Creating a therapeutic space that respects culture, ensures patient safety and promotes clinical recovery

A design that responds to clinical, therapeutic and cultural needs

Our aim was to create a safe, comfortable and welcoming environment where patients can be easily monitored and observed without overly intruding on their privacy and autonomy. This has implications for furniture, fixtures and equipment (also referred to as fitments) selection and how the facility is designed to operate. To ensure the right balance, we developed a testing environment where fitments were installed then trialed with clinicians and consumers. The testing results were used to inform the design.

The designs also enabled a shift toward newer models of care and operation that focus on restorative care. To support staff through the change process, the team ran several workshops with hospital staff and community members to build a shared understanding of the environment they were designing and the practice changes it would enable.

The Palmerston North region has a high Māori population. The new facility was developed in close consultation with local Iwi stakeholders, the Māori tribal groups representing the region’s Indigenous communities. The designs provide integrated courtyard spaces, a welcoming entry sequence and room for visiting families — known as a whānau room — as well as kitchen facilities that support culturally appropriate food provision.

Creating a blueprint and innovations that can be rolled out on future projects

The Australasian Health Facility Guidelines outline the design, operational and space requirements for hospital departments. However, they provide limited guidance for acute mental health facilities, with no standardized room templates or authoritative baseline for room sizes, layouts, adjacencies and functional requirements. Cultural needs — including spaces for spiritual and cultural practice, family-centered and social spaces, and culturally responsive design — are not covered sufficiently, leaving a gap in how designs can meaningfully respond to local context rather than treating culture as an “add-on”.

This made aligning the built environment design with the model of care more complex, particularly when balancing safety-by-design requirements  with the need for a therapeutic, everyday setting. 

The design team used an evidence-informed, co-designed and risk-managed approach, developing project-specific room templates and room data sheets to ensure consistency. Operational mapping and iterative stakeholder workshops were used to test workflows, adjacencies and observation strategies, informed by structured safety reviews. The principle of cultural safety — ensuring an environment is respectful, empowering and supportive of an individual’s cultural identity — was embedded early, guiding design choices like privacy gradients, shaping arrival sequences and informing the decision to have dedicated spaces for whānau and culturally responsive care.

The methodology (co-design, operational validation, safety by design and culturally informed planning) and the resulting room template suite can be adapted for other sites and service models, reducing risk and improving consistency across future mental health projects. 

While future projects will still need to be tailored to the local model of care and cultural context, our work on this project establishes a robust foundation in the form of repeatable process and a transferable set of planning principles that can be carried forward and refined across future programs.

The team also overcame a common supply chain challenge. Door sets are always difficult in mental health builds in New Zealand because each piece of hardware — door sensor alarm, continuous hinges and door hardware — is often manufactured outside New Zealand and comes from separate suppliers. The team worked with a local manufacturer to develop a door that met design requirements and addressed the shortfalls. We have since used the door for another project — the Sir Mark Dunajtschik Mental Health Centre in Lower Hutt that is currently under construction.

Sustainability

The design targeted the equivalent of a five-star Greenstar Healthcare rating. The design incorporates an energy-efficient façade, sustainable materials, low carbon structure approaches and a significant other number of elements.

All photos © Paul McCredie Photographer