Sustainable or “green” design minimizes the environmental impact of the construction and operation of buildings. At first glance, integrating environmentally sensitive design into a new high-security, technically and operationally demanding mental health facility for the District of Columbia might seem impractical or even unnecessary. Thankfully, the District did not see it that way. “Our decision to make the new Saint Elizabeths Hospital environmentally responsible as well as state of the art demonstrates our commitment to providing quality mental healthcare and protecting our environment,” said Stephen T. Baron, director of the District's Department of Mental Health.
Currently under construction, the new Saint Elizabeths Hospital will be occupied in 2009. The 448,000-square-foot, 292-bed facility will house both civil and forensic programs and integrate a variety of strategies that will reduce the building's environmental impact, reduce the District's operating and long-term operational costs, and increase the quality of patient care and the staff's working environment.
Background
Founded in 1855 at the urging of mental health advocate Dorothea Dix, Saint Elizabeths Hospital was the first large-scale, federally run mental health and psychiatric care facility in the United States. Originally known as the Government Hospital for the Insane, the site included a hospital for wounded soldiers during the Civil War. It was quickly dubbed Saint Elizabeths (the name of the original land grant) by patients who did not want to write home that they were being cared for at an asylum. The name stuck and became official in the 1920s. The hospital was transferred to the District in 1987.
When Dix convinced President Millard Fillmore to open the hospital, she could not have anticipated its future: The facility ultimately grew to include more than 60 buildings on 336 acres over the east and west campuses. In recent years, with the newest buildings dating to the late 1950s, the buildings no longer met the complex requirements of modern inpatient psychiatric care. To address the facility's issues, the District decided to construct a new consolidated facility (adaptive reuse was not a feasible option) to serve its citizens. In 2001, the District selected Einhorn Yaffee Prescott, Architecture & Engineering, PC (EYP) to design a new facility on a portion of the existing Saint Elizabeths site.
The new hospital will integrate residential, treatment, and educational areas for 292 patients (114 civil and 178 forensic) and staff in an environment focused on mirroring the rhythms and experiences of the outside world and intent on returning mentally ill patients to productive lives in the larger community. Civil and forensic patients will be housed and treated separately, but in equivalent spaces. Residential units for both groups will incorporate flexible spaces for social and therapeutic activities, with patient movement opportunities maximized through unobtrusive observation. Treatment “malls” will offer an array of therapeutic, educational, and social activities. Hospital support and administrative functions will share spaces, and advanced security and communications systems will be integrated throughout the facility.
The majority of the new building will be one story to maximize patient access to the outside, allow natural light into residential and activity areas, provide easy access to outdoor areas with minimal staff supervision, and limit elevator use. These benefits of a single-story design support the recovery process, shorten lengths of stay, and permit staff to focus on patient-related activities rather than escort functions. Saint Elizabeths is a major civic building, and the new building will include public spaces, such as a 250-seat auditorium to be shared with the community.
The building's main entrance (figure 1) will present a more formal face than the intentionally smaller-scale residential areas (figure 2). The building's location will provide views of large green spaces, recalling the tradition of expansive views and ample green space at Saint Elizabeths and other mental health facilities (figure 3).
Figure 1. The new Saint Elizabeths Hospital is scheduled to be completed in 2009. Illustration by Dikang Song, courtesy of EYP.
Figure 2. The residential areas will offer secure access to staff-supervised gardens. Illustration by Dikang Song, courtesy of EYP.
 Figure 3. The new facility will be surrounded by ample green space. Legend: (1) hospital entry, (2) secure entry, (3) unsecure units and treatment, (4) shared services, (5) auditorium, (6) service yard, (7) engineering and mechanical, (8) secure units and treatment, (9) secure yard, (10) parking, (11) existing building, (12) existing building, (13) gatehouse, (14) Congress Heights Metro Station. Illustration by Rhodeside & Harwell, courtesy of EYP.Sustainability
The decision to incorporate sustainability in- to the new Saint Elizabeths was made before the District formally adopted a green approach to public buildings. Early design discussions identified an interest in environmentally sensitive solutions. It did not hurt that many sustainable strategies can reduce operating and infrastructure costs. The challenge was to integrate these ideas throughout the project along with clinical, functional, budgetary, and administrative requirements.
While the list below is by no means exhaustive, it does demonstrate the range of approaches to environmental considerations at the new Saint Elizabeths.
Site use and redevelopment. At first blush, new development may not seem to be an environmentally friendly decision; sustainable design involves the reuse of existing buildings and sites wherever feasible. The effect is to reduce the energy required for the creation and transport of materials and demolition, as well as to reduce the amount of demolished materials that enter the waste stream. The new building, however, is located to effectively allow for operation of the existing hospital throughout construction. The new hospital is sited to encourage redevelopment of the majority of the campus, which includes numerous historic buildings, as part of a larger reinvigoration of the Anacostia neighborhood.
Green roof. The new hospital will include 28,000 square feet of green roofing that will cover much of the engineering and support spaces. This will be one of the largest—if not the largest—green roof in the District, and the largest on any mental health facility in the country.
A green roof is exactly what it sounds like. Soil and plant material are placed on a roof system designed to support additional weight and prevent leakage. Rainfall is held in the soil and used by the plants. Green roofs provide “quality treatment,” reducing the storm water facilities necessary on-site, and “quantity treatment,” reducing the amount of runoff that eventually ends up in municipal storm sewers. Green roofs reduce or eliminate the need for large ponds or facilities to remove pollutants and protect downstream ravines and wetlands. Most jurisdictions now enthusiastically accept green roofs as quality treatment of storm water. (For more sustainability and green design terms, see the sidebar.)
Bioretention areas. Bioretention areas, like green roofs, are used to deal with water that runs off roofs and paved areas on-site rather than piping it to storm water treatment facilities. Bioretention areas for this project are depressions planted with species that can withstand or require wet conditions. They contain below-grade sand and stone filters through which runoff passes. The plants and filters remove pollutants close to the sources of the pollution (i.e., roofs and parking areas). Bioretention areas vary in shape and size, and typically are perceived as attractive landscaping rather than as an engineered feature. At Saint Elizabeths, the bioretention areas will mitigate storm water, increase the amount of green space, and integrate with the landscape design.
Natural light. Natural light will be available throughout the building in patient, staff, and public spaces. Natural light offers distinct therapeutic advantages and boosts staff morale, as well as reducing the requirements, and related energy consumption, for artificial lighting.
Garden spaces. Secure gardens will be accessible from ground-level units, allowing patients access to staff-supervised outdoor areas. Spaces between units will be configured as gardens for therapeutic and recreational patient and staff activities. Overhangs and carefully selected plantings will provide shade for windows, reducing heat loads and operating costs.
Construction materials. Sustainable design calls for maximizing the use of locally produced materials to support the community and reduce the energy used to transport them. Natural materials that require limited maintenance are desirable. Materials should be easily renewable and responsibly produced. These decisions can be as simple as specifying a rubber rather than a vinyl base and as complex as evaluating the shipping distance of brick and material suppliers.
The new hospital's exterior primarily will be made of locally produced brick, with locally produced cast stone and copper sheet accents. Sustainability was taken into account when selecting interior materials too.
Environmental stewardship. Preconstruction site work included archeologic and environmental evaluations. Groundwater sampling wells installed as part of that work have been turned over to the District's Department of Health to allow it to continue to monitor the site as part of the District's efforts relative to improvements to the Anacostia River watershed that feeds into the Chesapeake Bay.
LEED certification. While the District opted not to obtain LEED certification under the U.S. Green Building Council's rating system (see sidebar), there was a clear interest in creating a green facility to the extent that it worked within the budget and did not interfere with the facility's operations. The LEED scoring standards were used as a part of the discussion on sustainable alternatives for the new Saint Elizabeths.
Functional consolidation. EYP's initial task focused on consolidating functions across the 336-acre campus from more than 40 buildings still in use to fewer than 10 located on just one portion of the eastern campus. This will significantly reduce energy consumption and increase operating efficiency.
Conclusion
The new hospital is a major step on the District's path to a more sustainable environment. The decisions incorporated into its design and construction will provide benefits that will last for decades, reducing its operating costs, decreasing the need for construction of infrastructure support facilities, and providing the opportunity for long-needed revitalization of the Anacostia neighborhood. The new Saint Elizabeths will be a symbol of environmental and fiscal responsibility, as well as a place for recovery.
 Marc Shaw, RA, LEED, is a Principal at Einhorn Yaffee Prescott, Architecture & Engineering, PC, in Washington, D.C.  Eric Kern, AIA, LEED, is a Principal at Einhorn Yaffee Prescott, Architecture & Engineering, PC, in Washington, D.C.  Richard J. Warsh, MSW, is Director of the Office of Facility Planning for the Washington, D.C., Department of Mental Health. |
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