Replacing the maximum security state mental hospital at Fulton means bringing the building itself in line with the modern mental health care philosophies and practices that its staff is using. The state has hired design firm Parsons Brinckerhoff to accomplish that.

This layout for the new Fulton State Hospital was presented to the Missouri Mental Health Commission in October.

This layout for the new Fulton State Hospital was presented to the Missouri Mental Health Commission in October.  It borrows a spoked wheel design used prisons for more than 100 years.

Vice President of Parsons Brinckerhoff, Tom Brooks-Pilling, told Missourinet the Biggs Forensic Center that mostly dates back to 1937 was built with confinement in mind more than rehabilitation.

“I’m not suggesting they didn’t have great programs back then. I don’t know what they had,” Brooks-Pilling said, “but when you look at the facility it’s really about warehousing and holding people.”

He said the new design will be radically different, adding, “It’s more of a hospital.”

“The present facility has been maligned for safety and security,” Brooks-Pilling said. “When we’re designing this new facility, safety is paramount, because without the staff and patients feeling safe … your mind is elsewhere. It’s hard for you to focus on treatment programs.”

He says the new hospital won’t look or feel like a prison but it will have security measures like those in a modern penal facility with three perimeter security fences, a closed-circuit television system, and alarms that go off any time a staff person gets into a horizontal position.

At the same time he said it will be, “a facility that brings in a lot of daylight, tries to create an uplifting and warm feeling – a therapeutic environment. We avoid anything that makes people feel incarcerated.”

One key improvement will be the lack of blind spots and hiding places.

“There’s all sorts of alcoves and places in existing Biggs where a patient, a client, could be hiding,” said Brooks-Pilling. “We don’t have any of those sort of spaces in the new hospital.”

“We set it up so that doors, if they’re intended to be open are locked open, so a client couldn’t intentionally use a door as a weapon to slam into an individual … the idea of having the building designed so people are watching other people’s backs, we’ve built that in throughout the facility.”

To accomplish the goal of increasing visibility, the new hospital borrows an element that has been built into prisons for more than 100 years. Living units will have a spoked wheel design, in which a staff person sitting at a central point can see what is happening in multiple units at the same time.

The Biggs Maximum Security Forensic Center is part of the Fulton State Hospital complex.

The Biggs Maximum Security Forensic Center is part of the Fulton State Hospital complex.

“From that position they can see everything that’s going on in that unit, and basically are watching the other staff’s back,” said Brooks-Pilling, “to make sure that they can focus on treatment and not necessarily worry about who might be sneaking up on them or what activities might be going on behind their backs.”

Brooks-Pilling said the staff has also been included in the design process.

“They ideas that they have, we vet and we incorporate into the process,” he said.

One example is what designers heard about how patients are brought into the current facility.

“When we got started on the project [a staff member] said, ‘When we have new clients come to Biggs Forensic now, they come in through a back door next to the dumpster. What does that make you feel like when your first experience going into this new facility is being brought in by the back door dumpster? Doesn’t give you a strong, dignified feeling, does it?’ We understood that.” Brooks-Pilling said the new hospital will have a “more dignified” and discrete patient entrance.

Brooks-Pilling says the new layout will be four hospitals in one. It will house 300 patients, or clients as they are called in modern mental health care circles, divided among four communities based on treatment programs and the severity of mental illness.

12 separate living units will have 25 persons each, grouped into communities of between 50 and 100 patients. Most treatment programs will take place in those communities.

All of those will share a common treatment mall being named The Hope Center. It will have a “town square” feel, according to Brooks-Pilling.

“It has your library, your place of worship, bank, hair salon, restaurant, shops, gymnasium/fitness center, classroom activities and such,” he said. Some patients will have free access to that, others will have restricted access based on condition.

A vocational enterprise area is also available where patients can do work and be paid for it.

“It really emulates life as we know it – a full day regime, from waking up, going through programming, doing some work, doing some activities, and then going back to bed. It’s a full cycle,” said Brooks-Pilling.

The projected cost of the project is $211-million dollars, that the legislature and the governor approved paying through a bond issuance. The first $92-million of bonds were issued in November. Later this year demolition of the current dietary, materials management, energy control center, and maintenance buildings will begin. Construction of the new hospital is scheduled to start in 2016 and be done by December, 2017, with the Biggs facility slated for demolition in 2018.

Earlier stories:

Legislature adopts Gov. Nixon’s plan to pay for new Fulton Mental Hospital

Mental Health Official pleased with Nixon plan to replace Fulton State Hospital

Administrators’ pitch: 211-million from bonds to improve Fulton State Mental Hospital