Nixon Forensic Center at Fulton State Hospital

Project highlights: Nixon Forensic Center at Fulton State Hospital

• Architecture firm:  Page
• Owner: State of Missouri, Department of Mental Health
• Location: Fulton, Mo.
• Category: E
• Project Site: Previously developed
• Building program type(s): Healthcare - hospital inpatient

• Replacing an outdated and deteriorating maximum-security facility, the 425,000-square-foot Nixon Forensic Center at Fulton State Hospital, located in Fulton, Missouri, transforms the caregiving paradigm through rigorous and dynamic planning. The design of the project, a psychiatric hospital for 300 inpatients, resolves two seemingly contradictory goals. It creates a safe, recovery-based environment while also providing security measures commensurate with the admission of patients who may do harm to themselves or others.

  Prior to this project’s completion, the previous hospital was the oldest in the state’s system of inpatient facilities and the last to be rebuilt. Beginning in 2009, injuries among staff and patients rose steadily, leading to workers' compensation claims totaling more than $4 million annually. Deferred maintenance had also soared to more than $73 million, and food was being prepared for 2,000 patients in unconditioned kitchens designed in the 1950s. The old hospital was widely considered the most dangerous place to work in Missouri—surpassing Department of Corrections facilities—making staff recruitment a major challenge and regularly threatening its accreditation and certification.

  As a people-first project, the new facility is sited in a park-like setting featuring broad lawns, native plantings, and walking gardens. Its transparency draws generous amounts of daylight into the internal spaces and offers views to nature and outdoor recreation spaces. Throughout, biophilic graphics depicting nature scenes and natural materials mark the entrances to each patient living space. Overall, the project promotes healing and recovery by normalizing its patients’ experiences, expanding treatment opportunities, and creating a safer environment for all. 

The design team envisioned the new facility as an organism with five major components that work in concert to provide unique scales of care for the important and stressful work that happens within. New patients and visitors are received at an administrative and support headpiece, the main interface with the community. The project’s body provides three familiar and architecturally scaled environments for patients and staff, including residences, the treatment clinic, and a town center-style treatment mall where patients can access services and socialize. The project’s fifth element contains back-of-house functions that power the primary care and administrative areas.

A good neighbor to the surrounding community, the hospital’s administration building presents its public face through transparency of function and material. Terracotta and glass modulate the façade, while the lobby features a deep canopy supported by columns in ordered and disordered configurations that evoke the complex work occurring inside. The canopy creates a front porch that welcomes the community for social events. Nearby, a circular lawn with integrated landscaping contains walking paths for community use.