"Caring" walls: in Lyon, architecture at the service of autistic people

The first residents moved into this structure of the Vinatier hospital on Thursday, which includes 10 beds, as well as a gym, a balneotherapy facility and a winter garden.

"When we resumed the service in 2019, there were planned periods of decontention. That is to say, the patients were restrained the rest of the time," notes Anne Duchamp, senior health manager of the neurodevelopment center.

In the new 1.107-square-metre unit, everyone has their own private room with bathroom. In the middle of the vast common area, a fossilised tree bathes in natural light. Patients, who spend around six weeks there, can observe the outside world through large windows or curl up in small "niches" to isolate themselves from others and cut themselves off from the world.

Its architect, Lionel Thabaret, says he was inspired by his experience in spa design.

"This project aims for deeper and more lasting relief, allowing us to limit the use of psychotropic drugs, with the idea that walls could truly have a healing role," explains Caroline Demily, head of the neurodevelopment unit, her voice muffled by small holes in the walls.

Modular

According to autism specialist Laurent Mottron, most researchers believe that "the role of perception is more important" in people with autistic disorders than in the general population and that it is necessary, if we want to adapt their environment, to limit noise and overcrowding.

These patients "often seek shelter from socialisation (...) and therefore need to have a place to retreat to, while remaining accessible" to the care team, notes the professor of psychiatry.

But they are not all disturbed by the same factors and, if architecture has a role to play, "the big word is the individualization of care", he insists.

At Vinatier, "we have a set of spaces that are very modular, so that the person can find a place where they feel good according to their needs," adds Ms. Demily, hoping that this unit, the first in France entirely designed for and with autistic people, does not remain an isolated enterprise.

Anne Royneau, a peer support worker who herself suffers from autistic disorders, was consulted during the development of the project on her feelings about space. A large part of the crises suffered by autistic people, she explains, are initially caused by sensory discomfort, especially when they live in a community.

"Return on investment"

While this type of architecture has developed a lot in the United States, "in France, we have always remained on the fringes because we consider that we are making functional structures," says Ms. Demilly. "Quality of life is not really taken into account in hospital buildings."

Vinatier invested seven million euros in this project, said Ms Duchamp, but the development of outpatient services and the reduction of length of stay and re-hospitalizations have at the same time made it possible to close 36 beds.

In the United States, the firm HKS has specialized in this new line of research called neuroarchitecture. "Today, our clients demand and are ready to pay" for projects that take into account the impact of spaces on the brain, assures one of its architects, Eric Kutche, himself autistic.

"Before, these things were the first to fall by the wayside in budgets," he notes. Today, we see that "the return on investment is significant, and not just in dollars, but in better patient health outcomes."

“If a patient can’t calm down, caregivers have to sedate them medically,” says her colleague Erin Peavey. “But if you can help them feel calm, reduce their agitation, not only is it more comfortable for them, it also makes things run more smoothly and it costs less.”