To be or not to be - Housing for homeless terminal people

Addressing Dutch healthcare provision and homelessness by redefining shelter design

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Abstract

People share a deep-seated need for a 'sense of home'. It is an intangible, psychological and sociological need that is projected on, and connected to the Built Environment (Rennels & Purnell, 2017; Dovey, 1985). Many people in western societies meet their 'sense of home' through traditional housing. Yet, there is a small marginalized group of homeless people whom are unable to do so. Many suffer from severe physical and mental health diseases, which makes it even more challenging to maintain a stable life. Dutch policymakers provide shelters to assist those in need, but these accommodations do not positively affect the well-being of the homeless. In addition, many shelters fail to facilitate the wish of homeless people of dying in the shelter (Klop et al., 2018).

Therefore, the aim of this research is to redefine shelter design so to improve the mental well-being of homeless people. This, by learning lessons from psycho-supportive design approaches in the healthcare environment. Hence, the main question in this research is: ‘Which architectural elements in the care environment have a positive effect on the (mental) well-being of homeless (terminal) people with chronic mental health problems?’.
The above question is answered by means of literature studies, case study analysis and fieldwork. From the results, several spatial-design components have been extracted and categorized into problems and solutions concerning the theoretical themes of: stigma; security; sensorial stimulation and environmental experience.

The results showed that privacy, daylight entrance, access to nature and social integration are the four main elements that positively improve one’s (mental or physical) well-being. Additional spatial-design components have been summarized into four conclusive Evidence-Based-Design guidelines and crucial design factors which may be applied on both urban and building scale. When all four guidelines are considered in the architectural design of shelters, the best mental health outcomes are achieved.
As the issue of homelessness is not yet solved and the number of people with complex care needs increase, the Netherlands is in desperate need of more assisted and affordable housing. With this research architects, urban planners and developers are encouraged to enter the discourse of homelessness. Moreover, they are stimulated to use the Evidence-Based Toolkit into the design process of new homeless shelters.