This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric…
Abstract
Purpose
This paper aims to look into the significance of architectural design in psychiatric care facilities. There is a strong correlation between perceptual dysfunction and psychiatric illness, and also between the patient and his environment. As such, even minor design choices can be of great consequence in a psychiatric facility. It is of critical importance, therefore, that a psychiatric milieu is sympathetic and does not exacerbate the psychosis.
Design/methodology/approach
This paper analyses the architectural elements that may influence mental health, using an architectural extrapolation of Antonovsky's salutogenic theory, which states that better health results from a state of mind which has a fortified sense of coherence. According to the theory, a sense of coherence is fostered by a patient's ability to comprehend the environment (comprehensibility), to be effective in his actions (manageability) and to find meaning (meaningfullness).
Findings
Salutogenic theory can be extrapolated in an architectural context to inform design choices when designing for a stress‐sensitive client base.
Research limitations/implications
In the paper an architectural extrapolation of salutogenic theory is presented as a practical method for making design decisions (in praxis) when evidence is not available. As demonstrated, the results appear to reflect what evidence is available, but real evidence is always desirable over rationalist speculation. The method suggested here cannot prove the efficacy or appropriateness of design decisions and is not intended to do so.
Practical implications
The design of mental health facilities has long been dominated by unsubstantiated policy and normative opinions that do not always serve the client population. This method establishes a practical theoretical model for generating architectural design guidelines for mental health facilities.
Originality/value
The paper will prove to be helpful in several ways. First, salutogenic theory is a useful framework for improving health outcomes, but in the past the theory has never been applied in a methodological way. Second, there have been few insights into how the architecture itself can improve the functionality of a mental health facility other than improve the secondary functions of hospital services.
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Psychological and epidemiological literature suggests that the built environment plays both causal and therapeutic roles in schizophrenia, but what are the implications for…
Abstract
Purpose
Psychological and epidemiological literature suggests that the built environment plays both causal and therapeutic roles in schizophrenia, but what are the implications for designers? The purpose of this paper is to focus on the role the built environment plays in psycho‐environmental dynamics, in order that negative effects can be avoided and beneficial effects emphasised in architectural design.
Design/methodology/approach
The approach taken is a translational exploration of the dynamics between the built environment and psychotic illness, using primary research from disciplines as diverse as epidemiology, neurology and psychology.
Findings
The built environment is conceived as being both an agonist and as an antagonist for the underlying processes that present as psychosis. The built environment is implicated through several means, through the opportunities it provides. These may be physical, narrative, emotional, hedonic or personal. Some opportunities may be negative, and others positive. The built environment is also an important source of unexpected aesthetic stimulation, yet in psychotic illnesses, aesthetic sensibilities characteristically suffer from deterioration.
Research limitations/implications
The findings presented are based on research that is largely translated from very different fields of enquiry. Whilst findings are cogent and logical, much of the support is correlational rather than empirical.
Social implications
The WHO claims that schizophrenia destroys 24 million lives worldwide, with an exponential effect on human and financial capital. Because evidence implicates the built environment, architectural and urban designers may have a role to play in reducing the human costs wrought by the illness.
Originality/value
Never before has architecture been so explicitly implicated as a cause of mental illness. This paper was presented to the Symposium of Mental Health Facility Design, and is essential reading for anyone involved in designing for improved mental health.
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Amy Wagenfeld, Connie Roy‐Fisher and Carolyn Mitchell
Providing veterans diagnosed with post‐traumatic stress disorder (PTSD), their families, and staff opportunities to experience physical and mental restoration in outdoor…
Abstract
Purpose
Providing veterans diagnosed with post‐traumatic stress disorder (PTSD), their families, and staff opportunities to experience physical and mental restoration in outdoor environments designed based on evidence is important. The purpose of this paper is to explore the relationship between evidence‐based collaborative design of outdoor environments and their potential capacity to contribute to a veteran's journey to wellness.
Design/methodology/approach
There is no existing precedent in the peer‐reviewed literature linking positive health outcomes associated with outdoor environments to veterans with PTSD. This review of the literature is conceptualized as a means to extrapolate these benefits to this unique population.
Findings
Access to nature improves physiological and psychological health outcomes. A collaborative design approach ensures that design outcomes meet specific populations' needs.
Practical implications
Many service‐members are reluctant to seek traditional treatments for PTSD, fearing threat to future military service and limited available resources. Alternative treatments, access to sensitively designed outdoor environments and/or a re‐examination of traditional treatments and the environments in which they are provided supports best practice approaches to ameliorating the debilitating effects of this disorder.
Social implications
An integrated design approach blending the skills of landscape architecture and occupational therapy is key to achieve design outcomes that support the healing process to meet the needs of this vulnerable population.
Originality/value
An inter and/or trans‐disciplinary team approach to design and programming of outdoor environments for veterans with PTSD blends landscape architecture with occupational therapy to ensure both form and function are achieved, thus positing positive health outcomes.
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Patients' movement in mental health facilities is frequently compromised for reasons quite apart from real physical incompetence. Accessibility within mental healthcare facilities…
Abstract
Purpose
Patients' movement in mental health facilities is frequently compromised for reasons quite apart from real physical incompetence. Accessibility within mental healthcare facilities is a more complex issue than universal accessibility standards generically allow for. The purpose of this paper is to critically question the adequacy of universal design aids as the main way to deal with accessibility in facilities for the adult mentally ill in the community.
Design/methodology/approach
Several community mental healthcare units (in both Great Britain and France) are reviewed and analysed while they are occupied and running. The focus of the study is on restrictions of movement and the use of universal accessibility devices. The data are part of a broader exploratory study of facilities for mental healthcare, which used empirical, comparative and user inclusive methods.
Findings
Mental health facilities are rarely designed for the model of care and staffing regimes which they will house. This discordance between the physical and organizational milieu inevitably compromises accessibility, even though patients tend to be physically able. Outdoor access, vertical circulation and the accessibility of bathrooms are particularly affected.
Research limitations/implications
Models of care, management and staffing requirements, therapeutic needs of patients and interpersonal relationships should be considered for accessibility during planning, in addition to traditional accessibility devices and design. Furthermore, more research is needed to address the ways that accessibility devices need to be altered to comply with the psychosocial elements.
Originality/value
This paper readdresses the traditional view of accessibility, suggesting the paradigm needs to be better developed and nuanced for mental healthcare facilities.
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Participation by patients, staff and visitors in healthcare design and planning offers multiple benefits in addressing the complex challenges of creating salutary environments for…
Abstract
Purpose
Participation by patients, staff and visitors in healthcare design and planning offers multiple benefits in addressing the complex challenges of creating salutary environments for hospital patients, staff and visitors. The purpose of this paper is to present the benefits of participatory design and design imperatives to facilities architects and landscape architects.
Design/methodology/approach
The paper describes three case studies in which participatory methods were used to engage users in decision making over 15 years and creates a framework using “design imperatives” that has been successful in the design of outdoor settings.
Findings
Nine design imperatives can be used to design facilities that achieve a range of therapeutic benefits for patients, staff and visitors.
Research limitations/implications
The research limitations of this paper are those of using case studies in general. The implications suggest that papers such as this can be used in future hypothesis‐driven research.
Practical implications
Designers do not have the luxury or ability to base myriad design decisions on experimental research findings, as almost all design is unique and a hypothesis waiting to be tested. The result is that guiding principles, or design imperatives based on participatory methods, can form the basis for design decision making.
Social implications
The social implications are that some form of participatory decision making in facilities design has benefits to multiple constituencies, specifically, patients, staff and visitors.
Originality/value
Although this paper refers to many existing studies and places the results and conclusions within a context that is supported by the literature, much of the value is because the results are based on practice. More than a dozen projects form the basis for concluding that general principles of design, person‐environment interactions and participatory methods lead to desirable and beneficial outcomes.
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Ana Paula Baltazar, Silke Kapp, Augustin de Tugny and Juarez Pereira Furtado
The purpose of this paper is to report on the point of view of architecture of an interdisciplinary research on housing and social integration of people with severe mental…
Abstract
Purpose
The purpose of this paper is to report on the point of view of architecture of an interdisciplinary research on housing and social integration of people with severe mental disorder (SMD) in Brazil after deinstitutionalization. It first aims to present the need for a qualitative evaluation of the way people with SMD deal with their living spaces (house and city); then to describe the method adopted to approach people living under control – in therapeutic residential services (SRTs) proposed by the State as the only alternative model for those leaving psychiatric institutions – and people living alone – with little psychiatric assistance and no dwelling support provided by the State. It aims to conclude with a discussion of the observed dwellings pointing towards the need to accommodate differences in any housing model adopted by the State.
Design/methodology/approach
The qualitative evaluation enabled the focus of participant observation on the way people interact with each other and with their living space. The authors followed the routines of chosen people with SMD in three different cities in Brazil and provided reports for the whole group to analyze them.
Findings
It was found that those living in SRTs are much more obstructed by institutional control than those living alone. Despite the difficulties and fragilities of those living alone because of the lack of support, they end with more possibilities for autonomy and social integration.
Originality/value
Most research on the subject approaches objective housing issues focusing on statistical results. This research evaluates qualitative dwelling issues, summarizing little pointers for future health policy on housing for people with SMD.
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This special “Anbar Abstracts” issue of the Personnel Review is split into six sections covering abstracts under the following headings:Career/Manpower Planning and Recruitment;…
Abstract
This special “Anbar Abstracts” issue of the Personnel Review is split into six sections covering abstracts under the following headings: Career/Manpower Planning and Recruitment; Health and Safety; Industrial Relations and Participation; Pay, Incentives and Pensions; Performance, Productivity and Motivation; Work Patterns.
Editorial This special issue of Industrial Management & Data Systems is a huge departure from our usual journal/ monograph style. This is an additional issue to the year's volume…
Abstract
Editorial This special issue of Industrial Management & Data Systems is a huge departure from our usual journal/ monograph style. This is an additional issue to the year's volume — a bonus in fact.