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

Toward a Future Orientation: A Supportive Mental Health Facility Environment

BACKGROUND

The provision of supportive environments is essential in clinical and environmental psychology. Mental health disorders are a major issue, and the experience of being at a mental health facility is affected by numerous factors related to the building's design.

AIM

The aim of this study is to explore the expectations of a mental health facility planning group regarding the potential impact of a supportive design on patients' mental health and staff's therapeutic practices when planning and designing a new mental health facility.

METHODS

The new mental health facility is a case study and data were collected through qualitative in-depth interviews with nine participants and analyzed using a thematic analysis. The participants came from a mental health facility planning group in a new mental health facility in Norway.

RESULTS

The overall expectation of the new building was related to a future orientation to support patients' mental health and therapeutic practices. Three main themes were identified: toward a future orientation, supportive building design, and work environment.

CONCLUSIONS

Supportive environments are expected to influence patients' mental health and staff's therapeutic practices, including providing options for novel treatment needs in contrast to older and more outdated buildings that are perceived as hindering appropriate treatment conditions.

Applying Trauma-Informed Design Principles to Therapeutic Residential Care Facilities to Reduce Retraumatization and Promote Resiliency Among Youth in Care

Purpose: This conceptual paper connects the literature on the experiences and needs of youth in therapeutic residential care, trauma-informed frameworks utilized in these settings, and early research on trauma-informed design to facilitate an understanding of these connections and move towards developing a blueprint for trauma-informed design in residential settings for traumatized youth. Methods: A critical literature review drawing on trauma theory, trauma-informed care, evidence-based design, and trauma-informed design was conducted to inform the argument presented in this conceptual paper. Results: While many therapeutic residential care models engage trauma-informed care approaches to support staff in promoting healing environments for youth who have histories of complex trauma, the focus has remained on the psychosocial environment of care, and has yet to be systematically applied to the design of the built environment in which these programs are implemented. By applying the principles of trauma-informed care to the built environment, trauma-informed design has the potential to reduce retraumatization and promote resiliency among youth in care. Conclusions: Ultimately, this conceptual paper illustrates the value of further developing trauma-informed design principles to apply to settings that serve traumatized youth, such as therapeutic residential care facilities.

Novel Multimodal Salicylamide Derivative with Antidepressant-like, Anxiolytic-like, Antipsychotic-like, and Anti-Amnesic Activity in Mice

Depression, anxiety, and schizophrenia may coexist in psychiatric patients. Moreover, these disorders are very often associated with cognitive impairments. However, pharmacotherapy of these conditions remains challenging due to limited drug effectiveness or numerous side effects. Therefore, there is an urgent need to develop novel multimodal compounds that can be used to treat depression, anxiety, and schizophrenia, as well as memory deficits. Thus, this study aimed to evaluate the potential antidepressant-like, anxiolytic-like, antipsychotic-like effects, and anti-amnesic properties, of the novel arylpiperazine derivative of salicylamide, JJGW07, with an affinity towards serotonin 5-HT1A, 5-HT2A, and 5-HT7 and dopamine D2 receptors. Firstly, we investigated the compound's affinity for 5-HT6 receptors and its functional activity by using in vitro assays. JJGW07 did not bind to 5-HT6 receptors and showed antagonistic properties for 5-HT1A, 5-HT2A, 5-HT7, and D2 receptors. Based on the receptor profile, we performed behavioral studies in mice to evaluate the antidepressant-like, anxiolytic-like, and antipsychotic-like activity of the tested compound using forced swim and tail suspension tests; four-plate, marble-burying, and elevated plus maze tests; and MK-801- and amphetamine-induced hyperlocomotion tests, respectively. JJGW07 revealed antidepressant-like properties in the tail suspension test, anxiolytic-like effects in the four-plate and marble-burying tests, and antipsychotic-like activity in the MK-801-induced hyperlocomotion test. Importantly, the tested compound did not induce catalepsy and motor impairments or influence locomotor activity in rodents. Finally, to assess the potential procognitive and anti-amnesic properties of JJGW07, we used passive avoidance and object recognition tests in mice. JJGW07 demonstrated positive effects on long-term emotional memory and also ameliorated MK-801-induced emotional memory impairments in mice, but showed no procognitive properties in the case of recognition memory. Our results encourage the search for new compounds among salicylamide derivatives, which could be model structures with multitarget mechanisms of action that could be used in psychiatric disorder therapy.

Environmental Transformations Enhancing Dignity in an Acute Psychiatric Ward: Outcome of a User-Driven Service Design Project

OBJECTIVES

The goal of the current project was to enhance the feeling of dignity for patients in the seclusion unit in an acute psychiatric ward through environmental design changes and to evaluate the effect of the refurbishment.

BACKGROUND

Treating people with dignity is essential in all health-related work and important for our mental health. Hospital architecture and design signal values that can promote dignity. Patients who must spend time in seclusion are at their most vulnerable mental state and the often worn-down like environment can challenge the feeling of dignity. How environmental design can promote dignity in seclusion units have not been studied.

METHODS

To reach suggestions for design changes enhancing dignity, we used service design that included a broad user group. The effect of design changes was evaluated by a questionnaire answered by the nursing staff during a 4-week period pre- and post refurbishment and included a control group.

RESULTS

The design concepts agreed upon were a welcoming atmosphere, contact with nature, room for privacy, close contact with staff, and a designated smoking area inside the unit. The evaluation found that the environmental design changes significantly supported the patients in their situation and the staff in their work.

CONCLUSION

We conclude that dignity design concepts are highly applicable also in an acute psychiatric setting and improve the situation of secluded mental health patients, which is much needed. Findings align with other environmental changes in psychiatric wards that improve the patients' well-being and reduce aggression.

Engaging U.S. Adults with Serious Mental Illness in Participatory Design Research Exercises

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.

Space and Well-Being in High Security Environments

Research into the spatial dimensions of deprivation of liberty and psychiatric hospitalization has a long and complex tradition. In this context, the increasing numbers of prisoners and patients in forensic hospitals have impressively shown how difficult it is to ensure security, therapy and rehabilitation when space is scarce or not well-suited. In this narrative review, we present the main findings of recent lines of research on spaces in prisons and forensic psychiatric wards, with particular attention to the links between overcrowding in prisons and secure forensic psychiatric hospitals and violence, the foundations of prison and hospital architecture, and on how the design of spaces in prisons and hospitals can influence well-being. We assess and discuss these findings in the context of the current debate on how well-being in secure spaces can support the achievement of rehabilitation goals even in overcrowded institutions.

Permanent Supportive Housing Design Characteristics Associated with the Mental Health of Formerly Homeless Adults in the U.S. and Canada: An Integrative Review

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.