to help you.

So today we have Dr. Katy Perry joining us from Case.

And, well, Dr. Perry, who is a course director of Human Experience Lab Africans.

And well, she's a psychologist, a researcher with autism and ADHD and she's a celebrated expert in health within the built environment research.

She earned her Ph.D. in human behavior and design from Cornell University.

And her work in mental and behavioral health design and research has been celebrated and showcased in various platforms, such as BBC.

So please help me welcome Dr. to the podium.

Thank you so much, Roxanna.

Thank you for having me.

Here at Texas A&M, I've actually never been down to A&M before, and I have already been totally blown away by all of the fabrication work and the design work that I've seen.

It's incredible.

So thank you for having me here.

Thank you for joining me.

I'm going to talk a little bit today about my work as an environmental psychologist.

And the idea of an environmental psychologist might sound a little bit like, I don't know, maybe I'm interested in climate change or pro-environmental behavior or recycling.

And that's certainly part of environmental psychology.

But I am much more concerned with how humans interact with the built environment and the things around them that have been designed for occupancy.

Because all of you are in architecture school, right?

You already have an appreciation for how the built environment affects our ability to heal and live and learn and learn.

And this goes back centuries, hundreds of thousands of years.

Humans have learned to design the environment around their needs.

To illustrate this, I've got the Asclepius from the fourth century B.C.

ancient Greece.

If you were sick around that time, there weren't very many places to actually get help.

Hence the low life expectancy.

Right.

And so people would travel, take pilgrimages hundreds of miles just to reach places like the temples at a sleepy town where they might be able to receive some spiritual and health guidance from the folks that were here.

As you entered through this kind of main ceremonial entrance, you'd eventually come upon what they called the avatar.

You would have an overnight stay in the avatar on this this lovely circular structure right over here.

And the Abberton was a place of both physical and mental healing.

The priests in the Asclepius would guide the gods to enter your dreams and provide you with a sense of healing and provide you with an idea of what the treatment was that you needed for whatever ailed you.

And sometimes those dreams were facilitated with psychedelic drugs, and sometimes they were treated with really, really early brain surgery that may or may not have worked out well.

But by all intents and purposes, from what we've been able to see from inscriptions that were left on stones among the site, a lot of people found healing here.

And by all accounts, it's one of the first hospitals, really a dedicated place for people to find healing.

There are some things about the Asclepius that we see in modern hospitals still today.

There's an emphasis on nature and this interplay between the natural environment and the built environment.

All of these buildings are open air, The use of stones and natural materials to create the space has biophilia.

Great.

We'll talk more about Biophilia and the incorporation of water around the site was integral to healing at the Asclepius.

So some of the things that we know make good modern design seemingly the Greeks also knew as well.

So this is my kind of my bias.

I believe firmly that design can heal.

I believe that we have known that design can heal since the beginning of early civilization and that people would walk hundreds of miles just because we designed a place that could heal them.

And yet there are other evolutionary things that have been ingrained in the way that we situate ourselves and the way that we design.

This is just a basic stock image of the African savanna, and yet it's a really wonderful representation of the relationship between humans and their environment.

It was heard of Prospect Refuge Theory, a couple, a couple of Prospect Refuge Theory folks.

I can talk about Prospect Refuge theory for an entire class, like an entire lecture.

I'll keep it to one side.

It describes our innate interest and our innate need to experience both safety and security as well as exploration in an environment.

We situated our earliest civilizations and created our first towns and cities and villages in places where we had both the ability to form an insular community that felt protected from outsiders and any threats while also being able to have a base from which to see and explore and expand our communities.

Prospect is that exploration?

Refuge is that security.

And it's not just from ancient civilization.

We still design this way.

We still situate ourselves this way.

Think about how you select a seat in, I don't know, in the student center.

When you go to Panera or Starbucks, you tend to not sit directly in the middle of the room with your back to everything.

You might feel a little bit more comfortable sitting in a corner where you have a little bit of refuge and the prospect of looking out on the rest of the facility.

You can see here, this is.

A. Library in New York City at Columbia and it takes advantage of this sense of protection while also being able to look out at the hustle and bustle of the city.

Right.

So as planners, as architects, as designers, we can take advantage of this innate desire for prospect and refuge by thinking about where we place windows, for example, how our site and the siting of other buildings around.

It gives us a sense of visibility and privacy.

There's still more that we can learn from our ancestors.

I mentioned Biophilia at the beginning of the lecture, and I know that some of you, especially if you're in Roxana's class, have explored Biophilia theory.

So this is Edward are Edward Wilson's Biophilia theory suggests that we have just like prospect refuge theory and innate connection to the natural environment.

We evolved in nature, and it's only in the last century that we've really almost entirely moved our lives indoors.

And so we have this this, like in our soul, this need to go back outdoors or at least bring the outdoors inside.

And that's where Biophilia theory really developed.

We've always situated our dwellings within nature.

We've taken advantage of the natural protection and materials and sunlight and rhythm that comes from building within nature.

And although when these cave dwellings were built, certainly they weren't calling it Biophilia theory.

we're going to situate our dwelling here because of Biophilic design principles.

And yet, when you look across time and across geography, a lot of the same principles apply to where we started to situate our homes.

Modern designers have started to use this Biophilic design makes places inherently more pleasant, inherently more healthy.

It aligns with a lot of our goals around sustainability and wellness.

And yet this is a principle that modern designers did not invent.

We just named.

It has been around for centuries.

So again, even though we didn't call it Biophilia theory, we didn't call it prospect refuge theory, there has always been an innate deep relationship between our environment and the humans that inhabit it.

It doesn't have to be super academic.

This is something that's ingrained in us and built into us.

We evolved to be designers.

We evolved to mold our environments to fit our needs.

Even if we weren't able to articulate exactly what those needs were.

This has never been more true than in the 1960s.

It's not just about how we feel in a space.

It's also about how our brain works in a space.

So early childhood researchers were really, really curious about how the environment actually affected.

Again, not just how we feel, but literally our brains and our childhood development.

So the earliest studies in 1964 exposed rats to different levels of stimulation in their environment and then evaluated their brains.

What they found was that rats who were raised in these enriched environments had higher rates of synaptic genesis, which is the rate at which you are developing new synapses, connections between your neurons and your brain.

They had more intricate dendritic arbors, which is really just the richness of the connections in your brain.

The rats that were raised in enriched environments had better brains.

And this was this was while the early childhood development community was like, this could be huge.

So we should probably replicate this and see if this is really true.

And they replicated it with so many different animals.

And every single time from the 1960s to 1990s, they found the same thing being raised in an enriched environment, especially in a crucial critical period when you're young, changed the nature of their brains.

This wasn't just true for lab animals In the 1980s, a group of researchers in North Carolina created the Bessa Darian program, and they took children from an impoverished neighborhood and put them into an early childhood development program, starting from when they were quite young and followed them through their twenties.

So rather than going to their local public school, they were in a specific program in a specifically designated and designed building.

This was not just about the learning materials, it was also about the way that the environment was designed to support the learning of those materials as well.

What they found was pretty remarkable.

Students that were in the Abbasid area in program had substantially higher IQ test scores and ultimately more success in their careers.

It wasn't just the learning materials, it was the way that the environment was built to support their learning as well.

O Weird thoughts issue here.

Sorry.

I'll read it to you.

Design can change your mind if the enriched environment hypothesis didn't convince you.

I'm going to continue to convince you, but I firmly believe that the environments that we inhabit are changing our minds every single minute of every single day.

Think about how you are feeling in this room right now.

How does the lighting feel?

How does your body feel in terms of your thermal comfort and your temperature?

Do you feel any air from the ventilation?

How does the sound feel?

All of this is acting on your ability to pay attention to me, to have interest in this lecture.

It doesn't matter if I have the most interesting or the most boring thing up on the screen.

The environment that's around you right now is going to affect how much you remember of what I'm saying.

The design of our environments can change your mind.

I love this quote from Harvey Bloom.

He was one of the first people in this article in The Atlantic to actually coined the term neurodiversity.

This is really one of the first times in print that we see the word neurodiversity show up.

Neurodiversity is one of the handful of words that I think are becoming kind of buzzwords in design, certainly buzz words on like TikTok and Instagram.

It's worth breaking down the definition a little bit.

Neurodiversity is almost like our fingerprints.

Everyone has a different brain.

Everyone has a different way of interacting with the world.

Preferences around how you communicate with people and learn and think.

We all have social, behavioral and cognitive differences.

Our brains are all totally different.

So neurodiversity is the spectrum of how our minds work.

Neurodivergent is what I am.

What I imagine many of you might be if you identify with something around autism, ADHD, dyslexia, dyscalculia.

But you might not even have to have a named condition to feel like the way you think and interact.

Diverges from what's typical and what's typical is really what's prescribed by our environment, right?

It would be a it would be a different behavior setting if I was to yell and cheer in here.

That would be out of context.

And yet the environment has prescribed that you sit here and listen if you have ADHD.

This might not be the best environment for you to sit and listen.

I get it.

But who can say what form of wiring will be best at any given moment?

Maybe there is an advantage to those of you sitting in here with ADHD.

Maybe you're not totally paying attention to every word I say, but there's something that's going to click for you that's different than the neurotypical person sitting next to you.

We need in the same way an ecosystem thrives with biodiversity, with a richness of flora and fauna.

We need students and teams, especially architecture and design teams that have different ways of thinking because then we can tackle different problems.

This is another way of looking at neurodiversity, specifically neurodivergent, or trying to get away from like a clinical specter clinical perspective around neuro divergence.

You do not have to have a diagnosis to feel like your brain works a little differently, but this is a nice way of illustrating that neuro divergence is not a deficit.

It's a difference in the way that we think.

While someone who is neurotypical may be pretty smooth across the board, not experiencing really any challenges in cognitive in any of your, you know, your cognitive areas.

Someone who's neurodivergent may experience some challenges maybe in working memory and processing speed, but may excel in verbal and visual skills, may be able to give the best presentation ever, but never turn that presentation in on time.

It's me.

I'm that person.

This is my spiky profile.

So how do we design for a profile like this?

It's really easy to design for the average, the even.

But how do we design for a spiky profile, especially when everyone's spiky profile looks totally different?

One of the things that we've done and some of the research that I'm currently working on at Perkins and will involve is our neurodiversity toolkit.

How do we design for a spectrum of brains knowing that it's really important?

If I haven't convinced you that design is important for your brain yet, then I've lost.

But knowing it's so important, can we create a spectrum of choice in the built environment that supports a spectrum of cognitive, social and behavioral needs?

This is really well aligned with universal design.

If you've heard about universal design principles, this is not a different universal design.

This is not yet another thing that you need to know.

It's kind of an extension or expansion of universal design, where Universal Design was really originally an opportunity to fix what ADA was missing in terms of physical accessibility.

We're now ready to move into other forms of accessibility as well.

What does it mean to be sensory accessible for someone who has hypo or hypersensitivity?

Really common for individuals with autism.

How do we create a space that can both have low stimulation and high stimulation at the same time?

And yet that's a form of accessibility.

That's part of creating an inclusive space.

It's not just whether you can use a mobility aid.

It's also whether you can tolerate being in that space in the first place.

So we've come up with six, what we've called experience categories.

These identify strategies within the built environment that can help us meet a spectrum of needs in our brain.

You can think about the audible environment again, Think about the noise in this room.

One of the things I'm very aware of is how the acoustic paneling is making my ears echo with my voice, which is a little distracting for me.

What about visually?

Can you see what you need to see?

And is it enough or too much environmental stimulation between the colors that you've chosen, The material ality of the furniture, the amount of light or glare coming in?

Environmental is broad, but this can also apply to things like environmental exposure.

We know that and I mentioned this in our lecture earlier today.

We know that exposure to ozone, smog, particulate matter can certainly exacerbate individuals who have learning disabilities.

Physical does.

It doesn't apply just to physical accessibility.

It's more about how much you are accommodated to move your body.

If you're neurodivergent means that you work better when you can get up and move to a different spot, sit down somewhere else, change your perspective, literally change your entire field of view.

Does your design accommodate that?

And although this is an architecture for health lecture and a lot of what you're working on is health care facilities, this applies to so much more than just health care facilities.

Think about the classrooms that you're in, the places that you work, the studios, for example.

And yet if we're thinking specifically about a mental and behavioral health care facility, is there nowhere more important to make sure that all kinds of minds are being accommodated?

Social applies to the ability to form social networks, but also to balance your privacy.

One of my favorite definitions of privacy, and I, I think I annoy a lot of people at work because they say, we need a space for privacy.

They design what looks like a closet.

It's just like a quiet, dark little room.

it's their space for privacy.

No, privacy is the balance of achieved and desired social interaction.

Someone may experience privacy in a crowded place.

Someone may need total isolation to experience privacy.

But privacy is not being alone.

That's isolation.

So we want to make sure that when we are designing an environment to support your social needs, we are accommodating different levels of desired interaction, not just isolation.

And then finally, cognitive.

This one is really broad.

How do we create a space for you to work the way that your brain wants to work?

Often that's a combination of policy and design.

If you're someone whose brain does not work on a 9 to 5 schedule, then probably you're going to need a conversation with your employer that you need a little flexibility in your job responsibilities.

But there are also things we can do in the built environment to support cognitive needs, like making sure that the levels of stimulation match what our executive system, our frontal lobe needs to function.

People with ADHD classically are hypersensitive.

We need more stimulation in order to work well.

People with ADHD will also be often be found working at somewhere like a Starbucks where there is music, there's people, there's movement, there's activity.

You need extra stimulation to get your executive functions on top of things.

How do you design that in an environment?

What we've been doing often is creating neighborhoods, neighborhoods of levels of stimulation so that you can choose almost like a choose your own adventure, choose your experience to match what your brain needs.

But as I'm sitting here kind of explaining to you how people might feel, how someone like me feels, the essence of neurodiversity is that everyone feels differently.

What I might need is something totally different than what you might need.

And so as much as we can go through empathy building exercises or take a human centered design approach, that idea of putting yourself in someone's shoes is often not quite enough.

Because whose shoes are you putting yourself in?

How do you know that You've put yourself in everybody's shoes?

And we all come to this with our own biases and our own personal opinions, right?

It's not a flaw.

It's just something that we need to recognize.

We're not getting the whole spectrum of opinion when we put ourselves in someone else's shoes who's sort of Thomas Kirkbride.

Yeah, I could do a whole thing on Thomas Kirkbride, too, but I don't have enough time to do the whole Thomas Kirkbride thing.

He designed a series of mental and behavioral health facilities in the early 1900s.

He was a physician, super well-meaning guy.

This was right around the time that Dorothea Dix wrote her landmark Journal article blasting facilities in the United States for being really inhumane, really institutional.

And Thomas Kirkbride was like, I am going to I'm going to change this.

This is so not the way that we're going to do health care.

And he designed his own facilities and they were called Kirkbride plans.

I used to have a picture of it in this PowerPoint.

They look like little bat wing structures.

So you come into the lobby and out into the wings.

You actually go by acuity so that the lowest acuity people who are probably a few days from being released are closest to the lobby.

And then high acuity out in the wings made sense, right?

He was really trying to I talked to a handful of groups about this earlier.

He was trying to democratize sunlight and ventilation and take advantage of views on both sides.

It's everything that you want in a building, right?

Wrong.

The individuals who are in the farthest areas of these wings had no supervision.

They were often getting less care, and so their outcomes were significantly worse.

Within 50 years, there were no Kirkbride plan hospitals in operation anymore.

And the ones that do remain now are almost all on the register of historic places because bad, significant things happened to their.

So Thomas Kirkbride had all of the empathy in the world.

He'd seen how these places worked and he wanted it to be better.

And yet that was not enough.

Yeah.

Sorry for the weird design on these slides.

My argument is that you have to have science and humanity at the same time.

By combining evidence based design with community engaged design, we get a humane, sustainable solution that actually works.

So by learning from existing research, we can remove some of the bias that comes from putting ourselves in other people's shoes.

But by engaging with the community and ultimately with end users, patients, occupants, we can validate what we've learned from research.

But you can't have one or the other with just research.

You might be missing a human element and with just trying to learn from other people and put yourself in their shoes, you're going to miss important things as well.

Evidence based design is probably something that you're pretty familiar with here, and I know that several of you are going to start to put together evidence based design diagrams with annotations that might look something like this.

This is something that I actually put together for a children's behavioral health unit that we were building.

There were a couple of things that were really important.

I wanted to emphasize that positive distraction was a key element, especially for an adolescent population in here.

And you can see based on the citations, right, that that's probably a good strategy.

Nursing rooms should be located next to high risk rooms.

Sensory furnishings.

This is a great I think it's well aligned with some of the principles of neurodiversity.

And we provide sensory furnishings to allow someone in an acute crisis to still control an element of their experience.

This is all well supported by literature, and yet that is not the entire story.

Community engaged Design.

While we can kind of point to the origin of evidence based design, community engaged design isn't as much of a finite thing.

A lot of it really started to evolve around New Urbanism, which really sought to engage the people who are ultimately going to live in a place about the social elements of that place, creating strong social connections.

But it's really evolved in the way that we do community engage, design differs from firm to firm.

It differs from researcher to researcher, but at the heart of it, it's really trying to figure out what occupants want and how you can engage them in the design process.

It's not architect on top, users on the bottom and we'll tell them what they want.

It's the humility that comes from inviting other people into the design process.

And what you learn from that can sometimes challenge evidence based design.

For a while.

It was thought that artwork made a difference.

We know that, right?

The things that we hang on our walls, the things that we look at every day, make a difference in our emotions and even our long term health for children.

Sometimes it was recommended to put abstract art something that looked kind of fun, funky people who in a mental and behavioral health unit that could be really, really triggering.

So if you had actually sat down with someone who had been through a mental or behavioral health crisis, you might not know that the abstract art that you'd picked out that feels very organic and biophilic could actually be an opportunity for someone in psychosis to overlay their fears onto a piece of artwork.

What might work in your average corporate workplace is probably not going to work in crisis room density.

This one I found this was from my own personal research that I found pretty remarkable.

We have gone back and forth in health design literature for too many years on whether we need shared rooms or private rooms, and for the most part we know that private rooms help people feel more secure.

There's less of an infection control risk.

If you can do private rooms, you should probably do private rooms.

But what we found in a study with veterans in an acute mental and behavioral health unit was that veterans actually seemed to prefer shared rooms when we talked to them.

Again, assuming having built an entire mockup in which there were shared rooms and this wasn't a cardboard mockup, we built a high fidelity private room mockup only to have veterans come in and say, Why aren't we doing this shared rooms anymore?

I really liked having my battle buddy.

And so in that way, everything that we had read in the literature was completely contradicted by what people who were actually going to be using this space needed in terms of their social interaction and their social needs.

We wouldn't have known that if we just relied on the literature.

And then finally, from a larger contextual perspective, in the same way that Dorothea Dix was trying to expose the institution ality of behavioral health units and Thomas Kirkbride was really trying to fix it, we know that mental and behavioral health institutions have abused people of color, people who speak different languages, people who can't advocate for themselves.

So when we think about designing a mental and behavioral health facility, especially in the United States, which is particularly litigious, and you can get sued for a lot of things, we put safety first.

How do we prevent people from harming themselves, harming others, and harming staff?

Often that leads to a really institutional feel.

Still, even if you walk around a health care design expo, you'll still see so much focus on anti ligature furniture, things that you can't actually hang yourself on.

And it's so it's still so blatant that that's our orientation to mental health.

We're just trying to prevent you from hurting yourself.

We're not trying to make you better.

It's not therapeutic.

How can we, with this context in mind, design a place that doesn't only protect safety, but is also a place of dignity and respect and conceals these safety features to make people feel more confident in the actual therapy of their space.

So have a couple of minutes to do some Q&A if you have any questions about this.

But I want to wrap up by saying I am here as a researcher with a Ph.D., but I really view my role, especially at my own firm, as a translator.

So translating between psychology and cognitive science and the built environment, translating between the people who are actually going to use the space and the research that goes into that space.

But I really don't think that you actually need a PhD to do this.

I'm sorry.

I really, really feel like I really feel like you can do this with intention as long as you have this orientation in mind that I'm going to look to the research, look to the experts, but I'm also going to recognize the expertise of the people who are going to be in this space.

None of that requires a Ph.D. You all already are going to leave Texas A&M with the technical skills you need to design a beautiful building, whether that's a hospital, whether that's a school, a workplace, whether that's someone's residence.

All of those places can change your mind and you can make a beautiful space.

But what's going to make you a truly human centered designer is to actually humble yourself and engage people in creating a humane space as well.

So thank you.

We've got what looks like like 2012 minutes.

To chat Q&A session, answering questions from Perfect.

So we're here any day.

We're perfect.

Yeah, let's get it started.

And that's going to be really informal.

If you don't think that you have a question about what I just presented, but you're curious about something else, feel free fast.

So I'm actually really interested in this topic, especially of built environment.

I'm a master's student and so that has to do with what I'm hoping to do with next year's project for my final studio.

And so my question is specifically doing the built environment in a housing situation.

What are some techniques that we can do for individuals who have, you know, dealing with different traumatic experiences?

And how can we create an environment that isn't obvious that, hey, we're trying to help your mental needs or behavioral needs or what have you, but have it be kind of going back to what you had just mentioned and that it's respectful to them still, but we're still addressing the needs that they have.

Are you talking like like public housing type of situation?

Yes.

Okay.

So interestingly, public housing has probably been one of the more well researched areas of environmental psychology over time, over the last few decades, particularly because residential areas are the that's the place we spend the most time.

So if we can have an intervention at the residential level, then we're probably going to be able to make a pretty big difference in someone's lives, especially because the housing that they are probably coming from is extremely low quality and we can make a big difference if we can improve that quality.

In terms of specific design strategies, one of the really interesting pieces of research, one of the most interesting pieces of research I think that I've come across is Vaid.

I can spell out her name for you, but for her doctoral dissertation was really interested in what she calls slum housing or autonomously created housing in India.

And there was a public housing program that was designed by a particular jurisdiction in India to move some individuals out of slum housing into what was arguably objectively higher quality housing in terms of safety and quality.

And what they found was that people were extremely unhappy and that their health was substantially reduced because they lost the social connections that formed in the slum housing.

So one of the things that we want to preserve when we think about moving people into higher quality housing and providing public housing is creating space for social connection rather than the sense of isolationism that can often occur when we're moving individuals from one place to another.

I also think that one of the challenges and if you look at where public housing is often situated, it's typically in airport airport paths.

So flight paths, it's by commuter rails, it's extremely noisy and the environmental exposure effects are really high.

So working with wonderful urban designers who have the opportunity to challenge policy and challenge zoning requirements, that's a big task, right?

Like I can't tell you and say like, just your public housing project to somewhere quieter.

But it's it would be remiss for me to tell you how to design the interior of a space if it's just constantly noisy and constantly being bombarded by by smoke and smog.

So there is like an environmental justice component of it that can't be missed when thinking about it.

There's a lot that goes into it.

I wish I could give you like a full answer and a full lecture on this.

But.

I would start with the Vaid and Gary Evans is work on residential housing quality.

I think that will give you a nice insight into some of the challenges there.

Thank you.

Yeah.

Yeah.

I was with you.

I think you looked great.

So my question, it goes back like to the 88, like we didn't accommodate really people's needs, physical needs until we have the Act Veda Act legislations.

So do you think there is a place where our time we're going to have maybe policies that's going to enforce this design approach and integrate it?

Yeah, I.

Mean, I think we're already starting to see it.

There are digital regulations in effect right now that require government websites to have certain levels of digital accessibility for individuals who have maybe visual impairment.

But it also has started to accommodate individuals who have autism, for example, and dyslexia.

So I think we're starting to really think about the intersection of brain design, how quickly that's going to actually make it into the built environment, I'm not sure, but it's absolutely infiltrating the digital environment already.

Yeah, I would I would be prepared for it.

Hopefully we do it better than we did the ADA.

I really enjoy your presentation is amazing.

Yeah.

One of your slideshow show shows that veterans prefer share room.

Yeah, I have many articles discussed about private room and share room.

I'm curious about the context of that, whether if you are talking about veterans in mental health facility or veterans in general.

I include the veterans in an apartment previously.

Yeah, that's a great.

Yeah.

Great question and I appreciate that.

How because you're looking at it from a critical research lens.

Like if I told you that, then could you actually take that and design other spaces or is it just specific to behavioral health?

I don't know.

I this study I'll tell you a little bit more about that study with my little sister.

I'll go back to that slide.

Here we go.

So this was the design of a new mental and behavioral health facility for acute crisis.

So this was inpatient high acuity, individuals who had substantial disturbance in Lyons, New Jersey, for the Veterans Administration, the VA, and we were HDR was contracted to design the new space.

They went in and did a high fidelity mock up, so they cap it was the same floor.

So all of the operations in the staff were the same.

They just took one patient room and redid it according to their design guidelines.

And then we sat down and asked staff and patients in informal interviews their opinions of the space before we invested money in redoing the entire thing.

Thank goodness we did.

You can read more about this case study online, but I, I don't know.

To answer your question, how.

What we had heard was that having a roommate gave you gave these individuals a sense of purpose and a sense of.

I don't.

Know what other word I would use here, really a sense of purpose around their treatment that if they could look out for someone else and help someone else through their treatment, that was really aligned with what they had learned as far as active duty service members that you were always looking out for.

Like literally the words Battle Buddy came up several times.

You always had someone in active combat with you to get through it and that you were looking out for them.

So while I think that that principle probably translates to other areas, I don't know if it translates to folks who have families.

Many of the individuals who are being treated in this facility did not have families and did not have very large social support networks in the first place.

So I don't know if you can get your your battle buddy somewhere else or if the facility can really help provide that for you.

I don't know.

But that's a good critical research question.

Any other questions?

Any to thank you for lecturing?

My question is kind of like if you look at the historical precedent excuse me, set by Thomas Cartwright, using all the best research that they could do, credit design, there is a point where they might have realized some of these patients aren't responding so well.

So then what can you do in a design, in a design type of response to react?

So great question because I think that comes up in modern architecture and construction through post occupancy evaluation.

We really like to do post occupancy evaluations of our buildings to figure out if they work and what's not working.

But often what we hear is like, well, we were the architects.

It's not our job to help them make it work and like they're not paying us to redo their facility again.

Also, we're the architects.

We don't want them to know that we did something wrong.

So I think that applies to this Thomas Kirkbride situation as well, because it's not just design, it's how people are using the design.

In this case, one of the reasons that the design failed was because there simply was not enough staffing to accommodate the way that the building consent design had a post occupancy evaluation been done.

I think our firm would have come back and said it looks like there are more aggressive incidents and negative outcomes in the wings of this facility.

I would hire more staff and put them in there because it's a much bigger investment to fully change the the architecture of an entire building than it is to change your operations and your policies.

So while that's not the ideal situation, ideally we would have wanted it to work right out, you know, right out of the gate we can say, okay, this is it.

You're not using it the way it's intended to be used.

And that's why we think you're having poor outcomes.

I have one question from Professor.

Thank you, guys.

You've been so engaged.

I love this.

Yeah, you are great presented to us.

So my question is, though, as you are saying, like the each and every person has their own perspective, how am I feel?

How am I seeing this piece?

So if it is very subjective, the first person to person, then how y'all come up with the designs that are strategic, let's say, okay, this would work for everyone.

Like the if it's a patient dealing with anxiety or someone is dealing with stress or mood ratings or something.

So how do you like fear vs relying on literature or like doing survey?

I hope that's.

Such a good question.

I think we found ourselves in a lot of trouble historically by assuming that something works for every body.

One of the things, one of the principles that I see applied to health care a lot to corporate interiors is to schools across the board.

That's really coming into play in all of our practice areas is the idea of choice and control.

That's part of Roger O'Rourke's theory of supportive design.

But we can see it in a lot of different places.

The more you can give people the ability to control their environment, control where they are, control the lighting, the temperature or the acoustics that allows for more of a one size fits all approach.

You're not you're not prescribing a space for one person.

You're prescribing an entire facility where they can choose how they're going to interact in that space.

So anything that allows more personal autonomy and personal control is going to fit more people.

Okay.

I think I got yeah, I got your point.

I'm taking questions.

Yeah.

So I'm Professor Roxana student Of course.

And asked her like multiple lines like this theory of supportive design.

So I saw the hospital layout in my country.

I'm from India, so like the whenever I zoom or get about hospitals plus picture coming, my mind is like typical patient rooms continuous like symmetrical geometry and everything is like so congested and stuff and hospital environment is like very depressing for you, like family or like the community is like basically focusing on community.

So the my question is like each and every space, not able to capture window views or something.

So like this idea of supportive design, not accommodate to each and every space.

Yeah.

So how like hospital is a large scale project.

So do we design like the in the pockets are just like very no not scaled and continuous rooms and not having goals.

I got something because I've seen hospitals some be some hospitals design bridge is not like the courtyard or some open spaces some like very solid mass and yeah.

Yeah I think that case when you have a space that's already been designed that clearly isn't accommodating.

All of the.

Design strategies that we'd like to see in the space and maybe there's not an opportunity to do it in the corridors and the patient rooms and the treatment areas.

I give this question lot.

I think we ultimately rely on patients to help us prioritize patients and staff to help us prioritize.

If you have a limited budget, an existing facility and not very much wiggle room, we often do a prioritization exercise.

If you were the architect of this facility, what would you change?

And that's going to give us a much better sense of where patients feel they need the support, the most and staff need the support the most.

Instead of us saying, Well, we need more windows, we need more ventilation, we need this, this, perhaps it's just a small change to incandescent lighting, right?

So in the event that you have a hospital like that, asking the people who are in there can help you narrow down the small, low budget things that could make a difference.

Yeah.

Okay.

Thank you so well, thank you so much.

That was a great Q&A session.

Really good.

Yeah.

Thank you, guys.

So I think we're at the end of our time and we have to wrap up the discussion.

Unfortunately, we cannot take off.

We cannot discuss the questions from the Zoom.

Well, feel free to I don't know which camera I'm looking at, but feel free to email or write me a message on LinkedIn.

I'm also on Instagram.

So if you have a question that you're dying to ask and I didn't get a chance to, please just send me a message and we can chat more about it.

Well, awesome.

Well, thank you again for joining us.

That was such a pleasure.

And here's a small gift.

that's so sweet of you.

Yeah.

I wonderful.

I and I know.

I remember my trip day, and then hopefully I'll be back soon.

Well, thank you again.

Thank you, guys.

Thank you.