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Saint Elizabeths goes green

June 1, 2007
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Washington, D.C., is constructing an environmentally friendly psychiatric facility

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.


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.