AT chats to… Heather Macey from Makower Architects about drawing on a history of trauma to rethink spaces for people with poor mental health.

 The farm, close to Wrexham in Wales, has been secured for a peppercorn rent. 

Tell us about Homestead Community Network?
We are developing a project called Homestead. The team has arranged to take on farmland and buildings in Wales – in a beautiful piece of countryside outside Mold, near Wrexham, not far from Liverpool on a peppercorn rent. We are working up plans to develop the first pilot project, Homestead, a specialist-supported home for people suffering with mental health difficulties, particularly psychosis. We’re looking at providing accommodation for around 30 people – we would rather call them residents but the NHS parlance is ‘service users’ – with a mix of low, medium, and high needs, half of whom are resident staff, makers and guests. The idea is to create therapeutic environments for mental wellness and creative enterprise that are preventative, not reactive and offer a social return on investment. Some say we are only at the beginning of a mental health epidemic, we believe projects like Homestead have the potential to save the NHS. We have estimated that every resident at Homestead will save a quarter of a million pounds a year, this pilot alone would save 3-4 million of tax payers money a year whilst also enriching communities and the lives of residents and staff.

How will the Homestead relate to the NHS?
It will be a privately-run charity but we’re looking at ways to link up with the NHS, which has said that it would be happy to refer patients to us, so long as we can prove that our facility is effective and meets the mental health needs of local and visiting guests. The aim is to provide a truly therapeutic environment as opposed to an institutionalised environment, so that we can provide real rehabilitation rather than a closed loop of remission / relapse / remission With inpatient stays and emergency care, which are detrimental to people recovering from mental illness.

How much do you see it as an architectural project?
It’s an architectural project – starting with an architectural brief – in that we have a very clear idea about the kind of environment we want to create. And there is are a specific set of activities and spaces we need to provide. So there’ll be on-site accommodation, but we’ll also cater for day visits and drop-in services, and will provide a range of wraparound services. We see it as a creative enterprise as well as a clinical enterprise. Just because the residents are mentally ill, it doesn’t mean they need to exist and to recover, in a silo. We want the activities on site to overlap with – and contribute to – the local communities. The project will evolve in phases but in the longer term we’re envisaging a pottery and a farm shop, equine therapy centre, animal rescue and roastery. We’re looking at the possibility of making space for SMEs on site. All the things that foster a sense of community and give meaning to day-to-day life.

 The proposal combines the retrofit of the existing farm buildings with some new build elements. 

What does that look like in architectural terms?
One issue is that spaces designed for people with mental health difficulties have become over-designed in response to the overestimated fear of violent incidents or suicide. Yet this can become a self-fulfilling issue. So we’re very clear about the kind of environment we don’t want, which is anything to institutional and sanitised. We want to make a place where people can be cared for in a dignified way, with whatever level of sociability or privacy they need. We’re looking at a retrofit of the existing farm buildings and also putting in some new build eco-cabins to provide more self-contained accommodation. But the main thing we’re interested in is the pilot prototype and the quality of care. Our priority is not delivering the architecture but realising all aspects of the project including creating a prototype which is deliverable and able to implement at scale. This will benefit from a truly collaborative cross-disciplinary approach. In fact, we’re thinking of organising an architectural competition through the Architecture Today/Architects Declare Regenerative Architecture Index and local partnerships.

What stage is the project at?
It’s just getting it started. The pre-app process is under way, and the initial feedback from Flintshire has been very positive. We have an impressive clinical team led by Dr Andrew Howe from the South London and Maudsley foundation trust and the University of Essex, as well as connections with the IOPPN at Kings. We are working on the clinical specification, and we’re about half-way through putting together our business plan. We’ve written to all of the London councils as well. We like the idea that the project has both rural and urban components. That people in the city could benefit from a complete change of scenery and deep immersion in the Welsh countryside and that, similarly, people struggling with life in a rural area could benefit from a period of recovery in an urban setting. So we’re keen to have at least one London borough on board to think about how this might look. We’re asking councils to look at sites that might not be sufficiently valuable for a develop to take forward, and to look at the possibility of building a plug-in day centre that could itself be super simple, but could plug into existing NHS services in the city as part of a wider Homestead Community Network. That sense of belonging and purpose to a place is very important. The model doesn’t work if it exists in the middle of nowhere.

And I’m thinking we might hold a pop-up festival, partly as a consultation exercise, partly to launch the project, but also to give a sense of the energy and variety that the project is going to bring.

How are you funding the project?
We have secured the land for a peppercorn rent. Now we’re looking at funding both to get the project up and running and to provide an ongoing income stream. We feel very strongly that the Homestead should cater for these mixed needs, which hasn’t been done before and grow nationally to meet the need. We’re looking carefully at the balance between care needs and funding streams. People with high needs bring in more funding, but also need more background service. Those with low needs are easier to accommodate but there is less money to support their care. There is a symbiosis here that can offer a shared purpose.

We’re also determined to create a nourishing and inspirational working environment for staff. We’re wondering if there’s a model where people who aren’t professional carers, but who need a break, could sign-up to volunteer for a fixed period of time, so they can take a break from their day-to-day lives and help others at the same time. Again, the challenge is to align the funding streams. The NHS tends to look at things in a very siloed way, so the challenge is to align funding streams and to demonstrate the mutual benefit that comes from layering different uses, and accommodating people with different types of needs.

It’s quite a departure from architecture. What was the impetus for the project?
Both Tim Makower and I have a close family members who have suffered from mental health issues, so the project is very much driven by our lived experience and a firm belief the system is broken, we have to at least try to use our skills to address that. My mum was sectioned when I was a teenager so I have direct experience of what those asylum spaces are actually like. I have a history of trauma, so I love the idea of a project that allows me to link my professional career as an architect with the reality and concerns that have shaped my personal life. Why are we so scared of being human? Why should I have a calendar invite that says ‘physio’ rather than ‘therapy’. The industry needs to learn to be more vulnerable. If we, as a profession, look at a lot of the architecture we’re designing, you’ve got to wonder if it’s actually making people more healthy and happy. I don’t think it does. Architects don’t actually live in the buildings we’re designing. They buy Victorian terraces. So why aren’t we talking about that? As part of this the practice is undertaking a much wider research piece around ‘what makes a healthy city’ trying to overlay findings from this onto everyday practice to really blow open this discussion in a wider sense.