A Different Kind of Hospital: “The Maison de l’Enfance et de l’Adolescence (MEA) in Geneva: A New Paradigm for Healthcare through Care, Medical Humanities, and Integrative Health”

In an era marked by continuous evolution, the healthcare landscape finds itself facing a need for transformation in the approach to patient care. It is within this ever-changing context that the visionary concept of the Maison de l’Enfance et de l’Adolescence (MEA) [1] in the University Hospital of Geneva (HUG) emerges. The central objective of this institution is nothing short of a paradigm shift in the provision of holistic medical care, particularly for young patients in need of psychiatric care. At the heart of this transformation lies a profound concern to construct a building that does not stigmatize, and a recognition of the imperative to shift the focus from the sickness to the individual in his or her family, connected to their environment and culture. The MEA’s architectural design and holistic approach to care are underpinned by a rich tapestry of scientific principles, such as Evidence-Based Design, the integration of Medical Humanities, and the practice of Integrative Health, all aimed at nurturing a more compassionate, educative, and engaging approach to healthcare. The MEA represents an innovative model that embodies the concept of “Care” and opens a new path towards more holistic healthcare, that includes the well-being of all those involved, including the health care workers.

The MEA building is the result of numerous studies conducted since the late 1980s, based on the concept of “Evidence-Based Design” (EBD) [2], which recognizes the impact of the environment on the patient’s recovery. EBD principles aim to improve the healing process and reduce risks for medical personnel. In practical terms, this translates to individual rooms, special attention to natural light and noise reduction, access to nature, and increased safety for the staff. The MEA incorporates these principles to create an optimal environment where patient comfort and recovery take center stage while ensuring optimal working conditions for the staff.

The MEA is not limited to being just a hospital; it aspires to be a true bridge between the medical world and civil society. It seeks to destigmatize the hospital environment by promoting interdisciplinarity and facilitating relationships with the outside world. Located in the heart of Geneva, near the Maternity and Children’s Hospital, the MEA is open to the general public, offering a variety of cultural and sports activities. It includes a versatile space for gymnastic and artistic performances, a screening room, a radio studio, a dance and music room, conference and teaching rooms, an exhibition space, and a dedicated health education facility in partnership with the Bioscope of Geneva University [3].

Within the MEA, culture is considered an essential element of the care of young patients. Exhibitions, workshops, and lectures in partnership with the Bioscope of Geneva University and the Cultural Affairs Department of HUG [4] cover a wide range of topics, from biodiversity to genetics, nutrition, and neuroscience, connection with art events and festival. These activities are open to schools in Geneva, from primary to high school, promoting health education.

At the core of the MEA, the concept of “Care” [5] is the cornerstone of every interaction between patients, their families, and the medical staff. This holistic approach to health places the child at the center of their own healing process. It is not just about treating symptoms but considering the person as a whole, recognizing the importance of care, attention to others, and emotional support. “Care” goes beyond the mere delegation of responsibilities; it aims to empower patients to actively engage in their own recovery. This philosophy transforms the medical experience into a collaboration between patients, families, and healthcare professionals.

Medical Humanities [6], an interdisciplinary concept, broaden the perspective of medicine by integrating the humanities, including literature, philosophy, ethics, history, religion, as well as the social sciences, including anthropology, sociology, and psychology. The arts also play a crucial role in this approach, as do their applications in medical education and practice. At the MEA, Medical Humanities are not just a theory but a tangible reality. The goal is to nourish the minds and souls of young patients and healthcare workers by providing access to cultural and artistic activities, exhibitions, workshops, and lectures in partnership with institutions such as the Bioscope, the public laboratory for life and biomedical sciences at the University of Geneva.

Integrative Health [7] takes a comprehensive view of health by harmoniously combining conventional medicine, non-conventional complementary medicine, and lifestyle medicine. This approach involves coordination between validated healthcare practices, patient-centered care, science-based approaches, and delivery by a multidisciplinary team. At the MEA, Integrative Health represents a major advance in healthcare delivery. It recognizes that an individual’s health extends beyond their physical body, encompassing mental, emotional, and social well-being. Therefore, patients receive a comprehensive range of care that takes into account all these aspects. The uniqueness of Integrative Health lies in its ability to actively involve patients in their own care. Patients are encouraged to share their own health beliefs and participate in defining their well-being goals. This collaboration between patients and healthcare professionals promotes the return or maintenance of health in a state of optimal well-being.

It is important to acknowledge that despite the pressing need for the transformative changes brought forth by the MEA, a significant challenge arises from the scarcity of public financing for such ambitious healthcare projects. In many regions, limited public resources often restrict the development of innovative healthcare facilities that prioritize holistic care and patientcentered approaches. The realization of the MEA was made possible through a unique private-public collaboration for financing. Primarily supported by two foundations, Children Action [8] and Hans Wilsdorf [9], this collaboration exemplifies the commitment of private entities to fill the funding gap and invest in the wellbeing of young patients. Furthermore, the creation of a dedicated foundation (Convergences Foundation) [10] to finance all cultural activities in connection with the city underscores the multifaceted approach taken by the MEA to bridge the gap between healthcare and society. While the MEA represents a groundbreaking shift in healthcare delivery, the broader challenge of sustainable financing for similar projects remains a notable limitation.

In conclusion, the MEA in Geneva stands as a beacon of innovation in the realm of healthcare. In an ever-changing world, it symbolizes the necessity for a profound shift in the approach to patient care, particularly for young patients in need of psychiatric support. This transformative model addresses not only the medical aspects of healing but also the well-being of the individuals, their families, and the healthcare professionals involved. It acknowledges the importance of an environment free from stigma, where the focus shifts from illness to the individual’s connection with their family, culture, and surroundings. The MEA, guided by the principles of Evidence-Based Design, Medical Humanities, and Integrative Health, brings compassion, education, and engagement to the forefront of healthcare. It endeavors to create an environment that not only heals but also nurtures. However, it is imperative to recognize the financial limitations in realizing such visionary projects. The scarcity of public financing necessitated a pioneering collaboration between private and public entities, with significant support from private foundations to bridge the funding gap. The establishment of a dedicated foundation for cultural activities further underlines the commitment to holistic care.

The MEA in Geneva is more than a healthcare facility; it represents a transformative force in healthcare. It showcases a vision where the patient, their family, and healthcare professionals collaborate to promote well-being, and it encourages other regions and institutions to embark on a similar journey towards holistic and compassionate healthcare. The MEA embodies the future of healthcare, where innovative concepts and creative financing open a new path for healthcare delivery, where the concept of “Care” takes center stage, and where the well-being of all involved is paramount.

1. House of childhood and adolescence.
2. Liddicoat S, Badcock P, Killackey E (2020) Principles for designing the built environment of mental health services. Lancet Psychiatry 7(10): 915-920.
3. Bioscope, Unige.
4. Artopie, HUG.
5. Tronto J (1993) A vulnerable world. For a policy of care. Paris: The Discovery, 2009.
6. Swiss Academies of Sciences (2014) Medical Humanities: The significance of the human and social sciences for the professions of medicine and health. Swiss Academies Communications 9(5).
7. Witt CM, Chiaramonte D, Berman S, Chesney MA, Kaplan GA et al. (2017) Defining health in a comprehensive context: A new definition of integrative health. Am J Prev Med 53(1): 134-137.
8. Children Action Foundation.
9. Hans Wilsdorf Foundation.
10. Convergences Foundation.