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Innovations in Architecture for Mental Health
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Innovations in Architecture for Mental Health

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (28 February 2022) | Viewed by 26837

Special Issue Editors

Dr. Gabrielle Jenkin

E-Mail Website
Guest Editor
Suicide and Mental Health Research Group, Division of Health Sciences, Univeristy of Otago, Dunedin 9016, New Zealand
Interests: Suicide; Mental Health; suicidology and suicide prevention; mental health psychiatric facilities
Ms. Jacqueline McIntosh

E-Mail Website
Guest Editor
Wellington School of Architecture, Victoria University of Wellington, Wellington 6012, New Zealand
Interests: architecture; therapeutic and rehabilitative built environments; therapeutic and rehabilitative design

Special Issue Information

Dear Colleagues,

Architecture and building design can play a critical role in the care of people with acute mental illnesses, although little has been published in this area. Acute mental health care is delivered in a number of settings, most of which involve containment of those who are mentally unwell. Examples include adult acute mental health wards, adolescent psychiatric facilities, forensic mental health facilities, and geriatric mental health facilities. The needs of those who find themselves in these settings are complex: some have acute mental illnesses such as schizophrenia, bipolar disorder, severe depression, and suicidal ideation; some have complex histories as victims and/or perpetrators of violence; others are dealing with psychosis, or are struggling with addictions and a host of other social problems.

Attention to architecture and building design in these places can either set the stage for the quality of mental health care provided and for recovery, creating an environment in which patients, staff, and visitors feel that they share a space that gives dignity to their condition, or it can contribute to delayed recovery and stigmatisation. The continuum of recovery, from entering a containment facility to departure back into the community, and the timing of this transition, raises challenges for philosophies of care and architectural design.

Increasingly, architects are turning their focus to new models for care environments—Maggie’s Centres for cancer recovery are one such example. If recovery is our purpose for these facilities, how are we faring, what might alternative visions look like, what are the new innovations, and what is the evidence base for successful delivery of mental health care in buildings designed to fit that purpose? And then, there are the broader questions of new philosophies of care that warrant greater consideration.

This Special Issue calls for commentary or research papers that identify, document or address features of building design and underlying philosophies of care relevant to acute mental health care architecture. Such research is likely to come from architecture and design, public, environmental, or occupational health, nursing, medicine, and health and social sciences. Papers that address social models for mental health care in the community are also welcomed.

Dr. Gabrielle Jenkin
Ms. Jacqueline McIntosh
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • architecture of confinement
  • recovery environments
  • mental health
  • acute mental health
  • suicide prevention
  • philosophies of care
  • design philosophy
  • forensic
  • adult
  • adolescent
  • older persons
  • models of care

Published Papers (5 papers)

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Research

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20 pages, 964 KiB  
Article
Engaging U.S. Adults with Serious Mental Illness in Participatory Design Research Exercises
by Kimberly A. Rollings
Int. J. Environ. Res. Public Health 2022, 19(11), 6743; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19116743 - 31 May 2022
Cited by 1 | Viewed by 1974
Abstract
Clubhouses are non-clinical, community-based centers for adult members with serious mental illness. The evidence-based model assists adults with identifying employment, housing, education, and social opportunities; wellness and health-promoting activities; reducing hospitalizations and criminal justice system involvement; and improving social relationships, satisfaction, and quality [...] Read more.
Clubhouses are non-clinical, community-based centers for adult members with serious mental illness. The evidence-based model assists adults with identifying employment, housing, education, and social opportunities; wellness and health-promoting activities; reducing hospitalizations and criminal justice system involvement; and improving social relationships, satisfaction, and quality of life. The model enables member participation in all Clubhouse operations, yet offers little guidance concerning facility design and member engagement in the design process. This case study explored the use of participatory design research exercises to (1) document member needs, preferences, and priorities to inform the design of a new midwestern U.S. Clubhouse facility and (2) meaningfully engage members (n = 16) in the design process. Four participatory design research exercises were developed, administered, and analyzed. Results revealed aesthetics and ambience; safety and security; ease of use and maintenance; adaptability, flexibility, and accessibility; and transportation as future priorities. Space and furnishing needs and priorities were also identified. Informal observations and participant feedback suggested that the participatory exercises meaningfully engaged members in a manner aligned with Clubhouse Model principles by centering member dignity, strengths, and work-oriented expectations. Future directions for research on Clubhouse design and member engagement in the design process are also discussed. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
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20 pages, 1185 KiB  
Article
Fit for What Purpose? Exploring Bicultural Frameworks for the Architectural Design of Acute Mental Health Facilities
by Gabrielle L. S. Jenkin, Jacqueline McIntosh and Susanna Every-Palmer
Int. J. Environ. Res. Public Health 2021, 18(5), 2343; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18052343 - 27 Feb 2021
Cited by 11 | Viewed by 6237
Abstract
Acute mental health care facilities have become the modern equivalent to the old asylum, designed to provide emergency and temporary care for the acutely mentally unwell. These facilities require a model of mental health care, whether very basic or highly advanced, and an [...] Read more.
Acute mental health care facilities have become the modern equivalent to the old asylum, designed to provide emergency and temporary care for the acutely mentally unwell. These facilities require a model of mental health care, whether very basic or highly advanced, and an appropriately designed building facility within which to operate. Drawing on interview data from our four-year research project to examine the architectural design and social milieu of adult acute mental health wards in Aotearoa New Zealand, official documents, philosophies and models of mental health care, this paper asks what is the purpose of the adult inpatient mental health ward in a bicultural country and how can we determine the degree to which they are fit for purpose. Although we found an important lack of clarity and agreement around the purpose of the acute mental health facility, the general underpinning philosophy of mental health care in Aotearoa New Zealand was that of recovery, and the CHIME principles of recovery, with some modifications, could be translated into design principles for an architectural brief. However, further work is required to align staff, service users and official health understandings of the purpose of the acute mental health facility and the means for achieving recovery goals in a bicultural context. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
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Review

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27 pages, 940 KiB  
Review
Trauma-Informed Design of Supported Housing: A Scoping Review through the Lens of Neuroscience
by Ceridwen Owen and James Crane
Int. J. Environ. Res. Public Health 2022, 19(21), 14279; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114279 - 01 Nov 2022
Cited by 4 | Viewed by 3782
Abstract
There is growing recognition of the importance of the design of the built environment in supporting mental health. In this context, trauma-informed design has emerged as a new field of practice targeting the design of the built environment to support wellbeing and ameliorate [...] Read more.
There is growing recognition of the importance of the design of the built environment in supporting mental health. In this context, trauma-informed design has emerged as a new field of practice targeting the design of the built environment to support wellbeing and ameliorate the physical, psychological and emotional impacts of trauma and related pathologies such as Post Traumatic Stress Disorder (PTSD). With high levels of prevalence of PTSD among people escaping homelessness and domestic violence, a priority area is the identification and application of evidence-based design solutions for trauma-informed supported housing. This study sought to examine the scope of existing evidence on the relationship between trauma, housing and design and the correlation of this evidence with trauma-informed design principles, and to identify gaps and opportunities for future research. In response to the commonly articulated limitations of the evidence-base in built environment design research, we combined a scoping review of literature on trauma, housing and design with insights from neuroscience to focus and extend understanding of the opportunities of trauma-informed design. We found that while limited in scope, there is strong alignment between existing evidence and the principles of trauma-informed design. We also identify three areas of future research related to the key domains of safety and security; control; and enriched environments. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
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32 pages, 1072 KiB  
Review
The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile—An Exploratory Review and Analysis Paper in the Cancer Survivors’ Mental Health Morbidity Context
by Eva Hernandez-Garcia, Evangelia Chrysikou and Anastasia Z. Kalea
Int. J. Environ. Res. Public Health 2021, 18(20), 10891; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010891 - 16 Oct 2021
Cited by 7 | Viewed by 5190
Abstract
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate [...] Read more.
Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators—with the central role in low-grade systemic inflammation—are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
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37 pages, 785 KiB  
Review
Permanent Supportive Housing Design Characteristics Associated with the Mental Health of Formerly Homeless Adults in the U.S. and Canada: An Integrative Review
by Kimberly A. Rollings and Christina S. Bollo
Int. J. Environ. Res. Public Health 2021, 18(18), 9588; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18189588 - 12 Sep 2021
Cited by 10 | Viewed by 6254
Abstract
The built environment directly and indirectly affects mental health, especially for people transitioning from long-term homelessness to permanent supportive housing (PSH) who often experience co-occurring behavioral health challenges. Despite a rapid increase in PSH availability, little research examines influences of architecture and design [...] Read more.
The built environment directly and indirectly affects mental health, especially for people transitioning from long-term homelessness to permanent supportive housing (PSH) who often experience co-occurring behavioral health challenges. Despite a rapid increase in PSH availability, little research examines influences of architecture and design within this context. This integrative review synthesized limited research on PSH design in the U.S. and Canada to identify built environment characteristics associated with PSH residents’ mental health, highlight gaps in the literature, and prioritize future research directions. A systematic search for peer-reviewed articles was conducted using nine databases drawing from multiple disciplines including architecture, environmental psychology, interior design, psychology, psychiatry, medicine, and nursing. Seventeen articles met inclusion criteria. Study design, methodology, built environment properties, place attributes, and relevant findings were extracted and iteratively analyzed. Three domains relevant to architecture and design were identified related to home, ontological security, and trauma sensitivity; dwelling unit type, privacy, control, safety, housing quality and location, and access to amenities; and shared common space. Integrative review results emphasize the potential of architecture and design to contribute to improved built environment quality and mental health outcomes among PSH residents. Methodological limitations and directions for future research are also discussed. Full article
(This article belongs to the Special Issue Innovations in Architecture for Mental Health)
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