The architecture of the psychiatric milieu

The last time a peer-reviewed volume on the future of mental health facilities was produced was in 1959, following a symposium organised by the American Psychological Association. The consensus was easy enough to follow and still resonates today: the best spaces to treat psychiatric illness will be in smaller, less restrictive units that offer more privacy and allow greater personalisation of space – possibly a converted hotel (Goshen, 1959). In some way, all those ideals have come to pass. An ideal typology was never established, but even so, units have shrunk from thousands of beds to units that typically house no more than 50 patients. Patients are generally more independent and are free to wander (within a unit) as they please. But the trend toward smaller and freer is reversing. This change is not driven by a desire to find the ideal building nor better models of care, but by growing concerns about budgets, self-harm and psychiatric violence. This issue of the Facilities comes at a time when the healthcare design is increasingly dominated by codes, statutes and guidelines. But the articles herein are a call to stop and think. We are not at the point where guidelines can be helpful, because they do not embody any depth of knowledge nor wisdom. These articles are intended to inject some new research on psychiatric/environmental interactions and also to remind planners and managers that guidelines might not tackle a core misunderstanding: fear-management about patient safety and the safety of society is not the purpose of the psychiatric facility. It is purpose is to create spaces that are suitable for improving the well-being of the mentally ill.

Are diverse factors proxies for architectural influences? A case for architecture in the aetiology of schizophrenia

Introduction The last half-century of epidemiological enquiry into schizophrenia can be characterized by the search for neurological imbalances and lesions for genetic factors. The growing consensus is that these directions have failed, and there is now a growing interest in psychosocial and developmental models. Another area of recent interest is in epigenetics – the multiplication of genetic influences by environmental factors. Methods This integrative review comparatively maps current psychosocial, developmental and epigenetic models for schizophrenia epidemiology to identify crossover and theoretical gaps. Results In the flood of data that is being produced around the schizophrenia epidemiology, one of the most consistent findings is that schizophrenia is an urban syndrome. Once demographic factors have been discounted, between one-quarter and one-third of all incidence is repeatedly traced back to urbanicity – potentially threatening more established models, such as the psychosocial, genetic and developmental hypotheses. Conclusions Close analysis demonstrates how current models for schizophrenia epidemiology appear to miss the mark. Furthermore, the built environment appears to be an inextricable factor in all current models and indeed may be a valid epidemiological factor on its own. The reason the built environment hasn’t already become a de rigueur area of epidemiological research is possibly trivial – it just doesn’t attract enough science, and lacks a hero to promote it alongside other hypotheses.

Tipovoĭ proekt korovnika na 100 golov

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Letter from Thomas Hope, architect, regarding drawings for ark of new synagogue

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Proekt tipovogo 2-kh kvartirnogo pereselencheskogo doma

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Proekt tipovogo 4-kh kvartirnogo pereselencheskogo doma

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Proekt tipovogo doma dli︠a︡ pereselencheskikh uchastkov obsluzhivaemykh Agrodzhoĭntom

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Proekt doma

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Tipovoĭ zhiloĭ dom pereselent︠s︡ev evreev Khersonskogo okruga po planu stroitelʹstva 1926 goda

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Proekt glinobytnogo doma tipa 7.50x4.00

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Naruzhnai︠a︡ vkhodnai︠a︡ dverʹ

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Zimniĭ okonnyĭ pereplet

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Proekt tipovoĭ shkoly I i II-kh komplektnai︠a︡

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Ispolnitelʻnyĭ chertezh karkasogo, krytogo cherepit︠s︡eĭ, zdanii︠a︡ dvukh-komplektnoĭ shkoly na poselke "Novyĭ-Putʹ", Krivorogskogo okruga i raĭona

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Ispolnitelʻnyĭ chertezh kamennogo, krytogo cherepit︠s︡eĭ, zdanii︠a︡ Larinskoĭ shkoly v poselke Tagancha, Krivorogskogo okruga i raĭona

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