Revitalizing Recovery

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Revitalizing Recovery

Prus, Victoria

URI: http://hdl.handle.net/10429/2550

Date: 2024-04-29

Abstract:

This thesis investigation focuses on understanding new ways to benefit patient experience and recovery within behavioral facilities. The current issue within behavioral facilities is that they are not fulfilling their duties in the sense that patients are not feeling well mentally, physically, and behaviorally. A large portion of the American and Canadian populations struggle with mental health issues and struggle to find help within these facilities, as their experiences are often associated with negative emotions. This thesis focuses on addressing the current issue of patient experiences in behavioral facilities which has been a continuous concern but remains unaddressed. This study's purpose is to find ways to improve patient experience and recovery time in behavioral facilities and to reduce re-hospitalization rates within these facilities. By using literature reviews, patient interviews, and analyzing current behavioral facilities, new design implementations have been discovered to benefit patients' mental, physical, and behavioral health. Along with patient interviews, helpful feedback was given to address the current issues and find solutions found through literature. It was found that there has been a push to implement new design features within behavioral facilities, but there is a lack of that push in Canada and the United States. Behavioral facilities have grown but still seem to be missing a part that fully helps their patients recover and benefits their overall health. A healing model has been developed to enhance patient experience in behavioral facilities and provides a framework for designing this type of facility.

Description:

The broad area of interest for this thesis focuses on the relationship between patient health and their experience within behavioral facilities. The main goal of this thesis is to outline innovative ways to improve patient experience and recovery time in behavioral facilities and to find ways to reduce re-hospitalization rates within these facilities. This thesis aims to leverage psychology to understand how patients perceive behavioral facilities, the issues with these facilities, and ways to improve the patient experience, recovery, and healing. The specific research focuses on improving patient health mentally, physically, and behaviorally through a new design model and healing design framework. It is known that behavioral facilities often have patients having a negative association with them and these facilities have high re-hospitalization rates. With this information, it is understood that there is a gap in the system that is struggling to help their patients succeed. This thesis focuses on a three-step process that intends to help patients transition to home smoothly and reduce the re-hospitalization rate. The three-step process starts with patients entering a traditional inpatient behavioral health unit. Once the patient has reached a point in their recovery, the intent is that they would enter “insert name of your unit”. This unit would work to help patients reintegrate into typical daily living and act as a bridge between hospital and home. Finally, once the patient is deemed ready, they will return home. The purpose of this three-step process is to create a more well-rounded patient experience and focus on improving their recovery with a healing design model. This healing design model is based on four core categories broken down into actionable design processes which include nature, materiality, connection, and experience. Diving deeper into the four core categories of the healing design model; nature which can also be understood as biophilia, is the human-nature connection. It is known that the implementation of biophilic elements such as plants, daylighting, and color, improves patient recovery and healing as well as productivity(Browning et al., 2020). The relationship we have with nature plays an important role in our lives and benefits us without us necessarily realizing it. Sunlight, fresh air, scenery, and plants are major aspects and benefits to human health. Sunlight gives us serotonin along with vitamins. Fresh air provides us with raised oxygen levels also raising our serotonin (Pinio & Ragione, 2013). When patients are exposed to daylight they often ask for less medication and have a shorter hospital stay(Kiefer, 2016). Plants and scenery work hand in hand as both have been shown to reduce stress and depression (Huntsman et al., 2022). Plants, sunlight, fresh air, and scenery all help boost creativity, productivity, better self-esteem, higher intellect, better cognitive performance, and overall better quality of life. The elements of nature and elements that mimic nature like art, textures, organic forms, and color are proven to aid patients in clinical settings like hospitals and behavioral facilities (Hill, 2021). The second core element materiality works hand in hand with nature. Materials that mimic nature like organically shaped furniture, wooden floor textures, different earth tones, and color variations have also been proven to aid patients. Color is proven to enhance well being, quality of life, reduce stress, and create a comfortable and home-like atmosphere. It is also known to influence positive moods and human behavior as it benefits physical, emotional and spiritual health (Wood, 1992). The third core element; connection focuses on patient connections to others and through spaces. Reflecting on spaces like public, semi-private, and private, patients have an equal balance of socializing with others but also having their own space to be able to reflect with themselves when needed. Often in behavioral facilities patients have many patients and the patient rooms hold from two to three beds. In this case that can be an issue for patients as they need time to themselves to help promote their recovery, autonomy, and dignity (Shepley et al., 2017). The fourth and last core element; experience, focuses on the overall health of the patient and their recovery and healing process. This is done through the implementation of alternative therapies and programming that is lacking or not seen in current behavioral facilities. The implementation of art therapy, music therapy, yoga, meditation, nutritional therapy and light therapy has all been proven to have many benefits such as improved mood, reduced stress and depression, promoted relaxation, communication skills, and enhanced overall well-being. These therapies and programs help support mental health, behavioral health, and emotional health (Sturmey, P. 2022). The goal is to study different spatial dimensions of behavioral facilities and implement a new solution to help patients recover, heal, improve health and to reduce the rate of re-hospitalizations. Mental illness is the leading cause of disability in the world (Kiefer, 2016). Recently there has been a push for more implementation of biophilia to the built environment as seen in Kronstad Psychiatric Clinic located in Bergen, Norway. The concept of this psychiatric facility is very open and transparent. The goal is to keep patients interacting with nature and with others. The various green zones provided by this facility encourage social interactions to help improve patient well-being. Kronstad is located in the middle of the city to keep patients feeling comfortable and connected to others as well as nature. Jacobs medical center located in San Diego, California also incorporates nature. The whole design of the building follows an organic form to follow nature. The building is built to have a vantage point on every level to be able to view nature and the views surrounding it. This facility allows patients to design their rooms and customize them to their own needs and wants. Jacobs Medical Center also provides a unique serenity room that is open for individuals to use, where they can calm down and feel light and hope. Incorporating biophilic elements into behavioral facilities is the best way to begin as this change can go a long way and benefit many people in the process. The implementation of nature in behavioral facilities has the potential to additionally help people heal, recover, and improve their quality of life as they are exposed to elements that continuously benefit both their physical and mental health. The goal is to find the best ways to implement biophilic elements for patients to have the best experience they can in hospitals while improving their overall mental and physical health. Behavioral facilities like psychiatric wards are known to have strict codes and rules for patient safety. These facilities are run on a strict, timely schedule and often do everything for their patients, which may seem good but when a patient has to transition to home they have an opposite environment. Patients go from little to no freedom to complete freedom and this transition from behavioral facility to home can have patients feeling overwhelmed and is too abrupt. Patients go from a codependent environment to an independent environment and that is when they often lose track of their process and go back to old habits and routines. Looking at both the Canadian and American statistics, it is evident that mental illness affects a large portion of the population. The rate for re-hospitalization for Canadians is on average 37% meanwhile the rate of re-hospitalization for Americans is 36%. The re-hospitalization rates are high and the reason for these re-hospitalizations can be from the hard transition from psych to home and also because the behavioral facilities themselves are not treating each patient uniquely to their illness. Behavioral facilities are known to be bland, and cold and have patients feeling anxious and uncomfortable. Patients are often trapped in the same spaces every day and repeat each day in the same repetitive pattern, which can cause more harm than good for a patient. Through literature reviews, patient interviews, and surveys, it is easily understood that patients struggle in behavioral facilities. Patients who are in psychiatric facilities should have a three-step process instead of the standard two-step process. This new second phase would be a new healing facility that is a perfect balance of home life and a psychiatric facility. This second phase facility can offer patients more freedom in their schedules, offer them alternative therapies, and programs, and importantly have biophilic implementations to help patients recover and heal before being sent home. Patients would have more independence and would be able to slowly get ready for a transition home while continuing their recovery and healing. This phase would help benefit patient health and focus on bettering their mental, physical and behavioral health. Through this study and analyzing different implementations of biophilia and other elements it is easily understood that these small additions aid in medical facilities and lead to positive outcomes for patients. This study focuses on developing a healing phase for patients as a step two process before patients are released home after psychiatric care. Connection with nature is shown to improve patient well-being, by different factors of heart rate, blood pressure, immune function, productivity, cognitive performance, stress, depression and even people's relationships with others. It was seen that after being exposed to biophilic elements like plants, water, air and sun, people felt more tranquil and comfortable and were able to recover faster. This proves that the implementation of biophilic elements in spaces helps to benefit patient outcomes and has an overall positive effect on their mental and physical health. Implementing biophilic-inspired elements into the second healing phase for behavioral facility patients can help patients' recovery and healing process as well as make their transition to home better. Using different activities and alternative therapies has also been shown to boost patient healing and health. The analysis and implementation of new private, semi-private and public spaces has also been shown to further aid patient health and healing and is something that is continuing to be explored in “the second phase healing” process for patients within this thesis investigation.

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