Trauma Informed Design for Behavioral Health – part 1

Inclusive Designers Podcast
Inclusive Designers Podcast
Trauma Informed Design for Behavioral Health - part 1
  • By: Janet Roche & Carolyn Robbins
  • Co-Hosted By: Janet Roche & Dr. J. Davis Harte
  • Edited by: Andrew Parrella
  • Guest: Meredith Banasiak
  • Photo Credit: Caleb Tkach AIAP

This just in… new changes are coming for those who create spaces for Behavioral Health. Combining the scientific knowledge from Neuroscience and the research evidence from Trauma-Informed Design is opening up new ways to optimize health, performance and access.

IDP is excited to share this 3-part series with Meredith Banasiak that explores the transformational shift in design towards an evidence-based, person-centered culture. She shares her insights for designing for behavioral health projects, from family clinics to eating disorder facilities.

• Part 1- Meredith’s story; sensory issues; and the concept of a ‘Shared Experience’

Part 2- The stigma of mental health; Solutions using Trauma-Informed Design for Behavioral Health Facilities.

Part 3- Social Determinants of Health; improving access to healthcare; designing for eating disorders facilities; and a new way to look at Post Occupancy Evaluations (POE)

Guest: Meredith Banasiak, EDAC, Dir. of Research, Boulder Associates; LinkedIn; Twitter

– References:

Academy of Neuroscience for Architecture, ANFA

American Institute of Architects, AIA

Basic Science of Light / Color

Boulder Associates

Boulder Community Health- Della Cava

Boulder Community Health- Tunable Lighting



“Bridging the Gap” (Healthcare Design Magazine article)

Clinica Family Health

Eating Recovery Center

 Colin Ellard – Cognitive Neuroscientist

Evidence Based Design, EBD

Flexsim Simulations

GoInvo-Social Determinants model

HIPAA: Health Insurance Portablitiy and Accountability Act 

Lifting the Gaze – How to focus to Change Your Brain

Nationwide Children’s Hospital, Big Lots Behavioral Health Pavilion

Adverse Risk in Playgrounds

SAMHSA: Substance Abuse and Mental Health Administration

Seattle Children’s Hospital, Psychiatry and Behavioral Medicine Unit

Mardelle McCuskey Shepley, BA, M.Arch, MA, D.Arch, EDAC

Trauma-informed Design, TiD

• Roger Ulrich Study

USC Santa Barbara ‘Dormzilla’ (Construction Dive article)



Trauma Informed Design for Behavioral Health- part 1
Guests: Meredith Banasiak / J. Davis Harte

(Music – Open)

Janet: In this series we will be discussing specific examples of design techniques that make a positive difference for people living with certain human conditions.

Carolyn: The more a designer understands the client and or the community the more effective and respectful the design will be.

(music up, then lower)

Janet: Welcome to Inclusive Designers Podcast, I am your host, Janet Roche…

Carolyn: And I am your moderator, Carolyn Robbins.

Janet: We have a really great show for you today, we are taking a look at how to improve the standard of care in behavioral health using a trauma-informed design approach. And for this important discussion, we are talking to the amazing Meredith Banasiak.

Carolyn: Let me tell you a little bit more about Meredith… she is a Fellow with the Centre for Conscious Design; maintains an advisory role with the Academy of Neuroscience for Architecture. She has published in psychology, medicine, and architectural research journals and books. And now she is here to share her passion for research and evidence-based design with us today.

Janet: And to make it even more special we have asked Davis Harte, or as I refer to her as Dr Harte, to be my co-host. Together we have co-founded the Trauma Informed Design Society and will be adding our insight from that to this discussion.

Meredith has done some incredible work on sensory issues and designing for human health along with Trauma-informed Design, to foster inclusivity and a healthier environment.

Carolyn: There is so much to explore here, that we’ve decided to make this a 3-part series. You can listen straight-through or choose to hear each section separately, let’s call it ala carte.

Janet: In this section, Meredith takes us through her life experiences that led her to the exciting field of Neuroscience and Architecture. We’ll also focus on sensory issues and the concept of a shared experience.

Carolyn: And of course, if you want to know more about any of the places or studies mentioned, we will have a really rich list of resources for you on our website:

Janet: Carolyn, I think we’ve covered all that needs to be said here up front, so I guess we should just start the show now, don’t you?

Carolyn: Agreed. Without further ado, here is our thought-provoking look at combining neuroscience with evidence-based design, with insights from Janet, Meredith Banasiak and Davis Harte …

Interview- Overview

Janet: Hi, and welcome to Inclusive Designers. I am your host, Janet Roche. And today, we’ve got a special guest host. You’ve seen her before on this show, Davis Harte. And today we’re going to be interviewing Meredith Banasiak. Welcome Meredith. Welcome Davis. How’s everybody doing today?

Davis: Great. Thanks Janet. It’s wonderful to be here…

Meredith: yeah, it’s great to be here.

Janet: Thank you for coming.

Interview- Section 1

Janet: So Meredith, let’s start this off a little bit. Let’s talk a little bit about your background and how you got started and, we did a little intro at the beginning, but we’d like to hear a little bit more about you from yourself.

Meredith: Great. Well, thank you so much for having me and thank you for all the work that you are doing on trauma informed design and all the resources that you’re making available.

So, I’m going to kind of go back to, all the way to childhood, because I have always struggled with sensory issues in the environment. And, when environments are overstimulating like in the city or the sort of sensory experience is just sort of really invasive, and intense, the first thing that comes to mind is, is almost like a church situation where, you know, as a little child and you’re in this very dense environment and you don’t have a visual field cause everyone’s taller than you and the smells are very invasive.

Those kinds of sensory experiences, I struggled with. And I felt they almost sort of hijacked my ability to think and my emotional state. And so, I always kind of wanted to understand what was happening in my brain, so I could kind of suppress it and make it stop. And at the same time, I wanted to design environments where I didn’t have to feel this way, or, you know, I didn’t know if everyone felt like I did. I kind of assumed that they did, but I kind of want to design environments where people didn’t have to feel the way I was feeling.

So, that’s my background into kind of this track of understanding people and then also designing environments. And so when I was in undergrad, this career of design research didn’t exist. And so I was, you know, I think we’ve all sort of forged our own path of how do you prepare for a career that doesn’t exist yet? For me, I was pre-med because I wanted to kind of go into the science and neuroscience, which even then wasn’t really a thing. And then I also followed this path of classics. So studying Latin and Greek and classical archeology.

What I came to realize later in life is that architecture is just doing archeology in reverse. So archeologists study artifacts and ruins to understand people and how they were behaving and what groups of people were doing. And architects, ideally speaking, should study people and cultures to be able to design our artifacts and buildings that can support those behaviors and support those cultures. So I feel lucky to kind of have experienced this equation from both ends, and it’s the same equation you’re just sort of solving for different variables along the way.

So, kind of, that’s my background and sort of how I got into this field. My professional degree is in architecture, but that came later in life. And when I graduated, I learned of an organization called the ‘Academy of Neuroscience for Architecture’, which was just emerging. This was around 2004. And it sounded exactly what I had been sort of preparing my whole life for. And I reached out and said, you know, how, how do I be part of this movement, of this initiative? And, at the time they had what they call the pioneer program where they brought a small group of people on to essentially pioneer what would be a new discipline in neuroscience for architecture.

So, I, I sort of took that on as a full-time role for a time, moved to Washington DC because that’s where the scientific funding agencies were, the AIA headquarters was located there. And as part of my training, I also got to work with a neuroscientist at George Mason University who studied learning and development in twice exceptional children.

So these are children who maybe have like attention deficits and giftedness, or maybe dyslexia and giftedness. And, and so, that was really interesting to study a population who also had an experience that, where they might be struggling with sort of environments. Cause if you think about attention, if there’s something in the environment that’s grabbing your attention, that’s preventing you from internally sort of focusing or staying on task.

So kind of that experience of being able to work with her, as well as just kind of my own sensory background, really motivated me to pursue a career in designing for inclusivity. And for people that fall outside this, mythical average, which most of our world is designed for.

Janet: Right. it’s kind of always fascinating to me that people like yourself and me, and I can’t really necessarily speak for Davis, but you’ve had this personal experience. Right. And you realize that your own built environment, maybe wasn’t what it should have been in order to foster you and you recognize that, that’s pretty amazing. I think most people just kind of go about their way and think to themselves that there isn’t anybody like me. I can give you a quick example. I’m allergic to latex and rubber, and I used to blow up balloons when I was a kid. And I would ask everybody else, like all my kid friends, and ask them if they too felt like their throats were closing up, if their tongues were getting fat, their lips and cheeks were on fire.

And then blowing up balloons is kind of a hard activity on your mouth and your cheeks and everything like that. They’re like, oh yeah, us too. And I’m thinking to myself, I can’t breathe. It can’t be the same thing. But for you, I think it’s really kind of interesting that you recognize that this is not, you know, this was not working for you.

Meredith: Yeah, absolutely. And, you know, in the seventies and eighties, there wasn’t really, sort of a label other than ‘sensitive child’ or ‘picky eater’, probably ‘my mom spoiled me too much’ was kind of the explanation.

Janet: The list goes on. I remember that. Right. (M: yeah). You know, it was sort of like, suck it up buttercup. (M: yeah). So I don’t know, Davis, did you have an experience like that?

Davis: well, I have a few thoughts just from this early part of the conversation is that, yes, this lived experience is so invaluable. And the more we talk about evidence-based design and research and information gathering, real-lived experiences are becoming more appreciated for their value that they bring to how we shape our spaces. So that’s one point, in the one bucket. And then, I mean, the second bucket is, is very personal because of knowing how my own family members experience, um, sensory processing issues and watching them navigate the world.

And what I’m feeling is that now we are coming to a place where the podcast and the information and the people are, we’re finding each other and realizing, all right now, we are outside of the, the bell curve, let’s center the edges of the population into this core of our designs. Very attunely in a way that can meet the needs of all kinds of allergies and all kinds of processing needs.

Our nervous systems are all at the core the same as each other’s but some are much more finely attuned and other, you know, how we process information coming in (J: Right) and circuitry can be de-emphasized with lower stress environments, as well as managed upwards once this knowledge and knowing about it.

My person is very aware of their sensory processing and they’re still young and they, to a certain degree, they know what’s going on in their brain. They’re happy and ready to articulate it to anybody and advocate for their needs in a way that was non-existent a decade ago. Never mind, when we were all children. So, I just applaud this, the wave that’s happening. And I am so excited to hear what else Meredith can share with us because it’s, it’s amazing. It’s an amazing place we’re in.

Janet: Right. And, both Davis and I really think that the Academy of Neuroscience for Architecture is a really kind of remarkable and wonderful place. We got an opportunity to present our poster earlier this year, or maybe it was even a couple months ago— time is but a blur at this moment— but we were really thrilled with that because we knew it’s such an important part of what we’re trying to do, how we’re trying to create this inclusive environment for everybody. So, yeah. It’s great. (M: Yeah).

Janet: So Meredith, tell us a little bit more about the role that you have now and what you’re doing with Boulder Associates and how do you describe what it is that you do?

Meredith: Yeah, sure. So ultimately I ended up in healthcare design, where, you know, inclusive design is an ethical obligation because everyone needs access to healthcare. So you know, when access to care or quality of care is somehow diminished or compromised for certain populations who are again outside this mythical average because of design, because designers weren’t thinking of them when they were doing these designs, then I think we failed as a design community in a major way.

So the firm I work for is Boulder Associates and we do exclusively healthcare and senior living work. And my role is Director of Research for the firm, but the cool thing is I am part of a group that we call BA Science which is our science-informed design entity under the design firm umbrella. And, and in a sense, we kind of function as a startup with the services that we provide.

BA science brings together human factors, which is sort of the effort that I lead.  And then I have a counterpart who does process and operational improvement, so kind of like using Leed methodologies. And then a third expert in sustainability. So often you see in firms like these, or even in projects, if these roles exist there, they’re kind of siloed out. And I found that, you know, when we came together and integrated, we were really able to approach projects as an ecosystem, where we weren’t just sort of told to stay in our lane.

And, you know, only, in designers, I think we feel this all the time, like all we can control is the design of the built environment. And when you consider that the built environment is this larger ecosystem which includes people and relationships and operations and processes, it’s a very sort of narrow and limited view. And you’re not fixing, you’re not solving the issues of the entire system.

So, you know, once we started working together, um, as a BA science group, we would come into projects, and, you know, sometimes it wasn’t always a design solution. It was an operational kind of process improvement solution that we were giving to the client. And that just felt right, because I, I think this sort of systems approach, that buildings environments are sort of this ecosystem. And so approaching it that way is just a better way to solve the challenges.

Janet: Right. For you, I think it’s more of like a personal project. Do you feel like that’s, sort of what you’re seeing with some of the shifts and the changes within the design world? Like, are people bringing their, their own experiences to it, or people are just recognizing that things are shifting? Do you want to speak a little bit on that?

Meredith: Yeah, no, I mean, I think there’s this growing need for expertise, but then the more experts you bring, sort of does it make things more disconnected? And so I think there’s also this responsibility to consciously integrate and work together, to again, to try to address the whole system. So ideal state, I would love for architects and designers to culturally begin to approach projects this way. Realistically, is this happening? Maybe not as much as we would like right now, I mean, you know, change takes time.

Janet: Right.

Davis: Yeah, the notion that it’s a way of working that is more both expansive, but also more intentionally focused. So, you know, what is transdisciplinary work or translational work, where, you know, you and other scientists are taking the time to do evidence, but we want that to be very hands-on tools for the architects and the designers. And they’re able to hit the ground and keep in budget and time. (M: Right).

And where the two shall meet, you know, that’s the excitement of trying to create these bridges that don’t add a lot of extra time and effort for all of those involved in doing it. because everybody agrees. ‘Oh, right, right. We do want to build spaces that are more inclusive’. it’s not like that’s really the problem so much as how the work experience is same as our lived experiences and the same as how we learn. There are many ways of knowing. It’s a shift that’s happening, but how do we help make that happen even more is the question… (M: Right).

Janet: Yeah, how do we help make that change? Because I think Davis and I have both run into this at the Boston Architectural College, where we look at designing for human health, (M: yeah) and then Davis and I in our work with trauma informed design. And, I still talk to architects to this day that basically will say things like, ‘we do that anyways’. And I’m like, ‘but no, you don’t. I can point to, like 12 things that you have that you just have not, you have either glossed over it or have thought very little of it or have not implemented it.’ (M: Yeah). So, you’re absolutely right. We need to, we want to kind of talk about how maybe we can make some of those changes or designers moving forward can start making those changes.

I don’t know what Davis’s experience has been with students recently, but I’ve noticed a real shift in how they are designing in just one semester, because now they have been now through three semesters of COVID and their design outlook is looking very different than it was just even a semester ago. (M: hmm) So I don’t know, Davis if you’ve, have seen that as well, or…

Davis: Yes, something along those lines. I hadn’t named it that way, but I think we’re all forced to look inward and be with ourselves in a way that we hadn’t ever had to before. And that’s creating a lot more of an uptick and understanding about human physiology and basic ways of responding. And what, how am I feeling in my body when this is happening or that’s happening or, and so, it’s forced us to be in our built spaces in a way that is very illuminating. Absolutely.

Janet: Right. I was so surprised at it. It was such a dramatic shift, right? Because now these particular students have just spent their entire academic career in COVID at this point. So, I don’t know Meredith if you want to jump in…

Meredith: Yeah, well, I love hearing your experience of students and COVID because this idea of the environment impacting us, our brains, our bodies, our ability, our behaviors, all of those things up until the pandemic was sort of a, had a niche following, I would say, but the pandemic, the general population understands that the environment impacts our health. and I think what’s frustrating is how much time we’re spending protecting ourselves from our built environment. There’s such a burden on us as human beings, instead of extending that out into the environment. Our environments shouldn’t cause us harm and they are right now.

So now this is now kind of mainstream knowledge. Everyone, the general population has accepted sort of the built environments really do impact their health. We live with this every single day.

And so it’s no surprise to hear sort of how your students are, are reacting in turn. you know, the other thing I was thinking is the work you’re doing as educators and sharing this knowledge, this evidence, with the focus on human factors with your students is really important, but if we think about sort of how long it takes for your students to actually, I don’t have a hand in managing projects and actually designing real public buildings, that might be 10 years from now. So, you know, are we looking at a 10-year long limbo period before this is sort of accepted as part of our design culture and practice?

Janet: I was almost going to hit the desk cause you’re absolutely right about that. I actually said that to the students too, because I was, as they were going through their finals, it was funny. I talked to each one of them individually and I knew what they were all doing, but it wasn’t until I had them essentially all in one room when we were sharing the finals with the whole cohort, I realized, I’m like, ‘oh my God, they’re like, they are now interpreting the world very differently. Right? And maybe it’s much more about no further than their own backyard, a la, you know, Dorothy of Oz, right? But I did think to myself, I’m like, well, wait a minute, like these are not people that are just start making some of these decisions for another 10, 15, 20 years…

Davis: I’ll counter all of that because it’s true that many people are pivoting and are new in the field. But in our cohort of students, there are some, you’ll meet them as they progress through the curriculum, Janet, who are actively working at firms right now and going back to school to get a master’s so that they can implement more sustainable human health changes at work today. (J: interesting).

Similarly, many students wonder, when I mentioned to them that they’re contributing to the field, that’s like unheard of to them. They can’t imagine what I’m talking about. But the fact of their interest cumulatively as a collective, as design scientists working together, their interest in certain topics, such as nervous systems or trauma informed design, that’s helping to shape the discourse, (J: right), and its building momentum.

So there may be— as is true for, you know, white coat science— it takes a while to show up in the public. But the urgency of the situation is for built spaces is such that there are folks doing things today. I got an email last week from somebody in Colorado who said, here’s the work my firm is doing, working with law enforcement officers in their space and how we’re putting ‘Design for Human Health’ principles into place to the best of their abilities. So not discounting all that has been said, but another layer of information for the conversation.

Janet: Absolutely. And it’s an important layer to have. I think both ends are correct, right? I mean, again, just the shift within these young designers, they were starting to look at things very differently because of the pandemic, right? And more involved with the idea of health and uh, human factors and really kind of understanding the brain and how we also work within the environment. I mean, just talking about biophilia, I’m not even talking about healthcare or you know, residentials or what have you. So I think both are very, very true.

And it will be interesting to really see, Davis and I, we already knew this was going to be a thing, but it was still a little bit of a hard kind of nut to break. But I think with the pandemic things have changed quite a bit and have really made a difference within the design community.

Meredith: yeah, absolutely.

Outro- Section 1

Janet: Meredith is so great… Her own story on how she got into Inclusive Design and Research is inspiring.

Carolyn: And since then, she has done so much more… as you’ll hear in the other sections.

Janet: As we said at the beginning, we decided to break our discussion with Meredith into 3 parts, so you can listen to either all at once, or separately.

Carolyn: Even if you’re listening to this as the straight through version, you may want to take a short pause for a bio break, or to grab something to eat, or just to ‘digest’ some of this information before moving on.

Janet: Coming up in the next section, more with Meredith as we explore how Behavioral Health Facilities are making good use of Trauma-informed Design, or as we call it here at IDP…TiD.

Carolyn: And if you do stop here, we’ll just add a quick thank you to Meredith & Davis. And thanks to all of you for stopping by too. Either way, we hope you enjoy all three parts of this forward-thinking series.

Janet: and as always, we will share the links for Meredith; Davis, Trauma Informed Design: and of course, many more things mentioned during this discussion… on our website at:…

Carolyn: That’s:… And of course, if you like what you hear, feel free to go to our website and hit that Patreon Button, or the link to our GoFundMe Page.

Janet: We hope to see you soon.

Carolyn: … maybe very soon if you are continuing on to the next part of the discussion.

Janet: … and if not, stay well and stay well informed

(music to end)


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