A new $100m mass timber clinic is part of a growing shift in how psychiatrists approach children’s mental health – removing aggression, adding daylight, and most importantly, connecting patients with nature.
Out is the Nurse Ratched-era designs – the straight corridors, the scary doors, and the feeling of not knowing where you are going. All replaced by universal design principles that actually work.
The new Californian 55,600-square-foot (or 5,160 square metres) “Ohana” clinic, a Hawaiian term that means “extended family” and a cognate for the Maori word, kōhanga, or “nest,” clinic is a part of Montage Health’s push to transform how mental health is managed not only across the USA but potentially worldwide.
“When people come into emergency rooms when they need surgery, they expect to be passive recipients of care in sterile spaces,” according to Susan Swick, the executive director of the new Ohana Center for Child and Adolescent Behavioral Health in Monterey, California, who spoke to Bloomberg overnight.
“When you come into a space for mental treatment, these are not passive treatments…it is critical that we engage a child’s curiosity and sense of agency rather than surrender.”
Designed by NBBJ, the practice behind “The Regenerative Lab” has been described as a 21st-century prep school. “Except here, youth are not moulded into cookie-cutter members of the elite but provided with the tools to mould themselves,” according to Alexandra Lange in Bloomberg.
Instead of long, straight, whitewashed hallways, the new centre has curved, sunlit, wood-framed corridors; instead of being surmounted by a belltower, the highest point is the eyebrow curve of the lobby roofline, supported by glue-laminated timber beams and columns, directing the gaze out to the hills and up to the sky.
The cladding comprises wood-slatted panels (prefabricated offsite) rather than running bond brick. The furniture is soft poufs and armless lounges, not Chesterfield sofas and straight-back chairs.
“The one building that could be described as right-angled—the hipped-roofed combination gym and cafeteria at the centre of the stepped courtyard—is split by an open breezeway and reads more art barn than headmaster’s office,” said Mr Lange.
The key is that the building provides children with choices in terms of space, activity, and companionship. The project is part of a wave of new projects in psychiatric design that integrate mental health services into communities physically and programmatically.
Over the past twenty years, there has been a growing shift from building “visually plain environments” to more complex and materially rich spaces that give those receiving services greater control. Timber plays an essential role in improving the mental health of occupants through an evolving design process known as “Biophilic Design.”
According to Forest and Wood Products Australia, “there is a growing body of evidence internationally demonstrating that connection to nature, biophilic design and wood is associated with improved physical and mental wellbeing.”
In its report, Workplaces: Wellness +Wood=Productivity, it found that biophilic design could reduce the impacts of ADHD, improve recovery rates from operations, and help reduce pain from medication.
“Wood is correlated with higher levels of concentration, improved mood and personal productivity,” according to Howard Parry-Husbands, who published Australia’s largest-ever study into the impact of biophilic design on the indoor environment.
Ms Swick said this visual openness is a key to children’s treatment. She adds, “There’s good evidence that treating the parent’s ADHD is much more effective than treating the child’s ADHD,” and we do that here—along with coming up with school plans and skills groups to help children whose impulsivity may have put them at a social disadvantage.
For Johnathon Ward, NBBJ’s design leader, Ohana took design cues from one of Montage Health’s existing buildings – at 1962 Edward Durrell Stone that, with its creamy concrete walls, abundant natural light and central domed foundation, has been mistaken for a spa!
When Montage Health requested proposals, “we came out here and worked for three or four days,” Mr Ward told Bloomberg, adding that “we spent a lot of time sitting under that tree,” pointing to sculptural live oak embraced by the building’s curtain wall.
“We realised they belong here, and this view—it’s free. We can embrace the trees, embrace the view, and layer the experience from public to private.”
“Seeing pieces of what’s happening in different parts of the building gives you the feeling that there is community at work here,” Ms Swick said, adding, “This isn’t something we hide; this isn’t an empty promise or window dressing.”
Now, she hopes to leverage interest in the building and turn it into a funding commitment—to measure care outcomes and eventually get insurers to help foot the bill for future buildings.
“There is promising evidence showing that when we do a little bit of prevention in treatment and involve families in treatment, kids get better faster, and there are lower rates of relapse. Our goal over time is to be persuasive with insurers.”
While Ms Swick and her team collect the data, Ohana is already making a statement, materially, that mental health care should not be secret, that it takes a community to help with mental health, and that children deserve the best design.
“There may be primary colours in the literature—board books, graphic novels, pamphlets on sleep—and in graphic, colourful, and contemplative artworks by a noticeably diverse group of artists,” Mr Lange said, “but the architecture and interiors are all wood, faded navy, and mauve, a sophisticated palette without chilliness and reassuring without goofiness.”
What makes Ohana unique isn’t a disembodied, medicalised, specialist version of care but a team convened with the idea that mental health care is part of our world. The best version of that care engages with both the natural and the social world, with abundant sunlight, without stigma, and with family.
- For more information about the Ohana Center for Child and Adolescent Behavioral Health, visit Bloomberg’s special feature. To find out how NBBJ is using mass timber and steel hybrid construction systems to build the future of cities, visit Wood Central’s article from November 2023.
