Trauma Informed Design

The Substance Abuse and Mental Health Services Administration describes individual trauma as resulting from "an event, series of events, or set of circumstances that is experienced by an individual as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning and mental, physical, social, emotional, or spiritual well-being."

Trauma is a common experience for adults and children in American communities, and it is especially common in the lives of people with mental and substance use disorders. For this reason, the need to address trauma is increasingly seen as an important part of effective behavioral health care and an integral part of the healing and recovery process.

Trauma-informed design integrates tenets of trauma-informed care into the design of buildings with the goal of creating environments that promote healing and recovery. Our research into designing for individuals coping with trauma suggests the following six strategies, which we have considered and incorporated into many of our recent projects including De Paul Treatment Centers, 3000 Powell, and Stark Family Housing.

Safety

Create the perception of safety in addition to actual safety while balancing privacy and the need for staff to monitor behavior. Open spaces with clear sightlines and few barriers will increase the sense of “spatial availability,” which mitigates perceived crowding. This is achieved by providing:

• clear sight lines and well-lit spaces
• wide corridors (avoid blind corners)
• open stairways and large elevator cabs without mirrors
• vision glass in doors and walls to allow visual connection between spaces
• multiple paths to destination (avoid dead-ends)

Nature

Promote connectedness to the natural world. Connections to nature have been found to reduce stress and pain, and to improve mood.² This is achieved by providing:

• natural light
• views to outdoors spaces and/or sky
• areas of planting inside the building
• landscape photographs and paintings
• spaces finished with natural materials and colors.

Comfort

Reduce or remove adverse stimuli and environmental stressors. This is achieved by providing:

• indirect lighting where possible to reduce glare/flicker (avoid fluorescent lighting)
• LED lighting controlled to match natural circadian rhythms
• paint colors in lighter, natural hues (avoid bold, warm colors)
• low-emitting materials and fresh air silently and at low speed
• well insulated building assemblies with windows to enhance thermal comfort and reduce drafts
• good acoustic separation between spaces and acoustic control within spaces
• furniture arrangement that allows prospect and refuge – arrange seating against walls looking out (avoid: seats facing a wall, seats with their backs to a door, face-to-face seating)
• non-representational or natural imagery (avoid symbolic significance in art that may be negatively interpreted).

Coherency

Incorporate a coherent narrative within the building to develop a sense of trust in the environment. This is achieved by providing:

• predictability in structure and finishes throughout the building (avoid irregularity, strong visual contrasts, dissimilar visual elements)
• logical sequential arrangement of spaces
• simple and clear wayfinding (avoid overstimulation)
• ample storage to reduce clutter.

De-escalation

Furnish spaces for de-escalation and self-care to promote mental health. This is achieved by providing:

• quiet rooms or small lounges for individuals in distress to be away from others
• spaces for groups to move to in the event that an individual in distress cannot be moved
• break rooms and quiet rooms with comfortable and uncluttered surroundings.

Empowerment –

Integrate options into the design to support decision-making opportunities for an individual in crisis that can help de-escalate behaviors triggered by trauma. This can be achieved by providing:

• movable seating or multiple seating options
• multiple paths to destination
• different settings for one type of use (for example, booth or table for dining)
• options for lighting levels through availability of controls (dimmers, shades, proximity to windows/skylights)
• operable windows
• space for personalization to reflect individual identity.

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While many of the tenets of trauma informed design can be found in our recent work—like the healing gardens of De Paul, the simplicity and clarity of Stark, or the narrative of Powell—it has become abundantly clear that these principles can be useful throughout all project types. The promotion of health and healing is not limited to healthcare or affordable housing but is something to be incorporated throughout all building design.