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Necia

Necia Mickel

Year of Award: 2015 Award State: South Australia Architecture > General
Health And Medicine > Mental Health
To investigate the role of built and landscape environment in improving well-being and recovery outcomes for veterans suffering stress including Post Traumatic Stress - Germany, Netherlands, UK, Canada, USA
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From an architectural focus after many years working on care environments, and with the advice and assistance of senior members of the Veteran community and Professor Alexander McFarlane, my study topic led me to the Netherlands and Canada, identified as having scale and experience similar to Australia with contemporary approaches in response to recent conflicts in Afghanistan. The study extended to UK and USA having experience not only with Afghanistan but also earlier conflicts in Falklands and Vietnam respectively.

Of interest is the varying focus on inpatient and outpatient care for military mental health in each country. Care is structured around outpatient clinic care in Netherlands and Canada, with acute patients referred to the public hospital mental health systems. In Netherlands the mental health system for the military also provides services for uniformed first-response personnel. In UK, the public health system and charitable organisations run inpatient units which offer acute, subacute care and outpatient clinics, while in USA these services are provided in the Veteran Affairs hospital system.

Typically the facilities visited were all well-considered, using techniques to de-institutionalise, de-stigmatise and normalise the spaces. Meaningful art and scupture, often pieces done by veterans, added storytelling interest. Art activity and display featured as an important therapy in all settings. Significantly military/conflict memorabilia is not used as a decorative element (minor exceptions). Good built spaces convey respect and some formality but also create a sense of security,comfort and familiarisation, balanced with the need for very robust design. Domestic activities/training, engaging new physical/mental challenges, and opportunity to physically wear off aggression and frustration are important elements. Rural or semi-rural settings with clear and unobstructed space to distant wooded areas, or large walled enclosures with trees and controlled low landscaping, provide a sense of security for the hyper-vigilant that there are no ‘hidden dangers’.

Design that supports an ordered, uncluttered, professional environment while offering familiarity, normality and security is a strong theme across the study undertaken. The opportunity for a veteran to interact with and control aspects of their physical environment, both built and landscape, promotes self-determination and independence – essential criteria on the pathway to recovery.

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