Environmental quality in pental health care facilities: POE and codesign experiences in CAPS-AD III units

Author(s)

Fernanda de Moraes Goulart

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Faculdade de Arquitetura e Urbanismo (FAU/SBI)
• Defense date: 2023-03-17

Examining board members

Rosaria Ono; Ricardo Codinhoto; Gleice Virginia Medeiros de Azambuja Elali; Márcio Minto Fabricio; César Imai

• Advisor: Rosaria Ono

Abstract

Mental health care facilities (MHF) offer specialized care to people suffering from mental disorders. It consists of a health service aimed at people in vulnerable situations; hence its ambiance must be constituted in a way that promotes the autonomy of its users, social bonds, and community life. Furthermore, the construction of these facilities must support the proposed therapeutic practices and the work of the health team. This research investigates which objective and subjective aspects of the ambiance in an EASM can contribute to its positive evaluation by users. Three Psychosocial Care Centers for Alcohol and Drugs III (CAPS-AD III) in São Paulo were selected as a case studies. Data were collected using the dream CAPS toolbox, which was developed for this research. It combines post-occupancy evaluation methods with codesign techniques in three stages. At the first stage, a specialist conducted an extensive evaluation of the built environment. The second stage evaluates the occupant s perception through a walkthrough with a key person (director), applying questionnaires with workers, and walk- along interviews with service users. In total, 100 workers and 12 patients participated in this stage. Finally, the data collected in the first two stages were compiled to support the third and last stage of the research, the participatory prototyping cycle (PPC). The PPC is a codesign model developed to accommodate participants profiles and explore their different capabilities. The tools selected for the CPP were: Make-believe in a 3D model (which requires acting capabilities), wish poem (doing capabilities), and visual interview with illustrated cards (speaking capabilities). Workers participated in pairs, completing 12 PPC sessions in total. 13 patients participated in the PPC in individual sessions. The activities were audio-recorded, and a textual analysis qualified and categorized the speech content using the descending hierarchical classification method. As a result, five positive aspects were identified in MHF environments; (1) Humanization, which makes health environments a welcoming place, (2) Attention to care and control, as long as safety is promoted with non-invasive surveillance strategies, (3) Maintenance and cleaning as an instrument to fight stigma and prejudice, (4) Patient rooms that promote opportunities to overcome challenges and (5) Living spaces that promote autonomy and freedom of choice. The discussion also addresses methodological lessons regarding implementing Codesign in establishments that promote mental health care. Finally, a compilation of 36 architectural strategies recommended for the construction, renovation, and expansion projects of MHF is presented. (AU)

• FAPESP's process: 18/25152-1 - Environmental quality in psychosocial treatment units: a post-occupancy evaluation in CAPS AD III units
• Grantee: Fernanda de Moraes Goulart
• Support Opportunities: Scholarships in Brazil - Doctorate