The buildings we inhabit can change the way we feel. That’s particularly relevant when designing mental health spaces, and yet there are no real guidelines that cover this field.
With one in five Australians experiencing a mental illness in any year, a researcher at the Melbourne School of Design says it’s worth considering how to design the spaces in which therapy takes place.
Stephanie Liddicoat is nearing the completion of her PhD on the architecture and the design of therapeutic environments, and was inspired by the idea that better designed therapeutic spaces could improve overall treatment and recovery.
“We can all picture spaces that we’ve walked into in our own lives that have just felt wonderful,” Ms Liddicoat said.
“Conversely I think we can all picture some spaces that we’ve walked into that have just been awful. Hospitals are often one of them — they make us feel more stressed and anxious.”
In her research, Ms Liddicoat visited therapeutic spaces in Australian and New Zealand, speaking with mental health clinicians and patients about the influence the environment had during therapeutic practices.
“The patients gave the most insight into the research — they could speak with such eloquence about their own relationship to their environment, what was supportive and made them feel calm and reduced their stress and anxiety,” she said.
Ms Liddicoat explained some patients felt anxious in environments that perpetuated mental health stigmas.
“So where we might walk into a counselling facility and the receptionist is sitting behind this huge, flexiglass safety screen and there are security cameras everywhere — that suggests to them that they’re dangerous, and that they’re going to act out,” Ms Liddicoat said.
“And that’s certainly not helpful if you’re trying to recover from something.”
Ms Liddicoat also found that completely internal rooms, excessive use of concrete and little natural light also increased stress amongst service users.
“All of those things made the space feel like a punishment and exacerbated those negative stigmas and those ideas of abnormality,” she said.
Visual and audial privacy were also very important.
“[In] a space where you might feel that you were on show, or that someone is going to intrude … you’re certainly not going to open up,” she said.
Risks in retrofitting buildings for therapy
A common occurrence during Ms Liddicoat’s research was the discovery that mental health spaces were often slotted into retrofitted buildings.
Ms Liddicoat recalled a visit to a school where the janitor’s closet was being used for counselling.
A therapist even told her about being given an office originally built as a fertility and family health clinic, with a gynaecological exam chair bolted to the floor.
“These are things that can’t happen — that’s certainly not conducive to the service user engaging in the therapy, feeling comfortable and safe,” she said.
Ms Liddicoat said clinicians were aware of the influence their work environment had on their therapy.
“They’d be very willing to adjust their spaces, but there is so little guidance on how to do that,” she said.
“These things are quite minor changes, but they can allow a service user to feel a lot more comfortable.”
Practitioners welcome guidelines for design
Senior mental health clinician Joanne Veltkamp echoed these sentiments.
“I do notice an environment that is too medically and clinically orientated leans itself to a more rigid and formal engagement with the person,” Ms Veltkamp said.
Ms Veltkamp said for the past 17 years, she and her colleagues had decorated therapeutic spaces with colourful curtains, cushions and artwork.
“The basis of our work is relational, in my mind,” she said.
“If you’re wanting a genuine, comfortable, warm interaction with somebody, it’s important to be in a place that’s safe and comfortable.”
On the completion of her PhD, Ms Liddicoat will have created a series of therapeutic guidelines, from furniture right through to fixtures.
Ms Veltkamp said this would be useful. “I think it would be helpful if you’re wanting to get the most out of therapy and … to be holistic and inclusive.”