New building at Old Vaasa Hospital creates revolutionary environment for forensic psychiatry in Finland

A new building is being planned for the historical area of the Old Vaasa Hospital, and patients in need of demanding long-term care have been involved in the design of its facilities. The aim is to support patient wellbeing in everyday life and boost the social sustainability of care.

The Old Vaasa Hospital is a state mental hospital that provides nationwide specialised care, expert services and mental state examinations. It is also Finland’s oldest hospital that continues to operate at the same location. Its oldest buildings date back to the 1800s, and the hospital area has been defined as a nationally significant built and cultural environment (RKY). However, many of the buildings are in need of renovation.

‘The renovation requires that the premises are empty, which is why a new building was deemed to be the best way to secure and even increase the number of beds,’ explains Client Manager Jari Auer from Senate Properties, which owns the buildings.

Senior Physician Pirjo Takala from the Old Vaasa Hospital says that there is a huge need for services provided by state mental hospitals in Finland. The number of beds in psychiatric hospitals has decreased from 22,000 to 2,700 (1970–2021). ‘It is particularly challenging to find places for patients with severe psychotic disorders who need long-term care and have problems with controlling their behaviour.’

Patients and staff have similar wishes

In summer 2022, Senate Properties, the Old Vaasa Hospital and the Finnish Architects Association organised an invitation-based architectural competition (in Finnish) for a new building. It sought design options that would suit the historical area and support the development of the operations.

The modern patient building must be able to facilitate a wide range of activities on three reception and examination wards intended for particularly demanding operations. That is why it was important to consult the users on the architectural competition entries. According to Takala, taking advantage of experience expertise is part of the daily life at the hospital.

‘The patients are represented in the extended hospital management group, among others, and peer counsellors assist visitors and help other patients on the wards and in different treatment groups.’

Sweco’s Project Management and Developer Group Manager Kaisa Narvio engaged hospital staff and, as one of the first experiments in Finland, patients of a forensic psychiatric hospital in the evaluation of five competition proposals. The competition entries were assessed objectively at four workshops according to a pre-planned process. One of the workshops was intended for patients.

‘I was happy to see how well the patients knew which parts of the yard are sunny and which are shady, and showed empathy towards each other. Additionally, the staff clearly acted as the voice of the patients at their workshops.’

The staff and patients had similar preferences, and everyone emphasised the importance of well-organised shared facilities, safety and outdoor recreation opportunities. According to Pirjo Takala, the importance of outdoor activities increases when a person loses their freedom due to illness. ‘It is important for the environment to provide positive and pleasant experiences.’

What will Finnish psychiatric care be like going forward?

Lukkaroinen Architects’ proposal Huomassa was chosen as the winning proposal. One of its special features is the cellular nature of the facilities instead of normal corridors. For example, safe cells are facilities designed to help patients regulate their behaviour without requiring traditional restriction means, such as isolation.

‘Safe rooms open up into the safe cell where, for example, an aggressive or self-destructive patient can calm down and gain control of their behaviour with the help of staff,’ Takala says. The safe rooms will also facilitate higher-quality rooming-in care.

The new building will have the hospital kitchen and a multi-function hall. All 48 patients will have their own room and access to the yard area through the ground floor without having to wait for their turn. In addition, the wards will have a sensory room where anxiety can be alleviated through music, among other means.

The new facility solutions will create a safe and cosy environment for the patients and staff, and allow the staff resources to be allocated flexibly. ‘I would imagine that the Old Vaasa Hospital will be leading the way in forensic psychiatry care in Finland,’ Auer from Senate Properties says.

Picture: Lukkaroinen Arkkitehdit