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CHAPTER 1

INTRODUCTION

INTRODUCTION

“Never give up on someone with a mental illness. When “I” is replaced by “we”,

illness becomes wellness.”

- Shannon L. Alder

Adolescence is a time of dramatic change. Young people often feel tremendous

pressure to succeed at school, at home and in social groups. At the same time, they may

lack the life experience that lets them know difficult situations will not last forever. Mental

health problems commonly associated with adults, such as anxiety and depression also

affect young people. Any one of these factors, or a combination, may become such a source

of pain that they seek relief in suicide. (COAST, St. Joseph’s Healthcare Hamilton, 2013)

At times, life can be difficult. Competing priorities like work, family, and money

can sometimes feel overwhelming. It’s no wonder that many people feel anxious and

depressed, at least once in a while.

According to the National Statistics Office (NSO), mental health illnesses are the

third most common forms of morbidity for Filipinos. Furthermore, a 2010 national census

that found 1.4 million people with identified disabilities showed that mental disability

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accounts for 14 percent for all disabilities. In the same NSO study, 88 cases of mental Page | 2
health problems were reported for every 100,000 Filipinos.

Also, according to GMA News Online, out of 170 countries, the Philippines ranked

150 in terms of suicide rates and has the lowest suicide rate among ASEAN-member states.

The estimated 2,558 (550 female, 2008 male) or 2.9 per 100,000 suicides in 2012 in the

country is lower than the annual global age-standardized suicide rate of 11.4 per 100,000.

On the other hand, the National Center for Mental Health's statistics project suicide rates

of 2.5 for men and 1.7 for women per 100,000 members of the population. These numbers

do not include unreported cases. According to a 2014 report of the World Health

Organization, there were 2,558 cases of suicide due to mental health problems in the

Philippines in the year 2012 alone. As a public health concern, mental illness hits the most

vulnerable sectors of society — the young and the poor.

That in consideration, there are only few specialized institutions for mental health

care, like the National Center for Mental Health in Mandaluyong City, Metro Manila,

Cavite Center for Mental Health in Trece Martires, Cavite, and the Mariveles Mental Ward

in Bataan, which are all run by the government. The bigger state-run hospitals also have

psychiatric wards as well, such as the Philippine General Hospital in Manila. There are

also private hospitals such as Makati Medical Center, University of Santo Tomas Hospital,

University of the East Ramon Magsaysay Memorial Medical Center, and Metro

Psychotherapy Facility offer mental health care services, as well as other smaller facilities.

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BACKGROUND OF THE STUDY Page | 3

Mental health is the foundation for well-being and effective functioning for an

individual and for a community. In the Philippines, however, mental health is not a priority,

which is evident in the government's low funding, lack of psychiatrists in the country and

a negative stigma that prevents Filipinos from seeking proper help. These facts do not

match with the country's current context, for cases of suicide has been rising, and these are

due to depression, anxiety, chronic stress, and post-traumatic stress disorder in the

Philippines.

With these problems compounded with the lack of proper mental health facilities

and rehabilitation centers in the country, there is a need for designers to incorporate new

technologies, psychology-developmental theories, as well as space and landscape design

for the facility to enhance the healing of the patients.

STATEMENT OF THE PROBLEM

The main issue in mental health care in the Philippines is the stigma between the

mentally deranged and the bad image of typical mental health care facility in the

Philippines. Also, people with mental illness are ashamed to seek help because of the

stigma associated with it.

Suicide rates have increased because of anxiety or depression. People with mental

illness commit suicide because they thought that no one is there to help them overcome

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their situation. The lack of help and support from other people makes people suffering from Page | 4
mental illness feel they are hopeless.

Facilities and treatment centers in the Philippines are not enough to handle the

increasing rate of people with mental illness.

OBJECTIVES OF THE STUDY

This study aims to design and create a treatment center that will make the clients

feel that they have freedom and that they are free to speak out the causes of what they are

experiencing so that professionals would know how to help them. Also, a treatment center

that engages the community to interact and create social relations giving each patients

purpose and lifting their mental health.

The goal of this study is to re-imagine the architectural design of the typical mental

health care facility in the Philippines to break the never-ending stigma between the

mentally deranged and mental health care facility typologies in the Philippines.

In this paper, the researcher will remove the stigma of admitting to a mental health

care facility between people with mental derangement.

The researcher will provide a new information on how to incorporate nature in the

architectural design that can help on the healing process of the clients. Also, the researcher

will apply therapeutic design concepts to the built environment to improve mental health

of the occupants.

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THEORETICAL FRAMEWORK Page | 5

Maslow’s Hierarchy of Needs. Maslow's hierarchy of needs is a motivational

theory in psychology comprising a five-tier model of human needs, often depicted as

hierarchical levels within a pyramid.

Maslow (1943, 1954) stated that people are motivated to achieve certain needs and

that some needs take precedence over others. Our most basic need is for physical survival,

and this will be the first thing that motivates our behavior. Once that level is fulfilled the

next level up is what motivates us, and so on.

Hierarchy of needs is about (a) human beings are motivated by a hierarchy of needs;

(b) needs are organized in a hierarchy of prepotency in which more basic needs must be

more or less met (rather than all or none) prior to higher needs; (c) the order of needs is not

rigid but instead may be flexible based on external circumstances or individual differences;

and (d) most behavior is multi-motivated, that is, simultaneously determined by more than

one basic need.

Figure No. 1.0

Maslow’s Hierarchy of Needs
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CONCEPTUAL FRAMEWORK Page | 6

Data gathering is greatly relevant in this project proposal and is a big help for the

researcher involved. The related projects, literatures, and research materials in any form

that were mentioned plays a vital role in this proposal.

Moreover, just like any other projects, this proposal will also follow a process,

involving analysis and assessment, presentation or architectural drawings and revisions and

modifications if needed. After this proposal is polished and had its final modification, the

presentation of architectural drawings will then take over.

Knowledge requirements include the necessary information for the said project to

be successful. The people with mental illness like anxiety, depression and suicide ideation

played a huge role in regards the background and information regarding mental illness.

Governing laws and policies in regards to the design and planning of a treatment center

helped in aiding proper planning design and analysis. Also, related literature, studies and

projects were used to provide ideas and information not only in design but also in planning

the project. All the said information were then analyzed and studied to formulate an

appropriate site planning and zoning, architectural space programming, building

systems/utilities analysis, etc. The result of the said study formulated a design that would

cope most, if not all, the needs of the project, AKBAY KABATAAN - Outpatient

Treatment Center in Pililla, Rizal: A Paradigm Shift in Mental Health.

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Knowledge Requirements Page | 7

- Related Projects and Studies

Input - Planning Principles
- Design Standards and Parameters
- Mental Illness Profile in Philippines
- Related Laws and Policies

Architectural Pre-design Provisions

- Site Planning and Zoning

- Architectural Space Programming
Process - Building Systems Analysis and Conceptualization
- Demand Analysis
- Form Analysis

AKBAY KABATAAN – Outpatient

Treatment Center in Pililla, Rizal:
A Paradigm Shift in Mental Health

- Architectural Design Programs and Concepts

Output - Site Plan
- Architectural Form
- Proper Building Design and Site Development

Presentations
- Architectural Drawings
- Concept and Drawing Boards

Figure No. 1.1

Conceptual Framework

SIGNIFICANCE OF THE STUDY

The major concern of this study is knowing what must be the proper place to

conduct the modern day treatment for those people with mental health problem. With this

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in mind, the project entails the development of the different centers that help those people Page | 8
to recover and be treated immediately with their past experiences in a more caring and a

human level of treatment. It will cater the people who has mental health problem in the

whole country.

BS Architecture Student. This study will help the students to be more practical

and realistic in terms of proposing and designing a project proposal. This study also gives

more knowledge and techniques to the student on how they analyze and plan well a

proposal like a treatment center for mental illness.

People with Mental Health Problem. This study will help the people with mental

health problem know that there are people who will help them overcome their situation. It

could be an eye opener for them to realize that there is still hope.

Pililla, Rizal Local Government Unit. This study may benefit the city planners

and designers of Pililla, Rizal thru gaining information regarding the treatment center once

the project is already approved. This will also be beneficial to the city in a way that it will

make the city known in the country in view of the approach of the treatment center.

Future Researchers. This study will help the future researchers to investigate and

analyze a treatment center for people with mental illness. Visiting sites, interviewing

people with mental illness and organizations related to mental health and having a reliable

data could be a big help for the researchers to be more realistic about the project proposal.

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SCOPE AND DELIMITATION OF THE STUDY Page | 9

The project proposal entitled, AKBAY KABATAAN - Outpatient Treatment

Center in Pililla, Rizal: A Paradigm Shift in Mental Health, consists of planning, designing

and analysis of a treatment center that would accommodate people with mental illness like

anxiety, depression and suicide ideation and help them to overcome their situations.

This study was limited only to the architectural programming, planning, designing

and analysis of treatment center for the people with mental illness. Also, basic architectural

drawings and sketches, building materials, utilities and structural systems, as well as

landscaping design is in consideration.

This study does not include budgeting and cost of the project, as well as engineering

drawings such as structural, electrical, plumbing, sanitary and mechanical plans. This study

does not include also the computation of the Return of Investment of the project. The study

merely focuses, as said, in planning and designing of the project.

This project was also limited to children and youth – aging 5 to 24 years old having

a mental health problem like depression, anxiety, schizophrenia, suicide ideation, chronic

stress and post-traumatic stress disorder.

DEFINITION OF TERMS AND ACRONYMS

Adolescence. Adolescence is the period following the onset of puberty during

which a young person develops from a child into an adult.

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Anxiety. It is a feeling of worry, nervousness, or unease, typically about an

imminent event or something with an uncertain outcome.

Chronic Stress. Chronic stress is the response to emotional pressure suffered for a

prolonged period of time in which an individual perceives he or she has little or no control.

It involves an endocrine system response in which corticosteroids are released.

Delusion. An idiosyncratic belief or impression that is firmly maintained despite

being contradicted by what is generally accepted as reality or rational argument, typically

a symptom of mental disorder.

Depression. It is a mental condition characterized by feelings of severe

despondency and dejection, typically also with feelings of inadequacy and guilt, often

accompanied by lack of energy and disturbance of appetite and sleep.

Hallucination. An experience involving the apparent perception of something not

present.

Mental Health. It is a person’s condition with regard to their psychological and

emotional well-being.

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Mental Hospital. An institution where patients with psychiatric disorders live Page | 11
while receiving treatment.

Outpatient. A patient who receives medical treatment without being admitted to a

hospital.

Paradigm Shift. A fundamental change in approach or underlying assumptions.

Post-Traumatic Stress Disorder. A condition of persistent mental and emotional

stress occurring as a result of injury or severe psychological shock, typically involving

disturbance of sleep and constant vivid recall of the experience, with dulled responses to

others and to the outside world.

Psychiatrist. Psychiatrist is a medical practitioner specializing in the diagnosis and

treatment of mental illness.

Psychotherapy. The treatment of mental disorder by psychological rather than

medical means.

Rehabilitation Center. A center or clinic where people with an alcohol or drug

addiction are treated.

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Schizophrenia. A long-term mental disorder of a type involving a breakdown in Page | 12

the relation between thought, emotion, and behavior, leading to faulty perception,

inappropriate actions and feelings, withdrawal from reality and personal relationships into

fantasy and delusion, and a sense of mental fragmentation.

Suicide Ideation. Suicidal thoughts, also known as suicidal ideation, are thoughts

about how to kill oneself, which can range from a detailed plan to a fleeting consideration

and does not include the final act of killing oneself.

Therapeutic. It is having a good effect on the body or mind; contributing to a sense

of well-being.

Treatment Center. A residential treatment center (RTC), sometimes called a

rehab, is a live-in health care facility providing therapy for substance abuse, mental illness,

or other behavioral problems. Residential treatment may be considered the "last-ditch"

approach to treating abnormal psychology or psychopathology.

Youth. The period between childhood and adult age.

AIMS Assessment Instrument for Mental Health Systems

ASEAN Association of Southeast Asian Nations

CRPD Convention on the Rights of Persons with Disabilities

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DOH Department of Health Page | 13

NCMH National Center for Mental Health

NSO National Statistics Office

PhilHealth Philippine Health Insurance Corporation

PHIS-MH Philippine Health Information System on Mental Health

PTSD Post-traumatic Stress Disorder

WHO World Health Organization

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