Ep 7: How the built environment affects our mental health with Jan Golembiewski

In this episode, Manisha Amin speaks to Jan Golembieski. Jan is a world leader in researching architectural design psychology. His work focuses on the relationship between experiences and the neurological mechanisms that cause them. Jan is an internationally recognised keynote speaker, has completed his PhD, and now runs his own practice – Psychological Design.



Manisha: So how important is our built environment for our mental and even physical health? Are four walls and a roof enough? Welcome to With, not for, a podcast from the Centre for Inclusive Design, where we look at how we can make our world more inclusive through natural built and personal experiences. My name is Manisha Amin, speaking to you from the lands of the Cammeraygal people of the Eora Nation here in Sydney, Australia. Joining me today on With, not for is Jan Golembiewski, architect, innovator, and director of psychological design, spearheading innovation in evidence-based architectural and urban design. Welcome, Jan.

Jan: Thank you so much, Manisha.

Manisha: So Jan, you’ve had over a decade’s experience in researching architectural design psychology, I’d really be interested in knowing how you got into this field in the first place, and particularly looking at the impact of physical environments on mental health as well.

Jan: Yeah, it’s an interesting question. I got into it because I was designing a mental hospital, but my interest in it was triggered much earlier when I was actually studying architecture and I’d run across this big discourse on architectural determinism; and we were taught more or less that you can’t use architecture to determine people’s behaviour and their mental health, and such things. And yet when I was learning that I was acutely aware that I’m very sensitive to the environment; I go into a place and I feel it, and it makes me feel different – and it makes me behave differently. When I’m in a nice hotel lobby, I kind of behave quite posh, and when I’m in a religious space I behave somewhat respectfully, and when I’m in a gym, I’m behaving like in a sporty way. And I actually am very responsive, and I think that most people are, which means that there’s something wrong with the discourse about architectural determinism. So when I went into study the effect of the built environment on mental health, I had this back of my mind that, “There’s got to be something in it.”

And I asked my boss at the time, someone called Helga Tembrumula, how I design to actually go beyond the programmatic brief and to actually design for people’s health and wellbeing, and she said, “Look, we’re a commercial practice, we don’t do that; we just follow the guidelines.”

Manisha: Right.

Jan: So I finished the project, and that’s when I started studying this stuff in earnest.

Manisha: And you actually did your PhD in this area as well.

Jan: And my master’s as well, yeah.

Manisha: And your master’s.

Jan: So I spent a good five years studying this stuff just as a student and then God knows how long ever since.

Manisha: And what drew you to it? Because I mean, it’s interesting you talk about how buildings made you feel, but was that feeling so strong for you, or did you see that as being something so imperative that actually it needed more study?

Jan: For that moment, it was something imperative, it needed more study. I used my own time to look into it and I found that there just was not enough study, what there was, was very old.

Manisha: Right. And what did it say?

Jan: Well, I mean it depends on how far you want to go back. You can go back right to classical architecture, and you can see that the classical world, they believed that architecture affected people’s behaviour and their spiritual states.

Manisha: Which kind of makes sense when you look at a church and the way a church might be built, it’s very different to the way a gaol looks and is built.

Jan: Yeah, of course. So we have been reading the typology of architecture for centuries; we’ve only been reading – most of us – written language for a very short time in comparison. We can look at a building and know what the building is from the outside, we can look at a building and know more or less what the layout on the inside is. In fact, that’s one of the things that I teach my students: look at the building from the outside and I want you to draw the inside; I want you to draw the plans.

Manisha: So that’s really interesting when we think about inclusion and exclusion in terms of who these buildings have been built for, and how that design has been built I guess to serve some people more than over people.

Jan: Absolutely, all buildings are designed to serve some people more than other people. The very fact that all buildings have front doors means that they’re there to serve some people more than other people; it’s just what they’re serving that’s really, really critical. We all need buildings to provide us with comfort and privacy, and we need that front door; we need to be able to exclude people from the spaces that we use for one reason or another, and that’s fine. And I don’t think there are many people that would argue against that, but it’s what we’re serving once they’re inside that is of real critical importance to me, and of course what we’re serving to the public from the outside.

Manisha: And tell me about that, like when you first started looking at this – and you’d done a whole lot of study – and then you actually went out and started to design different buildings from a health perspective. This notion of who’s allowed in, who’s not allowed in, and how people feel in that space must have really been of primacy, particularly when you’re looking at institutions that were there for mental health.

Jan: Yeah, absolutely. And I have to say that probably the best example I have, I guiltily put my hand up and say I didn’t do it. It is a facility called CAMH in Toronto and it was a very old fashioned Victorian Kirkbride style mental health facility, and they wanted to expand it – it wasn’t big enough, and the spaces in it were old and redundant. And it had hundreds of acres of – at least 100 acres of beautiful land it was on; it was set in this prime parkland with a great big wall around it in the middle of Toronto, and some people I know went and decided to flip it – take down the wall, leave the buildings in there as mental health facilities, update a lot of them – and turn that parkland into public parkland that is owned by the people who are being treated in the facility. So it’s theirs, but they’re given the opportunity to gift it to the city. And they ran the local streets right in; they continued that local street pattern into the facility, they put new buildings in there on that same street pattern, they put cafes and restaurants, and all sorts of facilities in there which are open to the public. But there’s one detail: they’re run by the patients.

Manisha: That is incredible.

Jan: It is incredible, and it is such a spectacular success. Not just was it successful within the campus that they exploded, but it spread outwards. Their local people in the local area felt so good about being given this park and being given this sort of new vibrancy in the area where they had just had a big wall before, that they actually really welcome those people who generally have very chronic mental illness. And even the local Starbucks, which is right across the road – I interviewed the people who work there, they said, “No, we don’t charge people from there. They come in, they sit down, they have their coffee; and for us it’s fine because they’re our locals. They’re the ones that made this place worth coming to, so we give them their coffee for free.”

Manisha: I love that idea.

Jan: So in my practice, one of the things that we’re working on now – and we’re quite in relatively early stages – is a project which is centred around a very small, but incredibly pretty town in rural New South Wales. And what we’re trying to do is create a masterplan that encourages maybe four or five service providers to come into the town and setup various different models for care for people with dementia and old age.

Manisha: Right.

Jan: And the idea is that the local pub will be specially geared to cater – or local pubs – specially geared to cater for that cohort of people, and the local restaurants, and the local pharmacy, and the local doctor; and all of those business, a lot of which are already there, will be kind of recalibrated to look after the people that come to town. And it’s nicely situated because it’s right at the end of a road, so it’s very safe, and the idea is that people can go and join the town in any way, and there’ll be at any given time, a few people who are being paid by the organisations that are there to just keep an eye out and watch out for those people if they need it.

Manisha: And what was the role of the people in your project as well as the project in Toronto? The people who were seen as the patients or the people who might buy in or be part of this age care centre, in some ways that’s more than that. What was their role in the decision making around what you would do and what you wouldn’t do?

Jan: I believe that they were heavily involved, now that I recall, and they were personally thanked as well for it. In the case of the village that we’re talking about in rural New South Wales, we haven’t yet gone to any particular cohorts of people and engaged with them just yet, but it’s going to happen because you can’t design for people without them. It’s like as a designer, you definitely have to make design decisions that are yours to make; you can’t design by committee and come out with something really good. And one of the reasons for that is that as a designer, you have skills that you’ve learnt over many years, and experience that you’ve learnt over many years, and you have an understanding of the capacity of architecture to make a difference, which even other architects don’t know, right?

Manisha: Right.

Jan: So you can’t expect everyone to know what’s possible, so the idea isn’t that you get people involved in actually deciding where the doors are going to go and that kind of grain of detail, but they are your clients. Those people are your clients, you have to listen to them; you have to understand – and this is where the way I take it – you have to understand their narrative.

Manisha: Tell me more about that. How do you understand someone’s narrative?

Jan: Well, people are very, very keen to let you know their narrative; they wear their narrative literally in the way they dress, in what they want to talk about, how they want to engage with you. People are very keen to let you know their narratives, and their architecture that they choose to live in reinforces those narratives. So an astute designer will be able to read those narratives, will be able to read those stories, and groove on those stories, right? And by doing so, they will be able to really go, “We can do this. Did you know that we can do this?” And people go, “Really? I didn’t even know that that’s possible.” And then the architect is able to really bring their richness and their experience in to enrich the narratives of those client’s lives.

Manisha: So it’s like you’re taking stories and creating something that someone didn’t really know that they could possibly have.

Jan: Yeah, often. Sometimes are very keen and know exactly what they want, and they’re great, but on the other hand, you can’t always rely on them to know.

Manisha: When is the point that you check? Or how do you check that the solutions that you’re coming up with are actually on the right track?

Jan: Constantly. We don’t design in isolation from our clients; as you say, we design “with our clients.”

Manisha : Right.

Jan: But we’re the ones doing the design, and our clients are there and letting us know all along the way what they’re comfortable with, what they feel good about, what excites them; and it’s really easy. Even working with people with dementia, they get it, right? They might not be able to remember their daughter’s name, but they do know what they like and they’re very, very keen to tell you what they like. In fact, those sorts of things are maintained beautifully even in the advanced stages of dementia. People know what they like.

Manisha: So when you think about – because you’ve done a lot of work in mental health recovery and with people with dementia, et cetera – when you think about people who have had mental health issues that have worked with you, who’ve told you what they like, are there lessons that you’ve learnt or things that you’ve seen there that you feel really are lightbulb moments in architecture that really need to be taken and transformed into what we see as traditional architecture?

Jan: Yes, but they don’t necessarily relate directly to architecture.

Manisha: Right.

Jan: They often relate to things that people don’t consider to be important for architecture, such as maybe – I’m thinking of one example: somebody who is diagnosed as having very chronic bipolar disorder, and what he really loves is music. So when I design a mental health facility, I routinely put a music studio in there; a place where they can go, and they can rock out on guitars that – total full volume and not really be heard from the next room because it’s soundproof. And it has to look like a professional studio, right? It’s got to look professional; it’s got to look the part. It can’t just be a multi-purpose room because people have to live their narratives.

Manisha: That leads me to this question around the spaces that we design, and I think in the last couple of years there’s been a greater focus on how we design the spaces that we work and live in; and especially in the last couple of years, we’ve seen this merging of work. And there’s no work-life anymore; it’s actually just all life in which we work and play, and those spaces are changing and are becoming more dynamic. What have you noticed about this change in terms of people’s mental health? And what are some of the things that we might want to think about?

Jan: It’s not a monolithic question, it’s not a monolithic answer. We have responded to the last two years of Zoom very differently – some people have thrived; some people have really been able to be heard for the very first time, and other people just can’t stand it. So it works both ways. I’ll tell you a story, I used to – when I was a child, I lived in Papua New Guinea and we had correspondence school from Australia, and after doing correspondence school for maybe a year or so, I came back, and I visited Australia during term time; and I was able to go and visit my teachers for the very first time. And prior to that moment, all I knew of my teachers was type written words because they’d type out words and send me letters – and they were on a typewriter; it was a long time ago – so I knew their writing. I don’t think I even knew their genders; they weren’t so much people as they were sort of distant teaches. And I went to visit them for the first time, and I was surprised first of all, to find out that they were in a tower in the city, not in a school, because I assume that being teachers, they’d be in a school, but this is a correspondence school, so they’re in a tower in the city.

And what really absolutely floored me was that almost all of them were disabled; they were in wheelchairs, and they were blind, and they were deaf, and it’s what the New South Wales government at that time was doing with their disabled teacher cohort, say, “Look, it’s difficult for you getting around a school, why don’t you come and work in this school? And no one will ever even know.” And I don’t know how they felt about it, but for me, it was extraordinary knowing that there are some things that are very enabling about distance communication.

Manisha: And when we think about the built environment and our homes, we do all have different needs and yet there are some things that are moveable, like there are some things we can do on a computer to change the settings to make something lighter or darker, or quieter. In a physical space that’s a lot harder. How would you recommend people start to think about their physical spaces in order to create good mental health outcomes?

Jan: So the history of the private home – a person’s home – really goes back to where people had a living room and maybe a bedroom, and the living room kind of had maybe a kitchen in it, and maybe out the back there was a toilet and a laundry. They were very, very basic, they weren’t places where people actually lived; they were places where people got through the business of sleeping and the very ordinary business of day-to-day life. Over the 20th century that changed rather radically, and you can see it in the history of 20th century architecture, when private homes – the turn of the 20th century – private homes were the very first time started having things like billiard rooms in them. I mean, they were wealthy people’s private homes, but they were private homes. So people started bringing in the idea of leisure and making that a part of their private home, so over the 20th century at times, there was kickback against that idea and people often neglected the idea of leisure or reduced it to the living room and the TV; the very, very basic minimal leisure, and really didn’t give it the credit that it’s due.

But with growing prosperity – and there is a lot of prosperity in Australia, certainly – people have started taking leisure more seriously, so leisure is one of those things that has crept into our private living spaces. Now work is. OK, we’ve had home offices for a while, but home offices even just a few years ago, were often places where there’d be a spare room and a spare bed in the room, often a lot of storage in those spaces – they were sort of secondary spaces because people went out to work. The idea that people work at home was never taken very seriously until the last two years, and now people are starting to go, “Hang on, we can do this. If we have the space, if we actually do clean out that third room and set it up properly, we can actually work from home.” The other things, the other intangibles that you might find in an office, such as prestige, that’s a very important part of work. It’s fine to have a space where you can work and you can change your Zoom background and put a Tibetan bell or something behind it, but if you can actually show the real background to the people that you’re communicating with, and if you can be in a space which you think is suitable for projecting who you are in your business world, then you can feel it too and not feel like a fraud with a fake Tibetan bell in the background.

Manisha: I’d like to ask you a little bit more about the mental health recovery work that you’ve done, and I understand you’ve done some really interesting work in Qatar as well.

Jan: That was a great project. I was by no means the only architect involved; I was the knowledge lead on that project. It was for the National Mental Health Facility in Qatar – as yet to be built, but it was a big project, and it won a very major award. That project changed a lot of things about the way I think about mental health design; every bedroom had its own garden – every room had its own garden – there are total of something like 300 gardens in that facility.

Manisha: And this is in Qatar, which is a really hot place, right?

Jan: Yeah.

Manisha: So it’s probably a bit of a butterfly moment, but what did those gardens look like? I’m fascinated.

Jan: Well, they were designed – they haven’t been built yet. They’re often very shady so that people could enjoy them and so that the plants could enjoy them, and they wouldn’t lose their moisture immediately. Mostly local species, and we chose a lot of scented plants because one of the delusions that’s most common among Arab people – and in that part of the world most of the people using the facility are going to be of Arab origin – is olfactory delusions. So different cultures – or I don’t know, maybe it’s different genetics? We don’t really know – but different cultures have different propensities to different mental symptoms, and one of the really strongest ones in the Arab world is olfactory delusions, so we put a lot of sweet-smelling plants and flowers because they are very welcome, and they disguise people’s olfactory dysmorphia. So that’s one of the things we did. We also had horse stables so that people could ride horses and lunge them, and just be around big animals and learn courage. As well as that, the wealthy Qataris – and Qataris are wealthy – often have horses, so they feel very comfortable among them.

We also put an area and facilities in for people to keep their birds because birds are also very important in Qatari culture. People raise pigeons, so they like to keep their pigeons, they also keep falcons, and they keep songbirds. They love birds, yeah.

Manisha: So what’s coming up for me is this idea that sometimes when we think about care or hospitals, the focus of the space is all about that one thing, so when we’re in a hospital, the focus is all about making sure all of the beds and all the structures are there to make sure we’re safe from a health perspective; there’s lots of beeps and buzzes when you’re in say, emergency. But what it sounds like here is that you’re not just taking into account the health of the person, you’re taking into account their culture, their communities, their way of living; and bringing that into these spaces as well.

Jan: With mental health, that is what health is.

Manisha: Right.

Jan: Safety is not mental health. In fact, safety is often at conflict with mental health.

Manisha: Say more about that.

Jan: Well, you lock a door to keep somebody in and keep them safe, and then they feel locked in.

Manisha: Right.

Jan: So if you are going to lock doors you have to provide such rich affordance in the space, so they don’t even realise that the door’s locked; they don’t want to go. So we considered things like the patient journey as they enter the facility, very, very carefully. First of all, we change its name from the National Psychiatric Facility of Qatar to the Al Wakra Centre for Respite and Recovery, right? So that you immediately go in there and go, “Well, this is not what I was expecting because I thought I was going to a mental health facility. This is genuinely a place for respite. I get that I could recover here.” So that’s, immediately from the language – the written language – but as well as that, we had no control over how people arrive; they often arrive in a ambulance or a paddy wagon. But what we did have once we did have control over once people arrived, was how they’d be treated. So the paddy wagon goes and reverses into a Sally port, which is a special room which locks arounds the vehicle to stop people from escaping, they open the back doors and then the patients come out, and they’re in a space.

Typically that space is a space where they’re searched for weapons and often injected with sedatives, and put in a room to cool down, but not in this particular instance; this was designed so that people would be opened out to a really very elegant room with comfortable furniture and things to do, and a very nice garden open so that they can leave. And the garden is designed so that you can actually see that you can leave – technically you can’t because you have to get through a pond, and it’s going to be very, very, very difficult to get through – we designed it very specially to make it difficult to get through. But visually you go, “OK, I’m not being locked in here; I’m being allowed out, but there’s enough good stuff in here – ” there’s was a juicing machine for a start with fresh vegetables and fresh fruit – so you’ve got something to do.

Manisha: So when we think about key performance indicators for some of these spaces and places, Jan, what do you think they should be?

Jan: I was really inspired by the key performance indicators of Khoo Teck Puat Hospital in Singapore, where one of their KPIs for the hospital – public hospital – was how many butterflies they had on campus and how many varieties of butterfly they had on campus, because that spoke to humanity as embodied within a natural environment.

Manisha: So that’s incredible, butterflies.

Jan: It meant that they had to have plants, they had to have orchids, they had to have a variety of natural environments; and they found that some of the varieties of butterflies that came and were spotted in Khoo Teck Puat Hospital were thought to be extinct.

Manisha: That’s incredible. And we talk about lead and lag indicators and how many beds we have in a hospital, and how difficult it is to talk about the benefits of that space and place, but by counting butterflies you’re getting all of that.

Jan: Well, you’re not getting how many beds there are, but number of beds in a hospital is a bit like asking, “How many pages were in that report?”

Manisha: Right.

Jan: It’s a very rough metric. In fact, it’s a bit of a furphy anyway because hospitals are mostly ambulatory anyway. Do you have a look at the – what is it? 500 or so beds, I can’t remember – at Westmead Hospital.

Manisha: Right.

Jan: It was 1,000. But they have more than 1 million patients come in through by foot a year, so number of beds – it’s not relevant.

Manisha: What do you believe would be better if you had been involved in the design of it or if you had worked with other people on the design of that think?

Jan: I seldom go into a space and don’t think about what I could have done to make that space better. It’s occasionally I go to a space, and I go, “Oh, they’ve done such a good job here.” There are some great designers who just have it, and they know it intuitively, or they had some special knowledge – whatever it is – there are some great designers who do it. Yeah, I’m always bizarrely critical of spaces. The way I see it is that as an architect, we’re set designers. We’re set designers and we’re preparing a stage for the play that is emerging in our clients’ lives, and we can set a stage with a gun on the wall where somebody’s going to get shot, or we can set the stage for a happy ending.

Manisha: I love that. Well, thank you so much, Jan, for your conversation today. And let’s all hope that we set all those stages for happy endings. So thank you for listening and for being with us here today on With, not for. If you’d like to know more about Jan’s work or how you can make the world more inclusive, please contact us on www.cfid.org.au or see the show notes. Until next time, this is Manisha Amin from the Centre for Inclusive Design.