Mental health: How architects can help direct a path toward recovery

May 23, 2018 Barry Kowalsky

Coping with chronic mental illness in growing urban communities will require a different design approach

 

No matter where we are today, technology has created certain expectations amongst us. Expectations to have access to information 24/7. Expectations to have round-the-clock access to goods and services—goods and services that can be shipped right to our doors.

These expectations are reshaping society and altering our most foundational institutions. But how do they serve our fundamental need for compassionate care and support? The healthcare sector is exploring this question right now.

More and more people are moving into cities. In fact, some predict two-thirds of the world’s population will relocate to urban areas by 2050. However, patterns of urban development are not yet capable of supporting chronic illness—particularly when it comes to people suffering from mental illness and addiction. The traditional model of healthcare service delivery needs replacing. But with what?

 

More and more people are moving into cities, but our current patterns of urban development are not yet capable of supporting a population with chronic illness.

 

Balancing institutional and community-based care is complex, but it’s crucial in our communities today. Currently, our Healthcare team is looking at implementing a progressive solution in Newfoundland & Labrador (Canada)—a transformation called Towards Recovery.

Established in 2017, Towards Recovery aims to deliver a comprehensive suite of services to better manage our contemporary mental health and addiction (MHA) needs. How? By addressing the “care anywhere” and “age anywhere” ideals:

Care anywhere: We want access to services in person, online, at home, at the office, where we shop, where we play, and in specialized centers like hospital and clinics.

Age anywhere: We want to age in the communities where we live. We don’t want to be relocated from our lives—especially not for chronic issues like MHA.

Towards Recovery uses a measured approach to system redesign that helps to inform and develop the most effective community-based strategies. This enables experts to fine-tune service delivery and further improve health system outcomes into the future. The plan also involves the New Adult Mental Health Facility, a proposed replacement of an existing 19th-century era psychiatric hospital.

 

The need for more access to MHA services

The prevalence of mental illness in Canada is staggering. Chronic depression, opioid abuse, suicide, issues associated with MHA have a heavy impact on the daily lives of Canadians—particularly amongst indigenous peoples, youth, and those in poverty. Check out the statistics below:

Who is affected?

  • 70% of mental health problems have their onset during childhood or adolescence
  • People with a mental illness are twice as likely to have a substance abuse problem

Morbidity and mortality

  • 1 in 5 people in Canada will personally experience a mental health problem or illness
  • Mental illness can cut 10 to 20 years from a person’s life expectancy

Suicide

  • Over 4,000 Canadians commit suicide each year—almost 11 per a day
  • Indigenous youth are five to six times more at risk

The cost of mental illness in Canada—health care costs, lost productivity, and reductions in health-related quality of life—has increased six-fold in the last 20 years. This is partly due to developments in scientific research, but extensive social outreach has also increased knowledge sharing and decreased the stigma surrounding mental illness. The percentage of people needing MHA services is rising in sync with urbanization rates, but we already know our healthcare model will not be effective in the big city. So, how can we support the transition towards recovery?

 

 

How architects can help redefine healthcare delivery

Through collaborating with healthcare professionals, we can use our innate ability to understand the big picture to plan healthy spaces that encourage diversity and improve access to services. Our aim? Use a holistic approach to fully understand what design means in the healthcare sector—and how it impacts human behavior.

This expertise will help to mitigate mental health issues. But first, architects need to comprehend the service components of a redesigned mental health and addictions system. These include incorporating a stepped care model, integrating technology, implementing specialized care services, and providing educational materials.

The redefined model will encompass promotion, prevention, and intervention services, as well as provide rapid access through a patient-centered approach. It will diagnose patients into acute, institutional, or community-care centers to relieve bed shortages. Best of all, it’s a measurable, self-reflexive model that provides the support to reduce these issues now and into the future. 

Yes, this will be challenging transition. But, it also affords us new opportunities to apply our design expertise at all levels of the built environment. By bridging connections between sectors, we can create healing environments and healthier communities for those coping with mental health and addiction issues.

 

Barry will be presenting his thesis “Designing resiliency in mental health and addictions services” in Room 02 at 10:40 AM at the 38th annual UIA-Public Health Group seminar in Paris on Thursday, May 31.  

May is mental health awareness month. At Stantec, we have signed a pledge with the World Federation of Mental Health. If you have a coworker, family member, friend, or someone you know who is dealing with a mental health issue, please do your part by focusing on awareness, acceptance, and early intervention. For those of you who have experienced this on either side of the fence, please share your stories and help create a comfortable space that can ignite conversations about mental health. Together, we can make a difference. 

 

About the Author

Barry Kowalsky

Barry Kowalsky focuses on the integration and service delivery of medical facilities to create efficient, inherently flexible buildings.

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