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The housing environment of people with severe mental illness

Marcheschi, Elizabeth LU (2015)
Abstract (Swedish)
Popular Abstract in Swedish

Bostäder med särskild service som upplevs ge möjlighet till socialt umgänge, avskildhet och återhämtning har positiva effekter på livskvaliteten hos människor med psykisk funktionsnedsättning. Vidare visar resultaten från denna avhandling att den visuella upplevelsen av miljön och upplevelsen av hemlikhet är betydelsefulla för att etablera en stödjande atmosfär. Boendemiljöer som utformas med hänsyn till dessa kvaliteter bidrar till att skapa en god platsförankring, en positiv social miljö mellan boende och personal och utveckla positiva sociala relationer mellan människor med psykisk funktionsnedsättning. Denna avhandling belyser därmed vilka fysiska faktorer som påverkar människor med psykisk... (More)
Popular Abstract in Swedish

Bostäder med särskild service som upplevs ge möjlighet till socialt umgänge, avskildhet och återhämtning har positiva effekter på livskvaliteten hos människor med psykisk funktionsnedsättning. Vidare visar resultaten från denna avhandling att den visuella upplevelsen av miljön och upplevelsen av hemlikhet är betydelsefulla för att etablera en stödjande atmosfär. Boendemiljöer som utformas med hänsyn till dessa kvaliteter bidrar till att skapa en god platsförankring, en positiv social miljö mellan boende och personal och utveckla positiva sociala relationer mellan människor med psykisk funktionsnedsättning. Denna avhandling belyser därmed vilka fysiska faktorer som påverkar människor med psykisk funktionsnedsättning och kan bidra till att vägleda planering och utformning av nya bostäder med särskild service. Tidigare bodde personer med allvarliga psykiska funktionshinder på institutioner ofta lokaliserade till utkanten av befintlig bebyggelse. Tillvaron var uppbyggd kring strikta rutiner, avskildhet och restriktioner vilket hade en negativ inverkan på deras välbefinnande. Sedan 1960-talet har nya boendeformer successivt introducerats i syfte att minska de negativa effekterna av institutionsmiljöerna. Idag är så kallade bostäder med särskild service en av de mest förekommande boendeformerna för människor med psykisk funktionsnedsättning och det är denna boendeform som studeras i avhandlingen. Boendeformen kännetecknas av att ett mindre antal personer med psykisk funktionsnedsättning bor tillsammans och har daglig tillsyn av personal. Forskning har visat att det förekommer undermåliga boendemiljöer även i denna form av boende, vilket i vissa fall medfört att en stämning som påminner om den som fanns i de tidigare institutionsmiljöerna har återskapats. Även om det är allmänt vedertaget att vår omgivning påverkar människors psykiska hälsa, och särskilt sårbara individer, så finns det lite kunskap om vilka fysiska aspekter av bostäder med särskild service som bidrar till välbefinnande och god livskvalitet hos människor med psykisk funktionsnedsättning. Målet med denna avhandling är således att öka förståelsen för vilka aspekter av den fysiska miljö som kan främja en positiv utveckling för dessa människors välbefinnande.

The housing environment of people with severe mental illness

68

Totalt omfattar arbetet empiriska studier av 20 olika bostäder med särkild service i södra Sverige Vid datainsamlingen har experter från miljöpsykologi och arkitektur, såväl som individer med psykisk funktionsnedsättning samt deras sjukvårdpersonalen medverkat. För att inhämta information om miljön i dessa bostäder samt boendes välbefinnande har expert- och brukareobservationer samt självrapportering genomförts. (Less)
Abstract
Supported housing facilities (SHF) are among the most common housing solutions for people with severe mental illness (SMI). A poor level of physical-environment qualities and the re-creation of institutional atmospheres in these settings have been found in recent studies. The research focus in the psychiatric field has, however, largely neglected these topics and the available knowledge does not provide sufficient evidence to draw any conclusions in terms of which physical environmental aspects support the well-being of people with SMI. The aim of this thesis is thus to reduce this knowledge gap and identify physical-environment affordances for psychosocially supportive housing facilities. The HEI model and a salutogenic approach are the... (More)
Supported housing facilities (SHF) are among the most common housing solutions for people with severe mental illness (SMI). A poor level of physical-environment qualities and the re-creation of institutional atmospheres in these settings have been found in recent studies. The research focus in the psychiatric field has, however, largely neglected these topics and the available knowledge does not provide sufficient evidence to draw any conclusions in terms of which physical environmental aspects support the well-being of people with SMI. The aim of this thesis is thus to reduce this knowledge gap and identify physical-environment affordances for psychosocially supportive housing facilities. The HEI model and a salutogenic approach are the thesis’ theoretical backgrounds that have led to the identification of physical-environment affordances, which have proven to be crucial for people’s well-being. Such affordances are operationalized in terms of visual pleasantness, homelikeness and indirect environmental effects. SHF (N = 20) were investigated with a multi-place approach by experts (N = 5), user-group panel (N = 3), people with SMI (N = 72) and staff (N = 117) (social actors). Four papers contribute to test the influence of the selected affordances on people with SMI: comparison of the views of different social actors (Paper I), evaluation of their impact on social climate (Paper II), observed behaviors (Paper IV) and on place attachment and quality of life (Paper III). Results suggest that SHFs with perceived greater physical affordances (visual pleasantness and indirect environmental effects) were associated with positive social climate perceptions. Moreover, the indirect environmental effects were found to be supportive for observed behaviors of interactions, attachment to place and quality of life responses. Place attachment and social climate mediated the effects of the physical environment. These findings suggest that future planning of SHF should focus on a housing design that sustains possibilities for social interaction, privacy regulation and restoration (indirect environmental effects) in order to support well-being outcomes among people with SMI. Methodological, theoretical and practical design implications are discussed. (Less)
Please use this url to cite or link to this publication:
author
supervisor
opponent
  • Professor Evans, Gary William, Cornell University, USA.
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Supported housing facilities, people with severe mental illness, multi-place analysis, physical-environment affordances, social climate, social interactions, place attachment, quality of life
pages
156 pages
publisher
Lunds Universitet/Lunds Tekniska Högskola
defense location
Room A:C, A-building, Sölvegatan 24 Lund University Faculty of Engineering, LTH.
defense date
2015-06-05 09:15
ISSN
0280-8269
ISBN
978-91-628-9427-6
language
English
LU publication?
yes
id
f3969477-7b04-43e7-b3c1-c684cf828117 (old id 5360798)
date added to LUP
2015-05-07 14:37:32
date last changed
2017-03-06 13:43:22
@phdthesis{f3969477-7b04-43e7-b3c1-c684cf828117,
  abstract     = {Supported housing facilities (SHF) are among the most common housing solutions for people with severe mental illness (SMI). A poor level of physical-environment qualities and the re-creation of institutional atmospheres in these settings have been found in recent studies. The research focus in the psychiatric field has, however, largely neglected these topics and the available knowledge does not provide sufficient evidence to draw any conclusions in terms of which physical environmental aspects support the well-being of people with SMI. The aim of this thesis is thus to reduce this knowledge gap and identify physical-environment affordances for psychosocially supportive housing facilities. The HEI model and a salutogenic approach are the thesis’ theoretical backgrounds that have led to the identification of physical-environment affordances, which have proven to be crucial for people’s well-being. Such affordances are operationalized in terms of visual pleasantness, homelikeness and indirect environmental effects. SHF (N = 20) were investigated with a multi-place approach by experts (N = 5), user-group panel (N = 3), people with SMI (N = 72) and staff (N = 117) (social actors). Four papers contribute to test the influence of the selected affordances on people with SMI: comparison of the views of different social actors (Paper I), evaluation of their impact on social climate (Paper II), observed behaviors (Paper IV) and on place attachment and quality of life (Paper III). Results suggest that SHFs with perceived greater physical affordances (visual pleasantness and indirect environmental effects) were associated with positive social climate perceptions. Moreover, the indirect environmental effects were found to be supportive for observed behaviors of interactions, attachment to place and quality of life responses. Place attachment and social climate mediated the effects of the physical environment. These findings suggest that future planning of SHF should focus on a housing design that sustains possibilities for social interaction, privacy regulation and restoration (indirect environmental effects) in order to support well-being outcomes among people with SMI. Methodological, theoretical and practical design implications are discussed.},
  author       = {Marcheschi, Elizabeth},
  isbn         = {978-91-628-9427-6},
  issn         = {0280-8269},
  keyword      = {Supported housing facilities,people with severe mental illness,multi-place analysis,physical-environment affordances,social climate,social interactions,place attachment,quality of life},
  language     = {eng},
  pages        = {156},
  publisher    = {Lunds Universitet/Lunds Tekniska Högskola},
  school       = {Lund University},
  title        = {The housing environment of people with severe mental illness},
  year         = {2015},
}