By Linda Hossie
Architects for centuries have depended on intuition and experience to create environments that generate a specific reaction
in the people who use the space. But neuroscience may change that. The ability to design the environment to elicit a specific
neurological response is slowly becoming a science, spurred by the work of the Academy of Neuroscience for Architecture (ANFA), the only institution in the world dedicated to studying the connection between the brain and architecture.
Dr. Eve Edelstein is president of Innovative Design Science, a faculty member at the NewSchool of Architecture and Design in San Diego and a Research Fellow with the ANFA. She is a leading figure in this movement for evidence-based design. Trained in both neuroscience and architecture, she and others in the field are building a body of evidence that will help architects create buildings attuned to the needs of people using those spaces. Edelstein talked with CrossCurrents about the implications of neuroarchitecture for mental health and addiction treatment facilities.
What are examples of the links between the brain and architecture?
Lighting is a perfect example. Scientific research has discovered cells in the back of the retina that aren’t used for vision. They integrate changes in light levels throughout the day and feed directly into the brain’s clock; these retinal cells set the circadian clock, the response of the brain to the changing time of day. What’s been so interesting is to see how circadian disruption can affect many aspects of mental function, mental health and biological function and medical health.
We can ask whether our architecture allows appropriate and natural cycles of light into buildings, particularly for people who spend a lot of time inside. It’s estimated that the workforce and certainly hospital patients spend 80 to 90 per cent of their time indoors. If our buildings don’t allow a natural light cycle, the endocrine systems that are driven by the light of day can become disrupted, and that includes hormones that drive stress responses. Studies have found relationships between sleep deficiency, depression and the amount of daily light exposure. This evidence from neuroscience supports what architects intuitively know about access to light through windows and other features.
How are neuroscience findings affecting actual architecture and design in health care?
I was part of the planning team for the redesign of St. Joseph’s Healthcare Hamilton, a mental health hospital in Hamilton, Ont. The light research drove our suggestions for how the entire building would be designed. That included proposing a garden space that would allow natural light inside as well as around the sides of the building. We also created wayfinding strategies using atria of different sizes and shapes, so that by virtue of the light coming into the atrium, people can understand where they are. We also created winter gardens, multi-storey atria in the middle of the building so people can sit by, see and be bathed in natural light at any time of year.
A lot of new design seems to focus on creating a calming environment. Does neuroscience support this trend?
In neuroscience, we look at stress responses and hormonal changes. Calming effects relate to elements like noise levels. We are finding interesting relationships between sound, unwanted-noise stress formers and cardiac responses and cortisol changes. Studies of night traffic, for instance, have found that increased cortisol levels and shifts in the normal daily cycle of cortisol are related to sound levels. Sightlines, views and access to and experience of outdoor spaces seem to be correlated with mental and physical health in terms of heart and stress levels. We have few definitive empirical studies, but taken together, the studies reveal a trend, a strong indication, in some cases, that design has a real biological and neurological impact.
Does neuroarchitecture have a role in the design of psychiatric facilities?
It’s helpful to look at the scientific evidence from biology and psychiatry. The difficulty is taking the information and translating it into something a designer can use. When I surveyed clinicians at St. Joseph’s Healthcare, I asked about different psychiatric conditions and their accompanying needs. It was clear that a continuum of needs exists and that it depends on the individual and their state of acuity. In any one individual you might find a multitude of needs that change over time. That’s true of all of us. Our needs change throughout the day, across time, according to our state of health, or the tasks we’re being asked to engage in. The challenge is, how can architects design for flexibility? I think flexible social space, flexible light, flexible quiet, flexible temperature, smell and colour are what people need and desire, and with a respect for these dynamic needs we can drive architecture in the right direction.
Many psychiatric facilities are moving towards private patient bedrooms and communal spaces for activities like cooking and
eating. Is there brain evidence for this trend?
Many studies have examined the effects of crowding, privacy and control, but it’s difficult to achieve statistical significance in small research studies. However, there are some interesting findings about the impact of isolation on depression, the increase in negative affect with isolation and the increase in positive aspect by being with a social partner. In one study of large hospital wards, people tended to isolate themselves more, but not in places with individual rooms.
Historically, psychiatric facilities have used isolation rooms to calm agitated patients. Does brain evidence show that this
environment is indeed calming?
I found a study that showed an increase in cardiac risk factors, even in people without a prior history of heart issues. But it’s an enormously complex question. The question also relates to the impact of one person’s isolation on other patients. The question for design is, how do you create a space that both serves the agitated individual and serves the rest of the individuals in that space? If we had sufficient staff and space to manage situations, including crises, it would be easier. What a designer can do is ask, what are the physiological responses at the simplest level of human beings so we can design to minimize an agitated state? We know that noise is related to agitation, and we have evidence that lighting is related to agitation as well, particularly among people with dementia.
Nurses at St. Joseph’s related a very interesting anecdote. The existing facility had exterior balconies, veranda spaces that were safe for patients and that opened to the air. The nurses told me, “We don’t need isolation rooms because if patients begin to feel agitated, or if we find they’re agitated, our first response is to direct them to have a moment to sit outside.” This suggests empirical evidence of some of the research attesting to the calming effects of nature and access to the outdoors.
Architecture affects not only how we perceive the world, but also how we interact within it. Here’s what research tells us.
Privacy and aggression. People with Alzheimer’s disease who have private rooms containing their own personal objects exhibit less aggression and
anxiety and fewer psychotic symptoms.
(“Environmental correlates to behavioral outcomes in Alzheimer’s special care units,” The Gerontologist, 2003)
Into the light. Retirement home residents living in buildings with a lot of daytime light show less cognitive decline than residents of
(“Use of bright lighting in senior care facilities associated with some improvement in dementia symptoms,” Journal of the American Medical Association, 2008)
Dimming the mind. Bright light seems to boost cognition, but it also counteracts relaxation and openness. A study of school counsellors found
that students interviewed in a dim room felt more relaxed, viewed the counsellor more positively and disclosed more than students
interviewed in a bright room.
(“The effects of interior design on communication and impressions of a counselor in a counseling room,” Environment & Behavior, 2006)
On the edge. A Harvard Medical School study found that people shown photos of everyday objects like couches and clocks preferred items
with rounded edges over those with sharp angles. The researchers speculate that our brains are hard-wired to avoid sharp angles
because we perceive them as dangerous.
(“Humans prefer curved objects,” Psychological Science, 2006. http://barlab.mgh.harvard.edu/papers/Curved2006.pdf)
When clutter is a good thing. A study by the Michigan Institute of Technology and the U.S. National Institute of Mental Health found that a generous scattering
of objects in a room increases the room’s memorability and establishes a reassuring sense of place.
(“Neuroscience and architecture: Seeking common ground,” Cell, 2006. www.cell.com/abstract/S0092-8674(06)01304-3)
Hitting the ceiling. Ceiling height in a room affects how people process information. A lower ceiling promotes greater attention to detail. Higher
ceilings promote abstract and creative thinking.
(“The influence of ceiling height: The effect of priming on the type of processing that people use,” Journal of Consumer Research, 2007. www.carlsonschool.umn.edu/assets/71190.pdf)
Seeing green. Studies of children and university students found that views of natural settings improve focus. Other studies have found
that attending to urban settings requires more cognitive work than gazing at elements of nature.
(“Effects of school design on student outcomes,” Journal of Educational Administration, 2009; “The cognitive benefits of interacting with nature,” Psychological Science, 2008)