Patient-centered (or human-centered) design approaches have helped designers to better understand patient needs and expectations during mental health treatment. Previous studies show evidence that the physical environment has an impact on the human experience, and the importance of environments that support feelings all humans strive for, including normalcy, safety, control, and belonging. This study adds to the body of knowledge around the role of the physical environment in mental health treatment.
This study is focused on understanding the patient perspective of the physical environment – both within and beyond the clinic – during mental health treatment.
This study involved a qualitative approach to investigate patient perspectives of the physical environment during outpatient treatment. Researchers began by identifying over 12,000 patients of Kaiser Permanente San Jose who had received outpatient mental healthcare, including medication management, psychotherapy, and/or group therapy in-person during the previous 12 months. After random selection and considering exclusion criteria (patients had to be between 18 and 85 years old, had at least one clinical diagnosis of a mental health disorder, and have the ability to understand English), 13 patients enrolled in the study. Researchers (who were also clinical psychiatrists) conducted 60-90 minute semi-structured phone interviews with each participant, using what is referred to as inductive analysis and a constructivist framework. This meant that the researchers were able to consider themes that they had guessed would come up in the interviews, as well as new themes they had not previously considered.
Findings include various aspects of how the physical environment where patients spend time either helped or hindered their mental health. Patients discussed some aspects of the clinic where they received care, but also other places they were spending time in and even mental imagery of other places.
Findings mainly focused on themes the researchers identified in the data as supportive to patients’ mental health. Themes included sensory design elements like natural light and plants, access to spaces that support creative activities like painting, spaces that allow for personal space even with social support, and spaces that created a sense of safety.
The findings also included several aspects of the physical environment that were not conducive to mental health, such as sensory design elements that were jarring such as harsh lighting and loud traffic, and social-relational elements such as crowded areas or seating positioned too close to a therapist.
Another theme described in the findings but not explicitly called out by the authors was how participants were thinking about their physical environment in perhaps new ways during the mental healthcare process. For instance, one participant described being in traffic and noticing traffic, but not interacting with traffic. Another participant described seeing different lights and feeling different textures in the road when driving. Another participant noted that they had not previously considered the connection between physical environment and mental health before the interview.
While the authors clearly describe the aim of this study, they do not include the specific questions they asked during the interviews, and the parameters within the interview method are unclear. Many of the limitations of this study are related to the exploratory approach and a very broad aim. However, this type of work is necessary and valuable in gaining an initial understanding of issues to lay the groundwork for future research.