'Meaning of Place for Identity, Spirituality & Mental Health'

Summarised from the chapter of the same name (pp155- in:
Curtis, Sarah. Space, Place and Mental Health. Farnham: Ashgate Publishing, 2010.

Perceptions of space may become disturbed in patients with psychotic illness - things we take for granted in everyday life are disrupted.
Phenomenology raises basic questions about these 'taken for granted' senses of being in the world and encourages us to try and explain them (see my previous blog entries on sense of place, Martin Heidegger etc). Research into this suggests that phenomenology may have a role in developing knowledge about schizophrenia. (see pp 156-157). Phenomenological perspectives remind us that the fact that one perceives the world in particular ways considered 'normal' does not necessarily mean that the world has an independent existence that exactly corresponds with our perceptions. Everyone perceives their environment slightly differently, but also through a 'shared lens' of biologicially or socially constructed frames of reference.

Societies have always had and ambivalent attitude towards individuals whose perceptions of the world differ from the majority - they tend to be either labelled as strange/psychotic/deviant and stigmatised or punished, or they are are valued and treated as sacred (tortured genius/savant etc)

Cultural diversity in concepts of wellbeing

There is significant cultural and social variations in the way we understand our relationship with both the natural and the built environment. Many cultures are less individualistic than the dominant European and North American cultures, and instead view natural landscapes and relationships with these as being very important for psychological and physical wellbeing.
Generally it seems that access to natural resources is essential for the general health of particularly aboriginal/native populations. Health for Maori is seen as a combination of mental, sprititual, family and physical wellbeing (p175). Alienation from the land has spiritual, social and psychological implications (as well as economic and political). See this research paper for more on this.

Also in the same book (Curtis, Sarah. 'Post-asylum geographies of mental healthcare.' in Space, Place and Mental Health. Farnham: Ashgate Publishing, 2010.

Newer mental healthcare units tend to emphasise the 'homely' and comfortable in their design though individual patient rooms still have obvious security and surveillance elements which detract from this feeling of homeliness eg. vision panels in the doors, sloping tops, recessed doors and handles, screens on the windows.  A paper reporting on discussions about the design of a new mental healthcare setting was interesting:

•  Nursing staff and consultants felt the security and surveillance features described above did little to encourage more relaxed social interactions between patients and staff, and impinged on patients privacy and liberty
• They also commented that it's impossible to reconcile all the needs and preferences  for hospital facilities for a diverse group of patients varying in age, gender, culture, ethnicity and faith groupings as well as in diagnosis.

For more on this, see these links:

• Sarah Curtis Creating ‘therapeutic landscapes’ for mental health carers in inpatient settings: A dynamic perspective on permeability and inclusivity
• ibid. Therapeutic landscapes in hospital design: a qualitative assessment by staff and service users of the design of a new mental health inpatient unit