"If someone had obtained the same results with a new medicine, it would have been a worldwide sensation," says Stefan Lundin as he explains how the use of forced medication and mechanical restraints decreased in the new building that he helped to design for psychiatry at the Östra Sjukhuset hospital in Gothenburg. He is now trying to understand, at a deeper level, why it worked.
To most people it is obvious that we are affected by our surroundings. But how does that happen? This is one of the questions that Stefan Lundin has been reflecting on extensively over the past few years.
Following a long, successful career as an architect at White in Gothenburg, he is now in the process of writing a doctoral thesis that investigates whether there is something that could be called "healing architecture".
In practice this question has already been answered; there are several examples of how healthcare buildings affect the results of treatment. One of these is the new building for psychiatry at the Östra Sjukhuset hospital in Gothenburg, which replaced the old hospital, Lillhagens Sjukhus in 2006. Stefan Lundin was one of the architects responsible for that construction, which received an award for best healthcare building, Vårdbyggnadspriset, in 2007.
"We were subsequently able to see clear differences between the old hospital, Lillhagens Skujhus, and the new building, for example regarding forced medication and mechanical restraints. The changes were fantastic. Staff spent less time on sick leave, and threats and violence decreased," he explains.
"Can we link this to the architecture? Yes, we should be able to."
There is not a great deal of research into these issues, and the need for a more theoretical understanding of what affects us and how has increased
"You could say that the key is to look for evidence for what has been experienced in practice, as has been done in the field of medicine. Harnessing the knowledge of architects like us and of people who work in healthcare."
This can help justify things such as higher costs. Provide arguments to the architects who will design the buildings and to the principals who have commissioned the work.
Stefan Lundin has been interested in theory for a long time. His degree project, which he did together with his wife and colleague Ulla Antonsson, also focused on this.
"It was a description of Swedish architecture from 1900 to 1930. We received positive feedback, and I could have envisaged continuing on that path."
But that's not what happened. After a four-month study trip to Greece and Italy, it was time to start work.
"Ulla had completed an internship at White and started to work there; after I while, so did I."
The couple climbed their respective career ladders in parallel and relatively quickly became leaders of a group each at the company.
"We talked about it recently. We must have been incredibly young. It was before we had children, because later when we were on parental leave we looked after each other's groups."
Eventually they also became partners in the firm – a career that could provoke a degree of envy, but it came at a price.
"They were extremely intensive years, with vast amounts of work and overtime. Being an architect is so much of an identity, a lifestyle. You don't work as an architect – you ARE an architect."
It all culminated in Stefan suffering from burnout.
"It has taken me a long time to recover."
Perhaps this has resulted in extra reflection on your professional role and what architecture should actually be for? An interest in the community surrounding the buildings? Well, that interest has been there all along.
"There was a time when I thought that everyone should become architects, as then you really learnt how everything is linked together; it would solve everything," he says smiling.
He describes his years of study at Chalmers. "We were part of a movement." It was the 1970s and Elias Cornell was a professor. Books were published such as Bostad och kapital [literally: housing and capital – a study of Swedish housing policy] and Rivningsraseriets rötter [literally: the roots of the demolition frenzy – about the past extensive demolition of buildings].
"One person who meant a lot to me at that time was photographer Jens S. Jensen and his photos from Hammarkullen [a residential area in Gothenburg mainly built in the 1960s and 1970s].
Stefan Lundin says that times have changed now. In that period the talk was of building affordable housing; now housing is built for affluent people.
"I find it hard to understand why more is not being built. It's needed, of course, and if I've understood it correctly, huge profits are made from construction."
One area experiencing something of a construction boom is the area in which he works: healthcare premises. This applies throughout the Nordics. And Stefan has become somewhat of a guru in this field.
"Not exactly a guru, but I do receive the opportunity to travel to a number of conferences and give talks," he says.
An important meeting took place at one of these conferences. "One of those decisive moments when paths cross," he explains. He met Roger Ulrich, an environmental psychologist who has been very significant to the thinking on how architecture can affect health.
"If I'd known how famous he was, I'd never have dared to approach him, but he has become an extremely important source of inspiration and an ambassador for this project."
Stefan Lundin now divides his time between his work at White and his work as a doctoral student at the Centre for Healthcare Architecture (CVA) at Chalmers.
"This gives me time to formulate and document my own findings, but also to study other people's research."
His studies are financed by White.
"We also earmark some funding each year for what we previously called Kunskapsbygget [knowledge building], but in this era of internationalisation it has been renamed White Research Lab. It is important for us as a company to stay updated with developments in research and to maintain contact with the academic world – both to enable us to do a good job, but also to identify skilled students.
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