Veteran-Centered Investigation of Architectural and Space Design Considerations for Post-Traumatic Stress Disorder (PTSD)

Trauma-Informed Design of Supported Housing: A Scoping Review through the Lens of Neuroscience

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.

Healthy Dwelling: Design of Biophilic Interior Environments Fostering Self-Care Practices for People Living with Migraines, Chronic Pain, and Depression

The benefits of biophilic interior design have been recognized by healthcare facilities, but residential environments receive relatively less attention with respect to improving the health of people living with chronic diseases. Recent “stay-at-home” restrictions due to the COVID-19 pandemic further emphasized the importance of creating interior spaces that directly and indirectly support physical and mental health. In this viewpoint article, we discuss opportunities for combining biophilic interventions with interior design, fostering disease-specific self-care. We provide examples of designing residential spaces integrating biophilic interventions, light therapy, relaxation opportunities, mindfulness meditation, listening to music, physical activities, aromatherapy, and quality sleep. These modalities can provide the clinical benefits of reducing migraine headaches and chronic pain, as well as improving depressive symptoms. The disease-specific interior environment can be incorporated into residential homes, workplaces, assisted-living residences, hospitals and hospital at home programs. This work aims to promote a cross-disciplinary dialogue towards combining biophilic design and advances in lifestyle medicine to create therapeutic interior environments and to improve healthcare outcomes.

Aging in place among older adults with histories of traumatic experiences: A scoping review

BACKGROUND AND OBJECTIVES

Adverse childhood and adult experiences can have far-reaching impacts, and when coupled with typical aging-related changes, may impede achievement of a suitable person-environment fit for aging adults. The objective of our study was to determine if extant literature connects older adults with trauma history to successfully aging in place.

RESEARCH DESIGN AND METHODS

We proposed a conceptual model regarding trauma history, adaptive capacity of aging adults, and trauma-informed supports for aging in place. We conducted a scoping review using six databases [key words older adult(s), aging in place, housing, trauma], with a full review of 32 articles.

RESULTS

Insights included: 1) Aging in place does not have to mean living in the same house over time. 2) The uncertainty of the aging process can be traumatic and can be exacerbated by previous traumatic experiences. 3) Environmental sensitivities can result from previous traumatic experiences and cause further trauma. 4) Housing precarity is a traumatic experience. 5) Permanent supportive housing is an important resource for people in crisis. 6) Community supports are critical to aging in place.

DISCUSSION AND IMPLICATIONS

Our review revealed insights about aging in place and trauma, but did not connect the vulnerabilities specific to aging adults with personal trauma histories to aging in place. Research is needed that confirms the relationship between history of traumatic experiences and difficulties with aging in place as well as trauma-informed approaches that can mitigate housing-related stressors and foster community living environments that provide equitable access to aging in place.

Architecture and Mental Disorders: A Systematic Study of Peer-Reviewed Literature

OBJECTIVES

To perform a systematic study about the contribution of architecture and interior design researchers in studying the effect of physical environment on mental disorders.

BACKGROUND

Mental disorders are a major health problem worldwide and related to severe distress, functional disabilities, and heavy economical burdens. Studies propose that physical environment design can trigger or reduce mental disorder symptoms. However, there is a lack of knowledge about the extent of architectural design research contribution to all types of mental disorder prevention or intervention.

METHODS

A team of cross-disciplinary researchers gathered information from peer-reviewed manuscripts about the effect of architectural design on enhancing or reducing mental disorder symptoms. Data were collected from manuscripts published between 2008 and 2020 (research related to the topic became clearer in quality and quantity then). Keywords including architecture, interior design, physical environment, and mental disorders were used in the systematic search. Databases were collected using online resources. Numerical data collected from quantitative studies were organized in tables.

RESULTS

Our data showed that there were a lot of studies about dementia and autism; few studies about schizophrenia, anxiety, stress-related disorders, and depressive disorders; and no studies about the rest of the mental disorders. General environment followed by housing facility design were the most assessed physical environments for mental disorders.

CONCLUSIONS

As all mental disorders can have a significant impact on the society, we conclude that architectural studies should focus more on improving or preventing the symptoms of all types of mental disorders through the design of physical environments.