Respite for the Troubled Mind - Supportive and Natural Spaces as a Therapeutic Tool

Abstract

Introduction: Mental health disorders are a major health problem worldwide and are associated with decreased life expectancy, suffering, and economic burdens. A prerequisite for the treatment of mental disorders is for an individual to be in an environment that is experienced as safe and supportive and that can promote health and well-being. Aim: The overall aim of this thesis was to explore the impact of built environments (indoor and outdoor) and integrating nature into therapeutic environments. Specifically, this research assessed the building design of a new mental health facility from the perspectives of personnel involved in planning and design, therapists, staff, and patients. Methods: Based on qualitative interviews with 51 participants, this thesis improves our understanding of supportive and natural spaces as a therapeutic tool. In other words, this research revealed how the physical environment can influence and impact therapeutic work and settings. A new mental health facility in Norway was the subject of a case study that explored the various perspectives of a project group’s members. Specifically, this work assessed the perspectives of those involved with planning and designing the new facility, therapists (e.g., clinical psychologists and psychiatrists), psychiatric staff, and patients. By using various methods like qualitative interviews (both individual and focus group interviews) and photovoice methodology, we aimed to enter the lifeworlds of the participants. Interpretative phenomenological and thematic analyses using van Manen’s existential themes of the lifeworld and a phenomenological hermeneutic approach were used to research lived experiences. Findings: Built environments can be actively utilized as tools in psychotherapy. Environments should not be considered merely as neutral and passive spaces for conducting and receiving psychotherapy. Rather, they should be experienced as places that may regulate and impact both therapists and patients, as well as the relationship between them. Findings from Study II showed that supportive environments influence patients’ mental health and staff’s therapeutic practices. For example, they provide options for novel treatment needs, in contrast to older and more outdated buildings that are perceived to hinder appropriate treatment conditions. Study III uncovered dilemmas between barriers and possibilities of staff’s use affordances, where the new environment offered numerous affordances that could be utilized in therapeutic practices. However, the staff pointed to organizational hindrances in making use of these identified opportunities. Study IV found that patients were able to find calmness, land, and rest in the new mental health facility because of its supportive design. Therefore, they were more open to therapeutic interventions that made the recovery process faster. The insights from this study underscore the importance of considering design features that address the various needs of patients engaged in mental health care. Conclusion: This thesis points to the role of the built environment in mental health care. Rather than just serving as a neutral backdrop, the physical environment actively shapes therapeutic processes and expands therapeutic spaces, patient experiences, and staff practices and should thus be considered a therapeutic tool.