As described in Winifred Gallagher's Power of Place, “we need places that support rather than fragment our lives, places that balance the hard, standardized and cost-efficient with the natural, personal and healthful.”1
Today, a new population is being shaped as a result of the ongoing fight against terrorism. Honorable soldiers and their spouses and children are its members who are adjusting to the invisible injuries of anxiety, depression, and post traumatic stress disorder (PTSD), among others. Current treatments disconnect the soldier and the family by separating guidance, therapy, and treatment among many facilities. The top mental wellness programs that do exist are for soldiers only, and are reactive to situations and/or have limited access.
According to the U.S. Department of Veteran Affairs, successful treatment of PTSD and other war-related mental health injuries must be treated promptly. At the same time, these diagnoses must remain secure to prevent the fear of stigma from deterring treatment.
To truly succeed, the Military Healthcare System and Department of Defense must create new entities; sensitive and thoughtfully designed environments that truly promote and contribute to the wellness of body, spirit, and mind for the active-duty military family as a unit-as a soldier, spouse, child, couple, and family.
Scientific research in the last two decades established a direct link between poor health, such as anxiety, depression, high blood pressure, and an increased need for analgesic drugs, and inadequate or psychologically inappropriate physical environments.2 Healthcare today embraces this evidence-based design research and the positive impact an environment can have on patient wellness and healing.
To pave the road toward evolution in the Military Healthcare System and mental health facilities in general, a new design model of mental wellness treatment is proposed in the form of a “wholistic” environment of “transitional healing.”
Making connections and discoveries
“Transitional healing” addresses the frag-mentation of access to care and support. It incorporates evidence-based design principles of patient and family-centered care. It also bridges the stages of healing and wellness of the body, mind, and spirit of the soldiers by including and addressing the needs of their families, who are integral participants in the process. It combines people and services in a tangible, physical space that involves and connects the family in every aspect of the design to facilitate the recovery journey of the individual (soldier, spouse, and child) as well as the family unit.
Integration on a military base would address three primary barriers that impact military mental health treatment for soldiers and their families as noted by the APA Presidential Task Force on Military Deployment: availability, acceptability, and accessibility.3 Its physical presence in the community it serves could also help alleviate and eliminate stigma associated with mental wellness and healing.
On the site would be a village of pre-fabricated modules organized around a central core (courtyard), forming a holistic, non-clinical atmosphere-one that promotes humane, interactive therapy and discovery. The target users (active duty soldiers, spouses, and children) are supported through a facility that focuses on Connection and Discovery (figure 1).
Figure 1. Connection and Discovery with the courtyard as the central core. Illustration by author.
Connection offers secure places to educate and prepare soldiers, spouses, and children before a deployment, or to connect during and reconnect after (figure 2). Here soldiers and spouses can learn about support programs that are offered and the potential psychological and behavioral issues that may arise. They are also given a tour of the facility and services offered to ensure healthy transitions before, during, and after a deployment or, in many cases, in between deployments. The initial environmental experiences help to form a subconscious bond of trust, easing the return when healing is truly required, especially for soldiers and families suffering from the effects of PTSD.
Figure 2. Connection (café and lounge). A neutral space of activity and camaraderie to connect with peers and family members. Renderings by author.
Discovery is a place that encourages learning, observation, and understanding, encompassing all formal therapy and counseling services for active duty soldiers, spouses, and children. It is divided into two zones:
Discovery 1 is for soldiers only. It is a place to seek individual and group therapy as well as assessment before and after deployment with fellow comrades who understand where you are going and where you have been (figure 3).
Discovery 2 supports the child, spouse, couple, and family.