Skip to content

MEETINGS – OF HOPE – AT MAGGIE’S

The diagnosis of a potentially life threatening illness is catastrophic news for the individual and their family and friends.

However, as I came to discover, during the production of a short research film – documenting the effects of architecture and the environment in health care – at the award winning Maggie’s centre at Gartnavel, Glasgow, there are patterns which we all seem to respond positively too, even amidst the most deeply distressing and disempowering of situations.

As the film was reaching completion this month, the World Health Organisation released headline-grabbing news, predicting a “tidal wave” of cancer diagnosis of 24 million new cases by the year 2035, adding, “The cost of treatment of cancers is … spiralling out of control.”

In my work, statistical evidence-based research is the gold standard, often based on randomised clinical trials and questionnaires, but, which cannot fully address the complexities of place, people and context. What I discovered at Maggie’s though, was first hand subjective, emotive responses, from all the contributors, of deeply held beliefs.  The sense of place – which constituted what Maggie’s meant to them – including the combination of light entering the building, the backcloth of trees, grasses and flowers, and the human interaction – was the distinguishing factor making a massive difference to how they felt. The benefits were tangible and offered direct evidence of the wellbeing benefits of integrating nature within the context of health architecture.

The qualitative approach applied in the film – getting to the heart of the context in a particular moment with dialogue – was a much more sensitive, immediate, honest and valuable methodology, to understanding the effect of Maggie’s on its users, than any statistic could ever reveal.

Given the “spiralling” cost of conventional medical treatment in oncology departments around the world, perhaps the natural sanctuaries created by organisations like Maggie’s, will go a very long way to providing accessible humane support to all who seek it?

If you found this interesting, please forward the film, or the article, to someone with – or caring for – a person with cancer.

Hopeful green stuff ……..

Tucked away – in a little known section of the Royal Botanic Gardens Edinburgh (RBGE) – is a natural woodland and wild meadow area – a secret idyll far removed from the rest of the city. Last year – funded by a Beltane Fellowship – I worked with RBGE and a neighbouring community from Pilton in West Edinburgh to explore how this area might be developed for nature play.

Nature play is child-led play using natural materials – loose logs, trees, soil, sand, rocks and stones – to follow their own play needs freely in an unstructured way.  This type of play is not universally offered by schools and nurseries, but a rare exception is the Secret Garden Outdoor Nurseryan award wining and unique 25 acre ‘wild’ play area woodland in Fife.  Here I observed young children roam and scramble the forest freely, self-generating their own learning and games – and even sleeping in amongst the trees – whatever the weather.

But not everyone can afford – or has access  – to this type of facility.

The Beltane project enabled parents from built up urban areas that have little or no access to natural play areas or woodlands to experience nature play.  Over a series of visits, the children – and their parents – had time to immerse themselves in this little known ‘wild’ area of the Botanical Gardens.   Naturally – without any adult intervention – the same child led play experiences took place.  Utilising the materials from the forest floor – and adjacent meadow – the children generated their own unique games and organized their own group dynamics.

What become apparent is the resilience and adaptability of children – from any background – to integrate with each other and their environment with minimal adult intervention in these wild areas.   I was struck by the sheer ability for a child’s imagination to adapt natural materials for play and communicate with their peers – working hand in hand, even with those barely known to them.

Through a process of observation and feedback, the families were able to make their ideas known and play a part in developing the nature area.   Using these findings, I generated a conceptual plan that formed the foundation of successful application to Calouste Gulbenkian to develop the nature play facility.  A series of further community interventions are planned for this year, with the aim of producing guidelines on managing biodiversity-rich urban sites for nature play and nature conservation.

An important step towards a new – and hopeful – nature play facility for Edinburgh has begun …

‘A child said, What is the grass? fetching it to me with full hands; How could I answer the child?. . . .I do not know what it is any more than he. I guess it must be the flag of my disposition, out of hopeful green stuff woven.’   Walt Whitman, Leaves of Grass

A ROOM WITH A VIEW ?

It’s one of those universally accepted truths, that in every hotel, guesthouse, or bed and breakfast – around the world – the rooms with the best views always cost more.

Why? Well, sadly, because it makes good business sense, as guests with more money, will generally pay more to have a room with a view.

And here’s another universally accepted truth. Everyone knows that a great view always makes you feel better. Why? Well that’s more complex, and is one of the reasons we have just published new research, which quantifies how the quality of the view matters too.

Our early study, exploring the urban brain on the move – using mobile EEG technology for the first time – generated global interest, showing a meditative effect of moving into green space in the city.  The international media and press wanted to know more.  ‘Could the benefits we found, apply to simply sitting and looking at a view of green space, as opposed to walking?’ they asked. The answer was a resounding yes.

Our follow up study, just published, explores brain activity whilst viewing different urban settings – sitting stationary.  In this research, we presented our participants with a series of images with grey scenes (buildings only), grey-green (buildings with some green space) and green space-only scenes.   We used a robust set of images, already scientifically proven to be sensitive to differences in subjective mental wellbeing. But a unique difference in our study was in measuring the EEG (electroencephalography) brain wave output of our participants as they viewed the scenes.

Using an Emotiv EPOC EEG recorder – as before – we measured the effect of different visual scenes on the same emotional parameters as in our mobile experiment i.e. excitement, frustration, engagement and meditation.   Participants also rated the images subjectively using validated psychological emotional scales.

In line with other research – and using the same subjective scales – we found participants consistently rated the green space urban scenes more positively.   This was good news, replicating other scientific research with the same photographs.

However a new and exciting new finding is the EEG output confirmed a restorative effect for simply siting and viewing a green scene – the green space scenes were consistently associated with higher levels of meditation and lower arousal (i.e. excitement) than the grey urban scenes.

By complete chance I was recently reading E M Foster’s classic 1908 novel, A Room with a View, and came upon the central character Lucy describing the scene from her Italian room.

‘It was pleasant, too, to fling wide the windows, pinching the fingers in unfamiliar fastenings, to lean out into sunshine with beautiful hills and trees and marble churches opposite, and, close below, ( sic. the river ) Arno, gurgling against the embankment of the road.” 

Few of us are blessed to live and work with as generous a view, yet simply having a window looking out on green space does make a difference. Many people simply don’t.

The research implications, for the design of our neighbourhood communities, and the workplace, is huge.  My belief – based on our evidence – is that everyone should have access to a view from a window to de-stress and detangle their mind from the complexities and demands of everyday life.

THE WORRYING TASTE OF INNER CITY STRESS

IMG_6472

I’ve been fortunate most of my life to have access to a garden or a nearby park, for sunny hours of reading, or time to simply sit, contemplate and de-stress. These natural environments are ideal for recuperation from fatigue and stress because they hold our attention with little effort – what’s called ‘soft fascination’ (Kaplan and Kaplan 1989).

But how is it for the countless millions of people who live in areas with limited or no immediate means of accessing similar green space in their neighbourhood? What, if any, is the effect?

This week a major new study which I co-authored, has just been published. Its initial findings are a far reaching and an important indicator on the value of green space to stress in areas of urban deprivation.

Our teams – led by OPENspace, the Universities of Edinburgh and Heriot Watt, together with the Universities of Glasgow and Westminster, the James Hutton Institute and Biomathematics and Statistics Scotland – measured the concentrations of cortisol – the stress hormone – found in human saliva, in unemployed adults (or not in work for some other reason), aged between 35 – 55 and living in socially disadvantaged inner city areas.

Cortisol acts as a stress biomarker but has rarely been applied before as a method to explore how the different attributes of our built environment act as stressors or de-stressors to inner city living.

Our data – scientifically measured and statistically controlled for other stressors such as income deprivation – illustrates that green space can help buffer stress for those living with poverty in inner cities. The effect appears to be stronger for women – whom showed patterns of stress ‘burnout’ in the areas of our study with the lowest levels of green space – compared to those living with higher levels of green space, whom showed much healthier patterns of stress regulation.

We are not suggesting green space can solve the problems of major life stressors – divorce, bereavement, redundancy – but – at a time when our own – and international – health and welfare services are evaluating new approaches to the wellbeing of our burgeoning populations, I believe our study is an important indication of the positive emotional impact of providing access to green space.

The taste of happiness and wellbeing may now be a palpable first step in the aid to recovering the unnecessary and unwelcome costly stress health implications in the poorer members of our community.

SPECIAL HOSPITAL WARDS FOR TEENAGERS

Teenage Cancer Trust  ©

Teenage Cancer Trust ©

More teenagers than children are admitted to hospital, but how many hospitals do you know that offer dedicated teenager wards?

40 years ago experts said teenagers should be treated in separate wards, but only a handful of hospitals in England provide special accommodation for teenage patients and the situation is much worse in Scotland.   Over 10 years ago, Prof Viner, a consultant at University College London, published research setting out a strong case for dedicated teenage wards in the U.K., resulting in a national press call. 

But next to nothing has happened.   It’s a national scandal with more and more teenage patients forced into adult wards that are increasingly occupied by the 65+ groups.  This is not conducive to recovery – and it may even impede it.

Recently, I witnessed my 18-year old son recover from an operation in an adult urology department in a Scottish hospital.  Waking up from the trauma, he was confronted with a ward of elderly male patients in various states of critical illness.  For a young person who had never experienced an environment like this, the situation was intolerable and met with a plea to ‘get me out of here’.   I observed an immediate depressive cloud descend over my normally optimistic son. Fortunately a quick escape ensued but what of those young adults with chronic diseases requiring long-term care who have nowhere else to recuperate?  How is such an environment affecting their recovery?

The UK needs to look worldwide for precedents; Australia, for example, where adolescent wards can be found in all the major hospitals.  The Teenage Cancer Trust  is steering a revolution in UK teenage hospital care – and has flagged the benefits of good design to recovery.  But this model needs to be rolled out mainstream – starting with just 12-16 beds set aside in a special setting within all hospitals.

My own research has shown how the design of hospital settings influences patient wellbeing.   Let’s take those lessons and apply them to teenage wards – the physical and social setting matters to these young people.

If you are a teenager or a parent with your own story please get in touch at  jenny.roe@york.ac.uk

GROWING SOCIAL DIVERSITY IN THE BOTANICS

botanics
© Kathy Taylor

Arriving in a new city or town for the first time, I always map and locate its Botanic Gardens – knowing I will find a sanctuary of solace and peace – and an insight into the unique plant culture of a particular place. I’ve visited some extraordinary botanical collections – from Barcelona’s stunning cacti garden on Montjuïc to the tiny aromatic garden of Mali Losinj with its rich mix of lavander, aloe vera and citrus scents.

Across the world, a single defining feature of all Botanic Gardens is their plant diversity. They are living libraries of rare species from around the world, scientific laboratories pioneering research and conservation, and home to a bank of stories from pioneering botanists and explorers who travelled the world to source and protect rare and endangered plants.

But these gardens are not always socially diverse. Research has shown that the people who visit botanical gardens are mostly middle-class, white people, and not demographically representative of the local population.

To some people, these places are more akin to a 19th century museums, with plants bearing labels with unpronounceable names, characterized by prohibitions and devoid of play.

Understanding these barriers – and how people perceive and might use botanical gardens – is important to fulfill the restorative potential of these beautiful places. This is the aim of a Beltane Fellowship I’ve recently been awarded. The project brings together the Royal Botanic Gardens Edinburgh and a neighbouring community to explore the opportunities and challenges in increasing access to the Gardens.

The project will kick off soon with a series of focus groups – so look out for most postings shortly.

beltane_logo_loresRGB

URBAN SPLASH

Image

What is it about water features in our cities that seem to have such magnetic power over busy adults and boisterous children?  Could it be a deep subconscious memory of the parched savannah of our past?  An ancient unquenchable trigger that ensures we locate and map water in our environment?

Sheffield’s town planners may have employed landscape psychology in their bold approach with urban-blue water features – creating a visual and soothing sound oasis. Whatever the intent, the outcome is not unlike Mitterand’s Le Grand Projects in Paris in the 1980s or indeed Versailles centuries before it.

Arriving at the city’s central station you are greeted by the spurts and gurgles of roaring jets and fountains – concealing the vehicular din of the city’s dual carriageways.  It is but a hint of the unfolding drama that can be discovered elsewhere in the city – which employs water on a scale unprecedented in the UK to regenerate its heartlands.

But what can all this urban aqua do for public health and wellbeing? Recent research we’ve carried out for CREW – Scotland’s Centre of Expertise in Waters –  and presented at last week’s GreenHealth Conference flags the health improving benefits of water settings – and water sensitive urban design – now a mandatory requirement of all new development in Scotland.

But – as Tim Smedley accords in his article in The Guardian there’s a long way to go in the health research.  What – for example – could the mobile EEG kit we’ve pioneered recently to explore restorative settings in the city reveal about the effect of water on stress?

Whilst water benefits from the play of sunshine and light on it’s surface, we know next to nothing of the effects of climate and weather on our visual or physical engagement with water – and the arising health benefits.

Even on a downcast day the people of Sheffield simply disregard the inclement English weather to interact and engage with its calming water features.

Now that’s interesting, isn’t it ?

FEEDING A MEGA CITY

Berlin street corner allotment garden

Berlin street corner allotment garden.

Mega cities are growing at an exponential rate.

Over the last twenty years urban populations have been increasing by over three million people per week. That’s equivalent to creating a new Boston, every working day somewhere in the world. United Nation projections suggest that the number of citizens living in mega cities will double from 3.3 billion inhabitants in 2007 to a staggering 6.4 billion by 2050.

But you don’t have to be a statistician, politician or scientist to realize that food production, fresh water supply and climate change are going to create major logistical issues for burgeoning urban conurbations.

And yet as much as 50% of our global food production is being wasted by poor distribution, inadequate storage or failing to meet the exacting appearance standards required of our major supermarkets.  And we’ve lost connection with how food is produced with much of what we eat being transported further than ever.

Ripping up vacant tarmacadam car parks and street corner plots in one innovative solution to cultivating our cities. Another new approach is vertical farming which is making upwards progress in meeting our increasing urban food dependencies.

But what is vitally needed is major visionary planning and policy to integrate urban farming permanently into green urban infrastructure.  Perhaps then we can generate our food in a sustainable, local and less wasteful manner?

Our ingenuity as an adaptive species to survive and thrive towards the next millennium depends upon it.

ENABLING PLACES

A soothing space - Gråbrødretorv Square - Copenhagen.

A soothing space – Gråbrødretorv Square – Copenhagen.

Have you ever experienced that terrifying, totally paralysing, sense of being trapped in a place that you could see absolutely no escape from?

This is how people with psychosis have described the experience of a city to me.  Being simply too frightened to negotiate our urban streets – which amplifies anxiety and paranoia in people with mental health problems – is almost beyond rational understanding for most of us.

Sadly, for many suffering from debilitating and acute mental health problems, their psychological condition deteriorates further when incarcerated in demoralising and dysfunctional secure units – described as madhouses - with their place of living becoming a physical prison.

Our care of people with mental health problems is a national scandal.  A recent U.K. independent inquiry says we are catastrophically failing.

Not only is this unethical – but it’s an economic issue.  Mental health care costs the nation far more than cancer.

But spending more money on secure units is not the way forward.

Imagine for a moment a hushed kind of city – not dissimilar to the experience of arriving from the metro into the heart of Copenhagen – akin to a city after snowfall.   A still and gentle soundscape, wide leafy streets, clear demarcation of the way ahead – free of street clutter, inviting cafes and friendly charity stores – places above all with a positive, welcoming mood.  This is an Enabling Place that can – and should – be designed to nurture and enable recovery from mental illness.

The government says mental health is one of its highest priorities butuntil it looks at “place based” solutionsnothing in mental health care will ever become clear.

HOPEFUL ARCHITECTURE

Maggie’s Centre Dundee by Frank Gehry                                                      Kathy Southwell ©

Universally we reward brand new glossy buildings and landscape – forgetting that these shiny new stars of the built environment don’t always hold up to their promise. But I detect a shift in tone amongst the awarding bodies – nominees for this year’s RIBA Stirling Prize were a group of contextual buildings – less star architecture – and more humane and poetic in their response to place.  Last week the RIAS awarded Maggie’s Centre Gartnaval ‘best building in Scotland’ – in recognition of OMA’s healing architecture offering restorative spaces – indoors and out – for cancer patients and their families.My own experience of Maggie’s Centre Dundee is of a light, cosy, domestic space – more akin to home than a hospital institution – nurturing hope.

So why don’t we reward more buildings for their healing power and affective quality – or indeed for longevity and adaption to our changing social world and climate?

Discussing potential nominees for an award in Hopeful Architecture with colleagues and students, a unanimous choice was Park Hill Estate in Sheffield.  As a child I recall this towering mass of 1960’s concrete – Europe’s largest ever housing estate – rising up above the city ring-road with an insistent and ominous presence, its longevity forever secured by Grade 2 listing in 1997 by English Heritage.  But – like most other high density, inner city estates in the 1970s – Park Hill hit hard times, descending into a hell of crumbling concrete, cockroaches and crime – an urban eyesore and a planner’s nightmare

But new life is whipping through Park Hill and it’s sky-high walkways. Urban Splash purchased the Estate for the nominal sum of £1 and have resurrected Corbusier’s original vision for high rise communal – and affordable – urban living for all – humanizing the Brutalistic concrete mass with touches of colour, light and landscape.

So what would your nominations be for Hopeful Architecture – health-sustaining and resilient buildings?

Follow

Get every new post delivered to your Inbox.