclusion andrecommendation


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I.1.11. DEFINITION OF TERMS

Person with mental disability - Is a person with mental or behavioral pattern or anomaly that

causes either suffering or an impaired ability to function in

ordinary life (disability), and which is not developmentally or

socially normative.

Medication - Treatment using drugs.

RehabilitationThe restoration of someone to a useful place in society.

ChildrenPeople age ranging from 3-12 years old.

AdolescentPeople age ranging from 13 to 20 years old

Mental Hospital/facility - A hospital for the care and treatment of patients affected with acute or

chronic mental illness. Also known as psychiatric hospital.

Self-reliantThe ability to move on your own. Independent.

CHAPTER I.2 REVIEW OF RELATED LITERATURE AND STUDIES

I.2.1. RELATED LITERATURE

Neurologically challenged individuals often have difficulty following environmental

cues. Many cannot distinguish normal visual cues such as exit or restroom signage. Yet careful

attention to way finding and places of transition is crucial to their successful use of environments.


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A childs attention span and safe navigation can be greatly impaired by their ability to

distinguish between important and unimportant stimuli. For example, a developmentally delayed

child walking into a classroom may be unable to recognize the space because all the chairs are

pulled out from their desks.

Classrooms, that have too much stimulus on the walls, doors, and desks can create havoc

in a neurologically delayed individuals mind. It becomes difficult for the individual to pay

attention to verbal instruction when there are many things occupying their sight. Therefore, in

areas where learning is essential, modifications should be made to simplify the environment and

reduce the amount of stimuli. This goal is illustrated through the conversion of a childs play room

into a therapy room by simplifying the space. (see photos A and B). The striped, yellow wallpaper

with a primary color border (photo A) was changed to a muted pink (photo B), which has been

shown to be a favorable color for people with learning disabilities. Additionally, all wall hangings

and visual stimuli have been removed or placed out of the view of the child while sitting at the

table. The carpeting was removed due to allergies and a pre-finished hardwood floor was

installed. A 100% wool carpet with jute back for play therapy and floor activities was chosen for

its low toxic, off-gassing (allergy related) attributes.

-

Impications, volume 6 issue 04, A.J Paron-Wildes, 2005

Mentally impaired children must have a different approach in terms of design, in this article they

use classroom as an example, little detail that can affect the learning and comfort ability of a

child, finishes, lighting fixtures and even signages can affect so much on the child learning ability.

In creating outdoor environments for children across the autism spectrum, design

considerations must address a broad range of challenges experienced by this population. Because

many of these challenges are shared by children with related disorders, the issues faced by a

large population of children with special needs can be accommodated with thoughtful, creative,

inclusive design.


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One goal of these environments should be to help children apply the lessons they learn in

the classroom to real-world environment, providing them with coping skills outside of the

classroom. However, heightened sensory issues are one of the most common challenges for

children with ASDs. It can be difficult for them to filter the amount of information coming at them

all at once in outdoor, public spaces. Therefore, outdoor environments for this population should

be both comfortable and supportive as they encourage skill-building.

- Outdoor Environments for Children with Autism and Special Needs, Naomi Sachs,

ASLA and Tara Vincenta, ASLA, 2011

Indoor environment should not be the only focus of the designer, the outside environment of the

building can largely affect the rehabilitation of a child with mental disability. For example, a

garden of a school should be carefully planned and designed, because this is the transition space

of them from indoor to outdoor community.

My design solution focused on providing unique spaces that would give the best possible

experience for residents who come from very difficult situations, as well as promote Mountain

Comprehensive Cares foster care services so that this project might encourage the receipt of

additional funding for projects that arise in the future. The result called for a home that comforts

users with soft, but durable textures, subtle colour, and easy flow of space. The use of natural

light, visual connections to the landscape, colour and a manipulation of space to create a pleasant

uplift to the occupants were integrated into a cohesive design solution. A vision of how the house

was to function was developed early, focusing on the users daily schedule and personal

responsibilities within the house. When space planning, it was necessary to address interactions

between male adolescents and plan for opportunities in which they could engage in community. A

stream words geared to a researched and psychological design response narrowed into three,

becoming the core of my design solution: heal, grow and become. These three words became the

core concept of my design and were translated into three dimensional space diagrams driven by

program requirements from the user. These three words work together, creating programs that


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often overlap. They may also operate individually, to define an area of program, unique to itself

and separate from others.

In healing, the child needs views to the outside in an open atmosphere. The child

also needs views to the outside in an open atmosphere. The child also needs areas of intimate,

private space. The design addresses this through personal spaces, such as bedroom, it is also

addressed with a therapy room that can be used for individual sessions, significant as a separate

place of recovery.

In growing, just as a plant needs space, light and flexibility, there are spaces within

the home that offer each of these things. Community spaces on the first level transform from

eating area, to lounge, to places to do homework, create, play games, chat on the back porch, or

play outside. An open landing on the second floor creates new community within the living core.

Here, a glass curtain wall overlooks the first floor and enables a child upstairs to see when their

housemate comes home or when a guest arrives. The design of this wall also enables light to

filtrate upstairs, brings second level monitoring capabilities for staff, and establishes a cohesive

relationship between the once separate two floors. In order to become one needs personal

space, areas to reflect, and opportunities of responsibility. The design addresses this through

adequate bedroom space for each individual equipped with furniture they can call their own.

Responsibilities include gathering personal laundry and linens each week and the potential of

contributing to a community garden on the plot of land behind the home. While activity in the

home is staff-monitored and well-organized, these new programs for space now create safe areas

in which the users have choices in their experiences in the house; a sense of freedom to enjoy

home as they choose.

-

The Design of a Psychiatric Residential Treatment Facility in Wheelwright, Kentucky

Serving Adolescent Males, Jenna Clem, 2011

The basic design concepts like texture, color, light and others must work accordingly in order to

properly rehabilitate in-patient residence with mental disability. The imbalance use of these basic

design concepts can greatly affect the health of the patients. In this article, the writer suggests


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that the facility must promote freedom without comprising the patientsprivacy. Rooms and

spaces must be flexible to make them feel that they are not inside an institution but instead, a

facility to enjoy and learn.

Community-based psychiatric inpatient units

There are 19 community-based psychiatric inpatient units available in the country for a total of

1.58 beds per 100,000 general population. Only 1% of beds are reserved solely for children and

adolescents. Thirty seven percent of admissions are female, while 6% of admissions are

children/adolescents. The diagnoses of admissions to community-based psychiatric inpatient are

primarily from the following two diagnostic groups: schizophrenia and related disorders (63%)

and mood disorders (24%). On average patients spend 69.65 days per admission. The majority

(51-80%) of patients in community-based psychiatric inpatient units received one or more

psychosocial interventions in the last year. All of community-based psychiatric inpatient units

have at least one psychotropic medicine of each therapeutic class (anti-psychotic, antidepressant,

mood stabilizer, anxiolytic, and antiepileptic medicines) available in the facility.

Community residential facilities

There are fifteen community residential facilities, or what is casually referred to in the Philippines

ashome-care facility. They are mostly available in urban areas. They provide for a total of .61

beds/places per 100,000 general population. About 3% of the beds in community residential

facilities are reserved for children and adolescents only. Thirty three percent of users treated in

community residential facilities are female and only 2% are children and adolescents. The

number of users in community residential facilities is 1.09 per 100,000 general population.

Mental hospitals

There are two mental hospitals available in the country for a total of 5.57 beds per 100,000

general population. Two percent of these beds are reserved for children and adolescents only.

Thirty eight percent of admissions in mental hospitals are female. The two hospitals are

organizationally integrated with mental health outpatient facilities. The patients admitted to

mental hospitals belong primarily to the following two diagnostic groups: schizophrenia and


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related disorders (71%) and mood disorders (18%). The number of patients in mental hospitals is

8.97 per 100,000 general population. The average number of days spent in mental hospitals is

209. Sixty-four percent of patients spend less than one year, 18% of patients spend 1-4 years,

13% of patients spend 5-10 years, and 5% of patients spend more than 10 years in mental

hospitals. Some (21-50%) patients in mental hospitals received one or more psychosocial

interventions in the last year. One hundred percent of mental hospitals have at least one

psychotropic medicine of each therapeutic class (anti-psychotic antidepressant, mood stabilizer,

anxiolytic, and antiepileptic medicines) available in the facility. There has been neither an

increase nor a decrease of number of beds in the last five years. The occupancy rate is about

92%.

Forensic and other residential facilities

In addition to beds in mental health facilities, there are also 400 beds (0.47 per 100,000 general

population) for people committed by courts for confinement in forensic inpatient units. All forensic

beds are located at the National Center for Mental Health. Thirty three percent of patients spend

less than one year, 38% of patients spend 1-4 years, 25% of patients spend 5-10 years, and 4%

of patients spend more than 10 years. There is only one residential facility (with 540 beds)

specifically for people (of any age) with mental retardation. This facility is managed by the

government social welfare service, which now operates beyond its bed capacity. There are six

facilities (250 beds - private and public combined) specifically for people with substance abuse

problems. There is one facility that cares for senior citizens aged 60 and above, both male and

female, who are abandoned, neglected and mostly suffering from dementia.

- WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN THE PHILIPPINES, 2007

The need for a youth in-patient with mental disability is clearly shown through these statistics,

there are no facilities that solely belong to the youth, they share with adults with them in a little

percentage, imagine living in a world where there is only a little to interact with, instead of

rehabilitating this can add to the stress of the patient.


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The Philippines have a National Mental Health Policy and spends about 5% of the total

health budget on mental health. The National Program Management Committee of the

Department of Health (DOH)acts as the mental health authority. There are 46 outpatient mental

health facilities available, of which only 28% are allocated for children and adolescents. There are

only four day-treatment facilities, of which 7% of the patients are children and adolescents. There

are 19 community-based psychiatric inpatient units, of which only 1% of beds are reserved for

children and adolescents. There are 15 community residential facilities, known ashome-care

facilities, located mostly in urban areas. Approximately 3% of the beds in these home care

facility beds are reserved for children and adolescents, and these age groups comprise 2% of its

patients. There are two mental hospitals available in the country, and only 2% of their beds are

reserved for children and adolescents. There has been no increase in the number of psychiatric

beds in five years. On average, approximately 27 per 100,000 of the general population use these

services. The average length of stay in mental hospitals is 209 days. In each of these facilities

and programs psychotropic medications are reportedly 100% available (WHO AIMS, 2007).

In 2002, the National Mental Health Program (NMHP) was reactivated. They identified the

following four of six areas of concerns to be prioritized: mental disorders, substance abuse,

disaster and crisis management, and women, children and other vulnerable groups. In the

treatment of mental disorders, the NMHP has indicated support for the policy shift from mental

hospital-based psychiatric treatment to community-based mental health care. This integration of

mental health care in general health services proposes, as a first step, the opening up of acute

psychiatric units and outpatient clinics in all 72 government hospitals, and the provision of

psychiatric medications. Budgetary constraints have allowed only 10 hospitals to open outpatient

clinics (Conde, 2004).

-

Child Mental Health in the Philippines, 2013, Consuelo Cagande

Just like the previous article the need for mental facility solely for the youth is shown clearly on

the statistics.


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I.2.2. RELATED STUDIES

RELATED STUDY ( FOREIGN )

Child and Adolescent Mental Health In-patient Unit, Merlin Park, Galway

Architects: MOBMoloney OBeirne

Architects

Location: Taylor Hill, USA

Year: 2010

No. of wards: 2

No. of beds: 20

Age: 0-18 years

MAJOR SPACES:

Sports hall

Dining Area

Conference room

Art therapy

Staff room

Catering

Court yard

Parents apartment

Childrens unit

Adolescents unit

Special care unit

Special care unit garden

Clinical support

Nurse station

Games room

Therapy room


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SITEDEVELO

PMENT

PLAN

Observation room Administration


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SECTION

ELEVATION


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The facility is the relocation of St. annes childrens centre from their older location in taylor hill. It

was relocated within the grounds of Merlin Park Hospital. Administration, childrens in-patient,

therapies, adolescent in-patient and special school are the five main functions of the facility.

The goal of the children psychiatric facility is to provide appropriate levels of assessment and

intervention to the children with mental or behavioral problems, in order to attain and maintain a

good state of mental health.

In order to identify specific goals for medication, rehabilitation and recovery, the in-patient and

day patient treatment program will focus on working with children and their families to clearly

apprehend the nature of their problems, in a cutting edge youth mental health programs, striving

to offer a flawless transition between in-patient, day hospital and community services.

FEATURES

1.

Facilities were modern, good natural lighting, spacious and well ventilated.

2.

Internal glass walls gives a sense of space and light reaches throughout the inside

facilities.

3.

Large windows to provide views on the outside landscape.

4.

Rooms has a direct access to gardens

5.

A sleeping quarter for parents visiting from afar.

6. A very bright atmosphere which can help the patient in a therapeutic sense.


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FACILITY COMPLIANCE WITH MENTAL HEALTH ACT 2001 (APPROVED CENTRES)

REGULATIONS 2006

1. DETAILS OF WARDS IN THE APPROVED CENTRE

2. RECREATIONAL ACTIVITIES


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3. RELIGION


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4. VISITS


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5. CHILDRENS EDUCATION


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6. CARE OF THE DYING


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8. PRIVACY


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9. PREMISES


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10.USE OF CCTV

CHAPTER I.3 RESEARCH METHODOLOGY

In this chapter, research design, population and sampling, research instruments used

for data collection will be discussed.


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I.3.1. RESEARCH DESIGN

Case study, Interview and brainstorming research design was used, because its the

most suited to answer the stated problem and purposes of the study.

The case study research is one in which studying the strength, weakness,

opportunities and threats of an existing same facility which can serve as a guide to the study.

Interview and brainstorming research design is in which you gather informations, suggestions,

and other data needed for the study through communicating orally with the professionals, nurses,

maintenance, security and other people which can serve as a stand-in respondents for the target

market which is the mentally-disabled children and adolescents.

CASE STUDY

Administration Building ( Main Lobby )


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Administration Building ( Hallway )

Main lobby of the whole complex of NCMH is located at the center. Offices like directors office,

engineering office and other offices are located at this building. Compare to other buildings,

Admin Building are well maintained. Offices are too crowded except the directors office, it was

not photo documented because of privacy.

Outdoor Recreation Facility

This court is located in front of the Administration Building. Outsiders can rent this court to play.

Shade is not provided, which is why it cant be used during the day , if there is too much sun, and


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cant be used during evenng because there is no lighting fixtures installed to light the court. It is

very dangerous to use by the patients because the flooring is the same as driveway which is

rough concrete.

Drive way/Walk way going to Childrens Dept.

Drive way/Walk way going to Childrens Dept.


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You have to go to Admin Building before going to Children Department. There is no sidewalk

available on the driveway going to the said department. It is also the route to go to outside

recreation activity.

Outdoor signages

There are few outdoor signages around the complex, it is 2.3 m high and little text on every

signages. It is difficult for patients to read which will is not recommended, because the complex

will not be self-reliant.


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School for Special Education

Interior of School

The school has only 2 classrooms. Its already deteriorating, and the classrooms plan is like the

normal classroom design. The interior of classrooms was not photo documented because its

locked. The school is used once a week.


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Boys Facility (Shang-Rila)

Playground

The playground is located outside of the Shang-Rila and adjacent to porch of the building. The

playground is unusable. According to the nurses its unsafe to let the children play on their own,

because of the risk of injuries and security, flooring is rough concrete, and the equipments are

already deteriorating and full of rust.


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Nurse station

Nurse station of the Shang-Rila is Facing the wards and isolation that is divided by rehas. At the

back are nurse locker and doctors office.

Dining Area

Tables and chairs are fixed, made of concrete finished by ceramic tile. Window are made of steel

for protection just like the other windows on the building. Lack of lighting fixtures and high ceiling

make the room dark during the evening.


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Fire Exit

Signage on top of the fire exit doors hard to read cause the text are already fading. Fire exit

leads to outdoor landscape.

Indoor Signages

Indoor signanges are placed in top of every door room.


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C.R

Window are also made of rehas, high ceiling for the patients safety in case they want to take

suicide. C.R. are dark and cramped.

Girls department ( Zonta )

Zonta is the building for children and adolescents girls.


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Zontas Lobby

Zontas lobby are composed of nurse station, waiting are and visitors are. Nurse station are

facing backwards towards the ward which is not favorable to nurse on duty, because they will not

see immediately what the patiens are doing. Visitors area are not private and overlooking to the

wards.

Zontas Social hall


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This is the place where they conduct their activities once or twice a week. Furniture like chairs,

tables, blackboards and the like available inside. Flooring is made of ceramic tile, windows are

made of steel bars.

Therapy Room


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EXISTING SHANG-RILA FLOOR PLAN


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EXISTING SHANG-RILA FLOOR PLAN


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AS-BUILT SITE DEVELOPMENT PLAN


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A mock facility review under the compliance with administrative order no. 2005-0029

of the DOH for custodial psychiatric care facility. The researcher is the one who scored the

checklist. Summary and recommendation after to prove the scores.

Republic of the Philippines

Department of Health

CHECKLIST FOR REVIEW OF FLOOR PLANS

ACUTE-CHRONIC PSYCHIATRIC CARE FACILITY

Name of Facility: NCMH, Zonta and Shang-rila division

Address: Mandaluyong City

Rate the Condition: 1=excellent 2=good 3=fair 4=bad

*note: unanswered facilities are not available or not visited by the researcher

1 PHYSICAL PLANT

__3__ 1.1 General Administrative Service

_3__ 1.1.1 Waiting Area

__3__ 1.1.2 Information, Reception and Business Office

__2__ 1.1.3 Office of the Administrator

__4__ 1.1.4 Toilet

__4__ 1.1.5 Laundry and Linen Area

__2__ 1.1.6 Garage

__2__ 1.1.7 Supply Storage Area

__3__ 1.1.8 Waste Holding Area

____ 1.1.9 Dietary

__4__ 1.1.10 Dining Area


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__3.75__ 1.2 Clinical Service

__3.5__ 1.2.1 Admission, Discharge and Follow-up Unit

____ 1.2.1.1 Admitting and Records Area

____ 1.2.1.2 Consultation Area

__4__ 1.2.1.3 Examination and Treatment Area

___3_ 1.2.1.4 Equipment and Supply Storage Area

_4___ 1.2.2 Nursing Unit

__4__ 1.2.2.1 Private / Semi-Private Room

__4__ 1.2.2.2 Ward

__4__ 1.2.2.3 Observation Room

___4_ 1.2.2.4 Toilet

__4__ 1.2.2.5 Nurse Station with Work Area and Lavatory/Sink

__3.5__ 1.3 Ancillary Service

_3.5___ 1.3.1 Psychosocial Unit

__4__ 1.3.1.1 Indoor Activity Area

__3__ 1.3.1.2 Outdoor Activity Area

2 PLANNING AND DESIGN

__4__ 2.1 Floor plans properly identified and completely labeled

__2.5__ 2.2 Conforms to applicable codes as part of normal professional service:

__2__ 2.2.1 Minimum of two (2) exits, remote from each other, for each floor of the

building

__2__ 2.2.2 Exits terminate directly at an open space to the outside of the building

__4__ 2.2.3 Minimum of one (1) toilet on each floor accessible to the disabled

_3,5___ 2.3 Meets prescribed functional programs:

__2__ 2.3.1 Main entrance of the facility directly accessible from public road

__4__ 2.3.2 Admission, discharge and follow-up unit located near the main

entrance of the facility

__2__ 2.3.3 Separate toilets and wards for male and female patients


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__4__ 2.3.4 Nurse station located and designed to allow visual observation of

patient and movement into the nursing unit

_4___ 2.3.5 Toilet immediately accessible from each room in a nursing unit

COMMENT:

The Znnta and Shang-Rila department needs an overall rehabilitation inside and

outside/landscape. They failed almost all of the category especially the nursing unit were the

review is bad. Especially the wards and isolation rooms. Materials on flooring, partitions and

lighting fixtures must be replaced. Rubberized flooring to avoid harm is advisable, prevention of

using rehas as a partition and replacements of broken lighting fixtures. Security of the patients

is also at risk because of the orientation of nursing station.

I.3.2. POPULATION OF THE STUDY

The target populations of this project are children suffering from psychiatric disorder

from at least 5 regions in Luzon and Visayas, and their families. Professionals, nurses and

students in the field of psychology and neurology specializing in children and adolescents mental

health.

10% of all types of disability in the Philippines are suffering from psychiatric and

intellectual disorders. Central Luzon has a total of 38, 889 residents with disability according to

2010 NSO census age ranging from 0-19. The number of residents suffering from mental and

intellectual disability is 3, 889. 25% of those are treated in community based inpatient,

community residential facilities and mental hospitals or a total of 972 children. The total

population which this proposal will cater according to statistics excluding patients coming from

different regions that may be admitted.


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1.

4 nurses from NCMH agreed that the mental hospital reflects a detention facility

atmosphere because of the materials and design used on partition walls.

2.

Patients are not allowed to move around the gardens and landscape areas because of

poor security, the NCMH surrounding are like forest. PGH doesnt have outdoor area for

psychiatric patients.

3.

Children in NCMH doesnt have a private room , wards only. PGH facility was not studied.

4. PGH and NCMH provide children their regular health medication, education and physical

exercises needs. However there are flaws, in education on NCMH , there are only 2

classrooms, and the facility was a rubble.

5.

Physical activities was provided in NCMH , for boys: Basketball, for girls: Zumba

6. On NCMH the visitors area was just adjacent to wards, so according to nurse its much

better if separated a few meters away or outdoor would be preferred. On PGN there is

none only visit inside the wards.

7.

Patients on both hospitals cant move around freely because of security in landscaping

are poor, they only move around the hallway around their wards for those patients that is

already healed and just needs more time.

8.

NCMH conducts mass in their gymnasium once a week, social outdoor activity was not

provided.

9. The NCMH facility was not adapting to change in terms of modernization, the facility is

very outdated because of lack of funds.

SUGGESTIONS:

1.

Better landscape, but within the eyesight of nurses.

2.

Better facility for education.

3.

Dayroom and sports complex which is secured for children suffering from mental-

disorder.

4. Dull colors of rooms, neon colors are not advisable because it can trigger patients on

doing something.


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5.

Rubberized isolation rooms and wards.

6. Much better partition that nurses can se the patient inside, not rehas.

7.

Non-skid tiles are advisable.

8.

Lighting fixtures that is not that bright in wards.

9.

Much better natural ventilation because air-conditioning is not provided.

I.4.1. COLLECTED DATA

INTERVIEWS:

KENNETH CATAPANG

ARISTOTLE TRINIDAD;

NCMH, Shang-rila department nurses.

1.

What do you think about the proposal ?

-

It good that the children are separated from adults.

2. Does your facility reflect an detention facility atmosphere?


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-

Yes

3.

Does the children have private rooms?

-

No , only an isolation room, and the partition is rehas

4.

Do you have facility for pediatrics, educational and physical needs?

- pediatrics=yes

- educational , yes but needs rehabilitation

-physical needs- not really , sports complex are not safe.

5.

Do you place dor family visit?

-

Yes, adjacent the wards

6.

Do patients move around freely?

- Yes inside the pavilion, outside no, security is poor.

7.

Do you place for spiritual activity?

-

Yes , every Sunday mass at gymnasium.

8.

Does the facility adapting to modernization ?

- No, lack of budget

9.

Any suggestions?

-

More safer sports complex

-

Ideal isolation room

- Dull colors finishes

-

Non-skid tiles

-

Better landscape

HANNAH SANTOS

JESSA MAE MANZANO

NCMH, ZONTA department nurses

1.

What do you think about the proposal ?

- Better facility for children

2.

Does the children felt discomfort if they are surrounded by adults?


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-

Not realy, they are usually separated, they will just meet occasionally for certain

events.

3.

What can you say about the education of the children?

-

Under-sped, same room for all

4.

What type of physical activities do children do?

-

Zumba, monthly activities

5. Is there any facility you lack that you think is important?

-

Spiritual activity for children

6.

What is your common problems inside the facility?

-

Hot, broken lights

7. Is there a need for a modernized psychological research center ?

-

Yes.

8.

Suggestions?

-

Better isolation room

- Nursing station must see all the wards ( no blind spot )

-

Light colors

-

Lighting fixtures that is not to bright

ACEJO CATULANG

PGH, children psychiatric ward department

1.

Does your facility reflect an detention facility atmosphere?


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-

Not really

2.

Does the children have private rooms?

-

None, restricted because of the facilities

3.

Do you have facility for pediatrics, educational and physical needs?- Pediatrics, yes, doctors maintenance support- Education, none- Physical needs, exercise

4.

Do you place for family visit?

-

None, ward visit only

5. Do patients move around freely?

- Yes inside the department, outside is prohibitted

6.

Do you have place for spiritual activity?

-

Yes, chael

7.

Does the facility adapting to modernization ?

- Dont know

8.

Any suggestions?

-

None


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I.4.2. NEED ANALYSIS

According to WHO-AIMS report on Mental Health Systems in the Philippines back in

2007, there are 19 community-based psychiatric inpatient units in the country, for a total of 1.58

beds per 100,000 general populations; only 1% is for children and adolescents. And a total of 15

community residential facilities in the Philippines or home care facility. They provide a total of

.61 beds per 100,000 general populations; about 3% of the beds are reserved for children and

adolescents. There are only 2 mental hospitals in the Philippines, a total of 5.57 beds per 100,000

general population 2 percent of those are reserved for youths. There has been neither an

increase nor a decrease of number of beds in the last five years. The occupancy rate is about

92%.

Average number of days spent in mental hospitals/facilities in the Philippines are;

64% of patients spend less than a year, 18% of patients spends 1-4 years, 13% of patients

spend 5-10 years, 5% spend more than 10 years. In the U.S the average length of stay in the U.S

is 7.2 days

Luzon has 7 regions; NCR, Bicol, Cagayan Valley, Calabarzon, Central Luzon,

Cordillera and Ilocos. The average patients per region in Luzon are 47 patients/region. The total

population of Luzon according to NSO as of 2010 is 48, 520,774. Number of People with disability

ranging from 0-19 years of age according to 2010 NSO census:

REGION NO. OF PERSONS

WITH DISABILITY

NO. OF PEOPLE

W/PSYCHIATRIC OR

INTELLECTUAL

DISABILITY (10% OF

PEOPLE WITH

DISABILITY)

NO. OF PATEINTS

THAT NEEDS

TREATMENT IN AN

INPATIENT

FACILITY (25% )

NCR 34, 244 3, 424 856

CORDILLERA 7, 049 705 176

ILOCOS 19, 067 1, 907 477


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CAGAYAN 14, 200 1, 420 355

CENTRAL LUZON 38, 889 3, 889 972

CALABARZON 45, 917 4, 592 1148

BICOL 26, 254 2, 625 656

TOTAL 185, 620 18, 562 4, 640

Central Luzon has a total population according to NSO census in 2010 of 10, 137,737.

If we used the information the WHO-AIMS report in 2007 these are the number of beds provided

for children and adolescents treated right now in an in-patient psychiatric facility are as follows:

Community Residential Facilities .62

Community-based psychiatric Inpatient units 4.81

Mental Hospitals 11.29

TOTAL 16.72

The total number of children and adolescents that needs treatment in an inpatient

facility in Central Luzon Region is 972 youths and the numbers of beds provided for them are only

16.72 beds and this numbers doesnt increase in the last 5 years.

The need for a new Regional Psychiatric Facility is clearly shown in numbers. Only

1.72% of patients that needs inpatient treatment are provided with bed/shelter. Overcrowding in

metal facilities will surely increase more in numbers in the near future, and this facility can help

control those issues especially in Central Luzon and also can provide help for other institutions in

the country.


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RESULTS OF SURVEY

PROFILE OF RESPONDENTS

1.1.

AGE OF RESPONDENTS

AGE NUMBER PERCENT

20-29 2 6

30-39 7 22

40-49 13 52

50 and above 4 20

TOTAL 26 100

1.2.

GENDER OF RESPONDENTS

GENDER NUMBER PERCENT

Male 3 11.5

Female 23 88.5

TOTAL 26 100

1.3.NUMBER OF CHILDREN W/ MENTAL DISABILITY

CHILD NUMBER PERCENT

1 21 81

2 or more 5 19

TOTAL 26 100

1.4.

STATUS

STATUS NUMBER PERCENT

Single 4 16

Married 20 78


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Widow 2 6

TOTAL 26 100

1.5.EDUCATIONAL ATTAINMENT

EDUCATION NUMBER PERCENT

Elementary 4 15

High School 15 58

College 7 27

TOTAL 26 100

1.6.

RELIGION

RELIGION NUMBER PERCENT

Catholic 21 82

Christian 4 14

Iglesia ni Cristo 2 4

TOTAL 26 100


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PARENTS BASIC KNOWLEDGE

2.1.How sure are you on the disability of your child.

The percentage of respondents answered very knowledgeable that they are aware of

the disability of their child are 83%. Some of the respondents answered; knowledgeable, not

knowledgeable and dont have a cluewith the percentage of 12%, 3% and 2% respectively.

2.2.How confident are you that you can control him/her.

The respondents was asked to rate how confident are they that they can stop the

child is the worst case scenario happen. The respondents rated are as follows: Very Confident=

19%, Confident= 11 %, Not Confident= 16% and Strongly Not Confident= 54%.

Percentage breakdown

Very Knowledgeable

Knowledgeable

Not Knowledgeable

Don't have a clue

Percentage Breakdown

Very Confident

Confident

Not Confident

Strongly Not Confident


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2.3. How secured are you feeling when he/she is around.

The respondents were asked if they are feeling some insecurity whenever the patient

is in the surrounding/their home. They are asked to rate it as Very Secured to Scared if they are

very uncomfortable whenever the patient is around. The respondents responds in terms of

percentages are as follows: VerySecured = 2%, Secured = 9%, Not Secured = 34% and Scared=

55%.

2.4. Are you shy about having a child like that?

The respondents were asked how shy are they to other people knowing they have

relatives with a mental disability. The respondents answers were: 62% said they are shy having a

relative like that while 38% said no.

Percentage Breakdowm

Very Secured

Secured

Not Secured

Scared


Yes

No


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2.5. How sure are you that he/she will recover.

The respondents were asked to rate if they are still hopeful that their child will

recover on his/her disability. This is to identify which respondents are willing to give their child

the prescribed medication of the professional. The respondents were asked to rate how hopeful

are they being 5 as Very Sure/hopeful and 2 as the Hopeless. These are percentage as follows:

Very Sure = 67%, Sure = 28%, Not Sure = 4% and hopeless in 1%.

2.6. How confident are you that an institution/hospital can help him/her.

The respondents were asked to rate their confidence/trust they are giving on the

institution or hospitals were their child is confined. The percentage breakdown were as follows:

Very Confident = 67%, Confident = 32% , Not Confident = 1%.


Very Sure

Sure

Not Sure

Hopeless


Very Confident

Confident

Not Confident

Dont trust


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2.7. Do you keep it a secret/ having a mentally disabled child?

The respondents majority answer was No having an 83% and some of the

respondent answered that they are shy or keep it a secret between family members with a 17%

percentage.

PARENTS INSTITUTION/HOSPITAL SATISFACTION

3.1. Are you still seeking for institution/hospital that will suit the needs of your child?

(if there is already rate how contended are you )

The respondents were asked to rate how satisfied are they on the current Institution

or hospital were their child is confined. The respondents Percentage Breakdown of answers were:


Yes

No


Very Contented

Contented

Not Contented

Strongly Not

Contented


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Very Contented at 43% , 32% answered that they are Contented, not contented parents were

19% of the respondents and 6% of the respondents was Strong not satisfied on the institution or

hospital.

3.2. How confident are you on giving the full responsibilities of your child to the

institution/hospital?

The respondents were asked to rate how confident they are on trusting and giving

the institution or hospital the full responsibility over their children. The detailed percentage

breakdowns are as follows: 61% said they are very confident and 39% said confident.

3.3. Do you see it as a detention facility?

Percenntage Breakdown

Very Confident

Confident

Not Confident

Strongly Not

Confident


Yes

No


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The respondents were asked if they think the hospital or institution as a detention

facility just like a prison. The detailed percentage breakdown are as follows: 38% said yes and

62% answered no.

3.4. Does it provide the needs of your child in terms of facility complimenting his

disability?

The respondents were asked if they are happy and contented on what they are child

getting in terms facilities provided for them. Thus the facility compliments the needs of different

type of mental disabilities. 91% answered that they think they are getting what are needed for

their child and 9% said that they dont.


Yes

No


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3.5. How satisfied are you on the wards and isolation rooms?

The respondents were asked to rate what they think and probably the patient think

on the wards and isolation rooms provided for them. 31% said that they are Very Satisfied, 42%

are Satisfied, 22% are Not Satisfied and 5% are not Strongly not satisfied.

3.6. Rate how satisfied is you on the education they are giving your child.

The respondents were asked if they are satisfied on the education and educational

facilities the patient are getting on their own Institution or Hospital. 42% were Very Satisfied,

18% were Satisfied, 16% were Not Satisfied and 4% were Strongly Not Satisfied.


Very satisfied

Satisfied

Not Satisfied

Strongly Not Satisfied


Very Satisfied

Satisfied

Not Satisfied

Strongly Not Satisfied


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3.7. How satisfied are you on the facilities provided for physical activities or sports?

The respondents were asked how satisfied are they in terms of physical activities or

exercise, are they provided with the facilities, if yes how satisfied are they. 22% of the

respondents were Very Satisfied, 47% were Satisfied, 27% were not Satisfied and 4% were Very

Not Satisfied.

3.8. How was the place or room intended for you when you visit?

The respondents were asked to rate their satisfaction on the room or place intended

for them when they are visiting the patients, are they happy, are they given enough privacy and

so on. 23% of the respondents were Very Satisfied, 38% were Satisfied, 29% were Not Satisfied

and 10% were Very Not Satisfied on the facility.


Very Satisfied

Satisfied

Not Satisfied

Very Not Satisfied


Very Satisfied

Satisfied

Not Satisfied

Very Not Satisfied


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3.9. Does it provide spiritual facilities complimenting your religion?

The respondents were asked if the facility intended for spiritual activity are

complimenting to their religion. 57% of the respondents who said Yes are Catholic in majority,

while the respondents that said No are all non-Catholic, the other 25% said that it doesnt matter

whether they are provided with the said facility.

3.10. Can they move around freely? (for the patients near recovery)

The respondents were asked if the patients near recovery can move around within

the facility and the outdoor environments like gardens, courtyards and other outdoor area. 38%

said that their child can move around freely but not outdoor because of security, the other 62%

said No.


Yes

No

Doesnt matter


Yes

No


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I.4.4. QUALITATIVE ANALYSIS

INTERVIEW APPROACH

The method used on the interview conducted is combination of the informal

conversational method and the standardized open-ended interview.

The informal conversational method questions flow from immediate context; there is

no predetermination of questions, topics or wordings. This to better understands the needs and

to better express their thoughts on the topic.

Standardized open-ended interview however is a method were the questions you

asked on each of the interviewees are the same, in order and predetermined. This was used in

order to get the informations needed for the research.

INTERVIEW RESPONDENTS

In total, there are 3 qualitative interviews conducted. It was single out to staffs,

because of their familiarity to children and adolescents with mental disabilities department or

institution. Staffs from two different hospitals that has this type of department were visited, the

National Center for Mental Health located in Mandaluyong City and Philippine General Hospitals

Located in Manila City, around the Taft avenue. There are 2 head nurse and 1 maintenance that

was interviewed.

Hannah Santos

Head Nurse, NCMH, Zonta Pavilion


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Aristotle Trinidad

Head Nurse, NCMH, Shangri-La Pavilion

Acejo Catulang

Maintenance, PGH, In-patient Psychiatric

Department

SUMMARY OF THE DATA GATHERED

Hannah Santos Interview:

- She insists on a much better facility because their department was already old and

deteriorating. The education of her patients in terms of facility is not appropriate for them

because it was mostly monotonous, means they only have single facility and type of

education for all types of mental disability of the children. Physical activities like Zumba

(patients in this department are all girls) were conducted on the sports complex. Spiritual

activity was conducted weekly on the indoor sports complex, but a facility solely for

spirituality without compromising the security of the patients is more favorable.

Ventilation is also a big problem on Zonta department, walls are made of concrete on the

bottom and a rehas on top. He also point out the positioning of their nursing station

where it was not directly facing the wards. The materials and finishes was also been part

of the discussion, a neutral paint finish is the most appropriate for this type of facility.

She also point out the use of lighting fixture, she suggest that a dimmer lighting for the

wards just like in a normal bedroom.


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Aristotle Trinidad

- Mr. Trinidad promote their facility because the children and adolescents are separated

from adults unlike in the other facilities. He insisted that the facility has a tremendous

potential which is thrown to waste because of lack of support from the government.

There are various activities for the patients of Shangri-La Department, like therapeutic

and basketball activities which is done in the existing sports complex of the NCMH. Even

though Sports Complex is provided he point out that it would have been better if the

materials used are much safer, he also insisted on a safer dayroom. A visitors room

which is private must be provided. A much better landscaping is highly advisable, unlike

on the existing outdoor areas of the NCMH. Just like Ms. Santos said a dull colors for wall

finish are advisable. A rubberized floor and walls for the ward and isolation room are

preferable if the budget is not limited. He also point out the type of isolation room they

have which is open, it would have been better if its private.

Acejo Catulang

- Unlike the previous two interviewees Mr. Catulang is a Maintenance staff of the PGH,

Psychatric Department. Because of it being inside a General Hospital the patients were

restricted inside on their wards only they cannot move around. Adults and Youths are

both on the same department. There is no place for education, physical and spiritual

activities. Visitors are accommodated inside the wards and doesnt have a proper place

for visit where they have privacy.

I.4.5. CONCLUSION

The data gathered in different types of method was a big help to achieve the main

goal of the proposal which is to promote self-reliance to the patients, while rehabilitating mentally


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and physically without compromising their social, educational and family interaction in order to

prepare them for the mainstream society.

Using the review of related literature, gathering of the information needed in order to

prove that the stated problems and significance of the study really exists. Through this review of

articles, books and other literatures, the researcher have now a wide range of view of what is the

facility about and the existing problems other than the problems stated.

Related facilities were studied to become a model facility to better understand the

planning and facilities required and necessary on this kind of facility. The researcher uses 3

methods of gathering informations, which is: interview, survey and case study. The researcher

picked National Center for Mental Health, shangri-la and zonta pavilion to conduct a case study,

the facility was documented through photographs. The researcher conducted survey on the

parents of patients suffering from mental disability. The survey was divided into three parts the

respondents profile, parents basic knowledge and facility satisfaction. The researcher interviewed

three persons 2 nurses and 1 maintenance.

Through this research method that was used to gather necessary informations, and

the data collected, the researcher therefore conclude that problems stated in Chapter 1.1 actually

exist and needed actions.

Specifically:

1.

Mental facilities/hospital projecting an image of a detention facility like prison.

2. Environment is were not designed to meet the needs of the users, especially the special

needs of a person suffering from mental disability.

3.

Further minimization of patients hurting themselves inside the wards and isolation room

through materials, finishes and proper orientation.

4. The plan and design of educational facilities is not meant for patients suffering from

mental disability but rather designed using the standard of an ordinary classroom for

normal people.

5.

Sports complex that is safe for the users.

6.

The promotion of individual dignity.


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7. Space for relatives interaction.

8. And self-reliance of the facility were patients can move around whether indoor or outdoor

without compromising the security.

I.4.6. RECCOMENDATION

The following recommendations are suggested for related research in the field of

psychiatry and neurology specializing on children and adolescents.

1. Because of the lack of time in doing this research study, I would suggest to continue this

research which will include outpatient facilities.

2.

For further improvement and development of the design standards done in designing this

type of facilities, I would suggest a research on the technological advances of the field of

psychiatry in terms of facility.

3.

I would also suggest the study of the laws governing the design standards used on the

existing facilities.

PART II. RESEARCH FOCUS

CHAPTER II.1 RATIONALE

The early and widely used lunatic asylums, the treatment of patients/inmates was

brutal and focuses mainly on containment and restraint. Psychiatric hospitals have evolved as

successive waves of reforms were introduced. However, psychiatric care in the Philippines

especially in terms of facility was as if frozen in time, based on the research methodology

conducted on the previous chapter of the research. Modern psychiatric facilities starting to

introduce evidence-based treatments that emphasize on curing with the use of combination of

psychiatric drugs and psychotherapy.


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Authors and professionals criticize the outdated design of the facilities. Psychiatrist

Thomas Szasz insisted that Mental Institution and Prison or any detention facilities are identical to

each other, medication and nursing staff acts as if a judge and jailers. A book entitled Madness

and Civilization was an instrument used to criticize psychiatric facilities, the author was the French

historian Michel Foucault.

Seclusions and restraints are the method used for treatment and management of

undisciplined and aggressive people suffering from serious psychiatric disability. The methods

used for seclusions vary from different institutions.

Seclusions and restraints are still a valuable method for treatment especially for

uncontrollable patients. These methods are used for security of other persons using the same

facility. However this method was debatable if it is really a method for curing or a method for

punishing? Even though how practical and safe these methods may be, the use of it could lead to

a greater morbidity and death.

CHAPTER II.2 PRINCIPLES AND RELEVANCE TO THE STUDY

Maximizing the quality of medication not in a medicinal way but on the aspect of

facilities used by the patients, nurse, professionals and others involved. Research studies

conclude that environment can affect the healing process of patients.

The study will focus on the innovation of minimization of seclusion and restraints in

mental facilities, without compromising the security of other people using the same facilities. This

is to maximize the quality of healthcare getting by the patients with mental disabilities.

The study will also focus on the use of the concept of Maslows hierarchy of needs.

This will be used in the planning process of the facilities in the proposed complex. This concept

will be used as a motivational method which will help to hasten the recovery of the patients. The

concept of the theory is include the curiosity of the persons to improve his/herself in order until

he/she reaches the peak or the self-actualization.


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PHYSIOLOGICAL NEEDS

These are the most basic requirements of a human body. If these are not meant, the body will

not function properly and will be broken. These are the most important and will become the

foundation of a human body.

SAFETY NEEDS

After the most important needs or the physical needs, the second group would be the safety

needs, a mind where he/she will feel safe, comfortable and free. A satisfying surrounding.

This will include:

1.

Personal security

2.

Financial security

3.

Health and well-being

4. Safety against accidents/illness

LOVE AND BELONGING

The third stage of human needs is Love and Belogings which involves emotions and feelings. If

this is not met, it can impact the individuals relationships in general, such as: Friendship,

Intimacy and Family.


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ESTEEM

After getting the acceptance of other people its for the acceptance of your true self. Self-respect

is vital for every individual. Imbalance of this level may result to individuals continuous seeking

for fame or glory. Which is not the answer the feeling of what they lack, this can cause

individuals depression because the feeling of failure.

SELF-ACTUALIZATION

Self-actualization or the final stage, this is the stage where you feel contented on all aspects of

your life. You are in a good state of mind and physical.

These principles will be a big help on the healing process of the patients. Applying a

much appropriate planning and design principles using these concepts and theory, will a big leap

on the modernization of the design standards of Psychiatric Institutions, not just in the Nation but

in the whole world. First, the minimization of seclusion and restraints, this will change the image

of being a detention facility, isolation rooms will not be seen any more as a punishment room,

instead it will be seen as a room for self-reflection. The facility will also promote self-dignity and

self-reliance if this concept is applied. The use of Maslows Hierarchy will boost the motivation of

patients to heal faster. This will serve as a challenge in order to get the self-actualization or being

dismissed from the institution.

CHAPTER II.3 APPLICATION TO THE PROJECT

The application of minimizing seclusion and restraints without compromising the

security of others is on the designs of all facilities used by the patients and their staff. Feeling of

restraints and seclusion is not just basically on the wards or isolation rooms, the patients can feel

the inability to move freely everywhere if its not design/plan properly.This is why design

techniques all throughout the building will be applied.

Innovative design approach to maximize the quality of healthcare the patients are getting in

details:


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1. Therapeutic Environment

The environmental surroundings can affect greatly on the mind of a psychiatric patients.

A report from The New York Psychiatric Institute stated that a large drop in number of

patients needed to be seclude when they occupied a new facility that has this kind of

environment. Using this type of design and consideration well promote individual dignity

and self-reliance.

Therapeutic Environments must have this attributes:

- The usage of non-institutional materials which is lively, and a little bit of colors and

textures. But still keeping in mind the colors that might agitate the psyche of the

patients.

- Natural lighting in all rooms.

-

Outdoor views for every rooms, leading to outdoor environment.

- Providing a direct and easy access to secured outdoor areas.

- Sound insulations in private rooms which discussions are held like conference room,

therapy room etc.

- Rooms must be free from any unwanted noises.

- Giving patient own visual rights, controlling the views patients would see.

- Giving the control of his own decision on his private room as much as possible.

- Planning minimal walking distances, short and easily accessible planning.

- Signage for the patient knowledge of whereabouts, promoting self-reliance.

2.

Aesthetics

A major factor on the institution public image and is a significant marketing tool. It will

also psychologically change the view of the public on metal institutions which is a

detention facility.

Considerations includes:

-

Use modern type of lighting systems, accessibility of natural lighting, indigenous

materials.


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- Soothing/calming colors and artwork.

- Awareness to details, color, scale and proportions.

-

Wide and bright open public spaces.

-

Comfortable nursing units and offices.

- Compatibility of the exterior faade to the surrounding environment.

3.

Security and Safety

The possibility of suicide of patients is one of the main concerns of the facility. It must

not create openings for this type of accidents.

Security and Safety designs without resorting to confinement:

- Utilities devices to be tamper-proof.

-

No clothes hook on shower rooms, and use of breakaway shower-rods and bars.

- Security of entrance and exits of staffs.

- Unbreakable glass for windows in bedrooms.

- Soft materials for walls like fiber-reinforced gypsum board.

- Elimination of all possibilities of self-injury in special features seclusion rooms,hardwares

like door knobs wil be eliminated.

- Solid material specified ceiling.

4.

Sustainability

The institution is serving for the healthiness and well-being of an invidual. The institution

must not only help individuals but also extends it potential on helping the well-being of

the environment.

This can change the image of mental facilities.

The use of Maslows hierarchy in the project will be on the site planning proces s. The

proposal will be a Mental Rehabilitation Complex composed of different buildings. Every building

will have a different approach on the design; the design of each building will reflect the 4 stages


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of needs in Maslows Hierarchy of needs. And patients will start from the fundamental needs up

to obtain the goal of self-actualization or dismissal to the outside world.

For better understanding of the application:

The building will be design appropriate for their needs. For example physiological needs building

will focus on the fundamental needs of a patients, more on the survival needs and will be limited

Mental Rehabilitation Complex

PHYSIOLOGICAL

NEEDS

SAFETY

NEEDS

LOVE ANDBELONGING

SELF-ESTEEM

SELF-ACTUALIZATION

OR OUTSIDE WORLD


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to that. Physiological needs will not have special facilities only available for example safety needs

building like entertainment are and the likes.

This method will motivate patients to recover faster in order to go to another building. Based on

research a patient driven by motivation is more likely to recover faster than other patients. This

will also help professionals taking care of them and giving medication because they can specialize

on the different stages of criticality of mental stability of the patients.

PART III. SITE IDENTIFICATION AND ANALYSIS

CHAPTER III.1 SITE SELECTION PROCESS

III.1.1. CRITERIA FOR SITE SELECTION

1.

Lot Size

2.

Site Physical Characteristics

3. Utilities

4. Zoning/Permitting

5.

Neighborhood

Site selection criteria were established to serve as a guidelines or requirements of the site that

will be analyzed and will undergo site selection process with various proposed sites that will

house the proposed Youth Mental Rehabilitation Complex. This are the criterias identified: Lot

size, Site physical Characteristics, Utilities, Zoning/Permitting and Neighborhood.

Below is an itemized list of the criteria, along with specific questions that were considered when

evaluating each variation and option.

1.

Lot/Site Location


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- Is the site large enough to accommodate future development? Will there be enough

outdoor areas?

-

Is the existing road accommodating vehicular and pedestrian traffic safe and accessible?

Thus unloading and loading for commuters available?

- Will the frontage of the development accessible to the eye? Will there any hindrances

exist that will block a sight?

- Will the frontage of the development accessible to the eye? Will there any hindrances

exist that will block a sight?

2.


- What is the slope of the terrain? Flat, rolling, etc. (5% for parking; 10% for buildings)

-

Are the soils well drained?

- Was it located in a hazardous area? Flood? Earthquake?

3.

Utilities

- Thus the water and sewer available?

- Is the electrical service sufficient?

- Thus the telephone and cable television available?

- Any provisions for storm water disposal? Like pumps.

4.

Zoning/Permitting

- Is this a permitted for a Institutional use?

- Are some parts of the land under protection of the government?

- Are there any restrictions or laws?

- Could the site comply with Planning/Zoning criteria?

5.

Neighborhood

-

Were the site situated in an Institutional area?


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- Were the site located or near a Residential area?

- Is the site located or near a mixedUse area?

-

Is this a rural, suburban or urban setting?

- Are there any opportunities in views?

III.1.2. SITE OPTION DESCRIPTION

These were 3 possible sites picked from different provinces of Central Luzon which will be the

target region of the proposal.

1. A site located in Brgy. Tabe, Guiguinto municipality of Bulacan Province.

2.

A site located in Brgy. Mamatitang, Mabalacat City of Pampanga Province.

3.

A site located in San Nicolas Pob., Concepcion municipality of Tarlac Province.

1. Brgy. Tabe, Guiguinto municipality of Bulacan Province.


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SITE CRITERIA

1. Lot/Site Location

-

Known as machine capital of Guiguinto.

-

An access road (Tabe Road) to the North Expressway was built by mobilizing resources

from the national government and local private sector.

- A road leads to MacAthur Highway.

- A total population of 7,204 people based on 2010 NSO census.

- Located in a municipality that has a density if 3,300 persons per square kilometer.

2.


- The terrain of the municipality was relatively flat in general.- The site is free from any types of hazards especially hazards due to water flooding.

3.

Neighborhood

- The site is located in Guiguinto municipality which is bounded on the East by the town of

Balagtas, on the west by Malolos, on the North by Plaridel, and on the South by Bulacan.

- The barangay is located in an urban setting.

4.

Zoning/Land Use

- Located in an Institutional zone.

- Nearby Institutional facilities:

Tabe Elementary School

Immaculate Concepcion Seminary

Angel of Light Academy

Tabe Health Center

Bethany Orphanage


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2. Brgy. Mamatitang, Mabalacat City of Pampanga Province.

SITE CRITERIA

1.

Lot/Site Location

- Located in the center of Mabalacat City.

- Has a direct acces to major highways of SCTEX and MacArthur Highway.

- Located in a municipality that has a density if 2,600 persons per square kilometer.

2. Site Physical Characteristics

- The terrain of the municipality was relatively flat in general.- No apparent Erosion

- Located in a slightly flooded aone during a storm.

- The soil is a mix of Angeles Coarse Sand and Undifferentiated Angeles Soil


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3.

Neighborhood

- The barangay is located in Mabalacat which is bounded by Concepcion, Magalang

and Mexico on the East, Angeles on the South, Porac on the West and Bamban

on the North.


4.

Zoning/Land Use

-

Located in an Residential, semi-Institutional zone.

- Development possible subject to conversion procedure.

- Nearby Institutional facilities:

Mabalacat Institute

Mabalacat Elementary School

San Joaquin Elementary School


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3. Brgy. San Nicolas Poblacion, Concepcion municipality of Tarlac Province.

SITE CRITERIA

1.

Lot/Site Location

- The barangay has a population of 5,412 as of 2010 according to NSO census.

- Located in a municipality with a 580 persons/square kilometer density.

- Beside Plaridel road connecting to SCTEX.

-

400 m away from A. Mabini Provincial Road.

2. Site Physical Characteristics

- The terrain is ranging from level (0% ) to very gently (3% ).

- It is not located in any hazardous area like flood and earthquake prone area.

- The majority of the soil is Tarlac Clay Loam


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3. Neighborhood

- The barangay is located in the west of concepcion municipality which is situated at the

center of the province. To its north is Gerona and Santa Ignacia, west is San Jose, south

is Capas and Concepcion and eastern boundaries are Victoria and La Paz. This is also the

location of Tarlac River.


4.

Zoning/Land Use

-

Located in a built-up zone.

-

Nearby Institutional facilities:

Atanacio Hospital

Concepcion Municipal Building

Concepcion South Elementary School

Benigno Servillano National High School

Concepcion North Central High School

III.1.3. SITE SELECTION AND JUSTIFICATION

The site that was selected was the site located in Brgy. Tabe, Guiguinto municipality

of Bulacan Province mainly because of the advatages of the site compared to the other two, in

particular:

1. Accessibility to national road of North Luzon Expressway and Regional Road of

MacArthur Highway. The most critical in the site selection is the accessibility of

the site in other provinces in Central Luzon. The site has a direct access on the

two major road of the Region.

2. The site is located in a low density structures area, many unused in the

surroundings. Preferred because there will be less works on the buffer for

pollution caused by too much population.


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3. The terrain of the municipality was relatively flat in general. Less construction

works is needed.

4.

The site is free from any types of hazards especially hazards due to water

flooding. A safe location that will shelter the patients.

5. It is located in an Institutional zone, development of this type of facility is

possible in this location.

CHAPTER III.2

Documents

Cabangunay, Vergel ( Part 1, Part 2, Part 3 and Related Appendices)