The physical environment of purpose-built and non-purpose-built supported housing for persons with psychiatric disabilities in Sweden

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.

Studies regarding supported housing and the built environment for people with mental health problems: A mixed-methods literature review

Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their findings in a thematic analysis. The built environment of supported housing involves three important and interrelated themes: well-being, social identity and privacy. If overregulated by professionals or located in problematic neighbourhoods or buildings, the settings could be an obstacle to recovery. If understood as meaningful places with scope for control by the tenants or with amenities nearby, the settings could aid recovery.

The meanings of place and space in forensic psychiatric care - A qualitative study reflecting patients' point of view

The outcome of care for patients sentenced to forensic psychiatric care is of importance not only for the patient but also for society, in preventing new crimes. In recent years, a person-centered perspective is influencing the care, recognizing the design of the physical environment as a therapeutic resource. To capture the complexity of patients' experience of the physical environment, a qualitative approach is needed. The aim of this study was to investigate the meanings of the patient room as a place and space in forensic psychiatric in-patient care from the patients' perspective. An explorative qualitative design was chosen, data were collected by photovoice; a combination of photographs, taken by the patients, followed by interviews. Eleven (N = 11) patients were interviewed. The interviews were analysed by a thematic analysis method. Four themes emerged from the data revealing the meanings of the patient room as a place and space: (i) striving towards normality; (ii) being anchored and protected; (iii) being at-home and homeness; and (iv) being in communion and meaningfulness. The findings show that the physical environment has a say in patients' basic needs and a role in maintaining normality. Substandard reveals a lack of respect and dignity towards this patient group. Involving patients in the design process of new facilities can be a way to make progress.

The influence of physical environmental qualities on the social climate of supported housing facilities for people with severe mental illness

The study investigates the extent to which the perceived physical environmental quality of housing facilities for people with severe mental illness accounts for perceived social environmental quality. Twenty facilities were assessed by people with psychiatric disabilities (residents), staff, and experts with regard to the physical environmental aspects of visual pleasantness, indirect environmental effects, overall physical quality, and the social environmental indicator of social relationship. The results suggest that residents' and staff's physical environmental quality perception accounts for social relationship quality perception, whereas experts' environmental assessment does not. Moreover, the staff reported a more positive social relationship perception than the residents.