Abstract
The environment in healthcare facilities can influence health and recovery of service users and furthermore contribute to healthy workplaces for staff. The concept of therapeutic landscapes seems to be a promising approach in this context. The aim of this qualitative meta-analysis is to review the effects of therapeutic landscapes for different stakeholders in psychiatric care facilities. A systematic literature search was conducted in the four data bases PubMed, PsycInfo, CINAHL, and Web of Science. Thirteen predominately qualitative studies were included in this qualitative meta-analysis. The methodological quality of these qualitative studies was assessed, using an adapted version of the Journal Article Reporting Standards for Qualitative Research, and a thematic analysis was conducted. The results were categorised into the three main themes of the physical (built and natural), social, and symbolic dimensions of the therapeutic landscape. Given the heterogeneity of the summarised data and an overall methodological quality of the included studies that can be rated as medium, the results should be interpreted with caution. Current findings are based almost exclusively on qualitative studies. Therefore, there is a need for quantitative study designs that investigate the relationship between specific environmental elements and mental health outcomes for different stakeholders in psychiatric facilities.
Highlights
Global research emphasises the positive relationship between direct experiences of natural environments and a wide range of health benefits [1,3,4,5], in addition to the key role nature plays in creating healthy environments [6,7], and in relation to an overall healthy society [8]
Perspectives of different stakeholders, e.g., service users (SUs), informal carers, and staff, from various psychiatric facilities were included and the results embedded in the three main categories: physical, social, and symbolic dimension
It cannot be ruled out that, through this strict approach, possibly relevant aspects were disregarded. This qualitative meta-analysis summarises how different stakeholders, e.g., SUs and staff, perceive certain aspects within psychiatric care facilities as supportive or unsupportive of SUs’ improvement in mental health (MH), and for carers’ and staffs’ satisfaction. It outlines that environmental factors can have a positive and a negative impact on SU MH and recovery
Summary
The environment has a significant impact on health [1,2]. Direct and continuous contact with nature can be preventive and health promoting [3,4,9], e.g., by increasing physical and mental well-being or reducing stress [10,11,12,13,14,15,16,17], and promoting social inclusion and social cohesion [5,18]. Ecosystems can have an impact on mental health (MH) [20], e.g., by providing spaces for physical activity and social contact [21,22]
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