The document discusses how the physical environment impacts mental health and well-being. It explores how factors like urbanization and modernization have increased stress levels and led to more mental illnesses. The design of healthcare spaces, like hospitals, often do not support healing and can add to patients' suffering. However, research shows that designing spaces with natural elements, access to nature, opportunities for social interaction, and spiritual/cultural considerations can promote optimism, sense of control, and aid the healing process. The paper examines how designing spaces with these principles in mind can positively influence behaviors and help mitigate mental disorders.

1. 1
Exploring the Elements of the Physical Environment That Impact the Mental
Health
Lakshmi Varshini Dontu1
Abstract:
“The best environment in which to awaken, to heal, and to grow is the one of complete freedom and
total safety”- DAN BRULE
This paper intends to focus on the spatial elements of the physical environment which impact upon the
mental health of an individual. Its impact is so intense, that it not only causes stress but also mental
illness. To understand the phenomenon, method adopted here is comparing the influence of the spatial
parameters on the mental health of the people impacted by urban stress and mental illness. Finally
exploring the elements and formulating the structure of spaces which support the healing for both.
1. Background:
Urbanization has resulted in a stressful day to day life. This increasing mechanical life has
resulted in the pressure on the person, thereby increasing stress. The increasing levels of stress and the
continuous exposure to it have further contributed to the negative impacts on the mental wellness of an
individual. Anxiety, fear, depression, phobias, personality and eating disorders etc. are a result of the
continuous exposure to stress. Different mental disorders are also caused as a result of this, which may
be curable or non- curable.
1.1. Problem Statement:
Stress levels have been increased in day-to day life which is detrimental to the mental well-being
of an individual. The number of people facing these disorders has increased. Health care systems are the
spaces meant for healing.
In general, the hospital environment is portrayed the other way; the endless stretch of corridors,
polished white flooring, plain surfaces bearing emotionless colors and the whole environment giving off
the disinfected smell. (Nousiainen 2011)
People associate their negative experiences and sickness with the environment. Despite having
the staff that cares for them, the healing process is slow because the surroundings stopped caring ages
1
V Year, B. Arch, School of Planning and Architecture, Vijayawada

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ago. Not only technology and hygienic requirements, but also the surroundings support healing.Despite
providing the acting field on the day to day life, the effect of the surroundings on the environment left
unnoticed. Different people react differently to varied surroundings. Architecture has to be filled with
life and should help promote healing of the patient and nourish the soul. (Schweitzer et al. 2004)
Architecture can be a dangerous tool and a powerful healer. Architecture is the livable frame in which
the buildings are environmentally responsive and which when handled properly can affect the people
and places positively. It has a power to manipulate moods and thinking of the people. Architectural
forms with life can change the psychology of people. A soulfully designed place can even change
criminals to humans. Colors have universal aspects and this can be therapeutically used to manipulate
people. Thus every aspect of architecture can be modified to heal the affected soul of the people.
Harmony of spaces, colors, forms and integrity of the built spaces with the natural setting help the
treatment of psychologically affected people. (Day 2004)
Mental illness is age old problem. Mental patients can also be treated at home with appropriate
care and affection. But the prejudice and stigma prevailing in the present society has resulted in the
alienation of those mentally challenged people from the society. The mental care centers are generally
located away from the city and they portray an image of anxiety and hollowness. When proper
environment is provided, the spaces can themselves aid in the healing of the various psychological
disorders.
Various surveys carried out in India during the second half of the 20th
century showed that such
illnesses prevailed as intense as elsewhere and common to both urban and rural areas. Simple and less
expensive treatments are available in India. In India, the psychiatric care is given through custodial
mental care systems and general mental hospitals. According to a survey conducted by National Institute
for Mental Health and Neuro-Sciences, Bangalore (NIMHANS), 10% of the mental care needs are only
met. There is a dire need to find alternate approaches to mental health care system which are feasible to
the Indian context. (Srinivasa Murthy et al. 2005)
The research paper focuses on the study of the relation between behavioral health and physical
environment and to analyze how spaces built and unbuilt can influence the behavioral aspects of the
mentally challenged. The study focuses on the spaces which create negative impacts on the mental
health of the people and formulate guidelines for the spaces which can create positive impact on the
mental health. To study the spatial requirements and the impact of different spaces on the psychology
and retrieve appropriate conclusions, suitable for the intellectually challenged. To study all the factors

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such as nature, technology, art, built and unbuilt spaces and analyze their amalgamation with the site to
result in a healing environment where mental disorders can be mitigated.
2. Overview
2.1. Urban Stress In Indian Scenario
Increasing trends of modernization and urbanization has led to the mechanization of life of the
people. Different causes for this mental health increase the negative impact on the mental health. This is
detrimental to health. These impacts may lead to mental disorders which can be cured and can be non-
cured. Stress may be caused by routine day to day life incidents and also due to continuous exposure to
the deadlines. The conditions of people being affected by urban stress are alarming.
2.2 Mental Illness In Indian Scenario
Mental illness is a prevailing social issue from ages ago. It has been recorded in the oldest
scriptures possible all over the world. There are hardly any definite causes for mental illnesses. They
may be acute or chronic and there were very few effective treatment methods available till
recently.(Srinivasa Murthy et al. 2005)
Different traditional and conventional treatment methods were used before the advent of the
European power in the 18th
century. Different local and folk treatment methods prevailed during those
days and more than 90 percent of people believe in them. Traditional medical practitioners using
Ayurveda provided necessary treatment before the discovery of modern tranquilizers. After
independence, the infrastructure for the mentally ill has been developing. (Anant Kumar 2004)
In India, mental illness was considered to be a curse. (Anant Kumar 2004) The mentally ill were
considered a source of disturbance to the social life and the stigma prevailing those days in the society
resulted in their isolation and they were kept in closed and custodial places called ‘asylums’. This added
to the suffering of the mentally ill. They had to live away from their family and stay within the lifeless
bounds of the mental hospitals where their agony has increased. They were prisoned within the walls of
the hospital and were forcefully made to avail of the medical services which hardly helped them to heal.
The important thing about traditional mental health care is that it does not separate the mind from the
body in understanding the illness during the treatment. (Srinivasa Murthy et al. 2005)
Different policies were introduced by the government like National Mental Health Programme
(NMHP). All India Institute of Mental Health (AIIMH) and National Institute of Mental Health and
Neuro Sciences (NIMHANS) have come up. Awareness has started regarding the mental care the better

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facilities were made available which added to the advance in the research in the field of psychiatry. The
active involvement of the family of the patients added to the innovations in the field of mental health
care. (Srinivasa Murthy et al. 2005)
3. Architecture as a Healing Model:
The physical environment plays a major role in shaping the behavior of an individual. Built form
and environment can influence the spiritual and mental health. Architecture has a power to manipulate
moods and the way of thinking of the people. People’s mindset changes from place to place. Spaces
react differently at different times of the day. Architectural forms filled with life in it can change the
psychology of people. Architecture should be able to grab the soul of the place and should reflect the
ideology of the built form.
Day describes that people cannot forcibly be made to live in a space. The livable space has to be
created by capturing the soul and essence of the particular space. Beautification of the spaces is to be
encouraged though no one observes them. Environmental design is the art of nourishing senses. Sensual
perception of the space is the common practice everywhere. People also sense the invisible reality
beyond the built form. The sense of the individuality of spaces and the spirit of the form is to be
conceived through the design. The feel of life is induced in the designs using the repetitive forms and
colors with balanced contrasting elements. The same volume of space when used for different function
and by different people changes in its nature. The behavior of the space transforms with the inclusion of
light into it. Christopher Day says, “Space, shape, light and color all weave in conversation with each
other to create one atmospheric whole”. (Day 2004)
Quality of internal space is as important as the physical setting of the structure in the site. The
design should flow with the terrain and should be suitable for respective domain. The globally accepted
and generalized technologies or materials may not be suitable for all the places. Architecture should be
localized with respect to materials, technologies. (Day 2004) Day is against the generalization of
architecture. Environment can affect the health of the people in the health care systems. This paper
focuses on the impact of different environmental elements on the psychological wellbeing of an
individual and studies on how different physical parameters affect the health and the role of the
environment on behaviors, actions, and interactions.
From earlier times, people seek a safe shelter for themselves to heal. But then, there were no studies
done on the physical environment and followed traditional methods where natural and supernatural

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forces were used for healing. Now we can design, build and adapt healing spaces and measure their
restorative effects. To optimize the physical, mental, emotional and spiritual healing, one must
understand the elements of space.
The positive effects of the space were well known since ages ago. Ancient Greeks designed their
health care spaces in such a way to surround the people with nature, music and art to restore harmony
and promote healing in the absence of other treatment modalities. The paper is based on different studies
done by different experts in the field of health care. Architecture of the health care spaces rarely
concentrates on creating the environment that promotes healing. Modern environments have become
cluttered, noisy and show negative effect on the physical or psychological wellbeing of the patient. The
aesthetic aspects used in the hospital design are purely for patient satisfaction. Environment influences
behaviors, actions and interactions. Physical environment not only can directly aid in the healing but
also become the supportive background for different dimensions of optimal healing environment.
Elements of environment may directly show the impact or on the behaviors, actions and interactions of
patients, their families and the care takers. (Schweitzer et al. 2004)
4. Healing Spaces
A design that increases physical activity may reduce depression. Environment can also influence
the actions by communicating through images, symbols and metaphors. Through different studies, it is
evident that stresses, anxiety, depression, loss of control are detrimental to health. Optimism, hardiness,
self- efficacy, coherence, and a sense of control are linked to good health. A logical building design and
adequate parking and way finding using signage, art work and other visual clues, can help patients
navigate their surroundings without getting lost or having to depend on others.
Spirituality has the evidential effect on the health care. For some patients, illness may not be a
physical or emotional crisis but a spiritual one as well. Patients may be faced with their own morality.
Prayer and religious affiliation are associated with health benefits. Hospitals are challenged to meet the
needs of religiously diverse populations who may not differentiate spirituality and religion. Nature may
be the most universal image of spirituality which can be used to differentiate.
Poor design contributes to restrictive family access as a result of insufficient space in patient
rooms and waiting areas and lack of confidentiality when only curtains separate patients. Furniture
arrangements have shown to have an effect on social interactions. Waiting areas, day rooms and lounges

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in health care settings show its effect on the behavior and social health. The relationship among patients
and physicians, nurses and other care givers is also affected by the design. (Schweitzer et al. 2004)
Low health literacy is a risk factor for poor health. Design that incorporates libraries near each
unit, internet access near patient rooms helps transform hospitals into educational resources.
Incorporation of various complementary healing traditions into the hospital design helps healing.
Community rooms for tai chi, yoga, journaling, drumming and other modalities may eventually become
main stream for healing spaces. Architecture itself can become a complementary healing modality.
4.1. Role Of Physical Environment On Behaviors And Actions
Physical environment, not only acts as the dimension of healing in its own, but also can be
combined with other factors to create an Optimal Healing Environment. Environment may direct help or
hinder the health of an individual or impact on the health by manipulating behaviors, actions and
thoughts. (Schweitzer et al. 2004)
i. Intention and awareness:
It is evident from various studies that stress, anxiety, trauma, depression, and loss of control are
harmful for health. However, optimism, self-efficacy, coherence and sense of control are important for
the total wellness of an individual. These are the skills which can be learned and practiced. Hospital
surroundings are generally dull with a gloomy look, without any proper signage. Best design is the one
which allows the patient to navigate on their own without being dependent on the others. Using proper
signage, self -learning environment can be created. The patients are to be given opportunity to
personalize their spaces which gives patients a sense of control and familiarity.
ii. Wholeness and energy:
Mental health and spirituality are closely linked. Present day designs concentrate more on the
technological needs than the spiritual ones. For some patients, illness may not only be an emotional
crisis but also a spiritual one. People link their negative experiences to their spiritual health. Prayer and
religious affiliation lead to the good health and healing spaces are challenged to meet the spiritual needs
of the religiously diverse population as well. Nature is the most universal image of the spirituality. Open
and semi open spaces promote calmness. Landscape is integrated with the built form to promote the
spiritual wellness.
iii. Healing relationships:
Social support is the major element which helps the speedy recovery of the ill. Health care
spaces have been separating the patients from their family, provoking a feeling of being alienated from

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their family. Families want to be near their loved ones. The sensible healing spaces should allow the
longer stay periods of the family members. Social connectedness can be improved through the design
providing interaction spaces and activity spaces. Caring relationship with the nature and environment
also plays a major importance in healing.
iv. Health promotions and collaborative treatments:
Teaching stress reduction and health promotion techniques is important. By including
community meeting spaces, gathering spaces, wellness centers, outdoor walk ways, transition spaces and
semi open sit-outs, the soul can be nurtured and the healing can be promoted. Various complementary
healing methods can be adopted like massage for relieving stress, acupuncture, yoga, tai chi,
journaling, painting, journaling, drumming, arts etc. (Schweitzer et al. 2004)
4.2. Spatial Parameters:
4.2.1. Personal space:
Customization of the personal space is the main aspect of healing. To reduce stress, in the
offices, personal cubicles are to be allowed to be personalized according to the interest of the office
workers. The cubicles are to be separated with some indoor plantations and the work privacy of the
individuals is to be protected. (Venkat, 2014).For the mentally ill, the personal rooms are to be made
lively and individual rooms are to be provided to ensure the privacy of the individual. Room décor,
cleanliness, temperature, noise, light etc. play an important role in converting a normal space to a
healing space. (Schweitzer et al. 2004)
4.2.2. The sensory environment:
i. Smell:
Pleasant aromas can reduce blood pressure, slow respiration and lower pain- perception levels.
(Schweitzer et al. 2004) Work spaces with pleasant smells reduce the anxiety and thereby help improve
the work efficiency. Negative odors are found to stimulate anxiety, stress and fear. (Sunkara, 2014)
ii. Sound/noise:
Noise is often a highly negative environmental characteristic which increases the stress, anxiety,
fear and depression. One of the most common complaints these days are the distressingly high levels of
noise pollution in the workspaces. (Venkat, 2014). High noise level in the mental health care settings
often leads to the increased time period of the hospital stay. Tile surfaces, metal equipment, alarms,
beepers and overhead pagers contribute to high noise levels. 45 decibels is considered as the optimum
noise level in the mental health care settings during day time and 35 decibels during night time.

8. 8
(Grumet, 1993) This leads to the sleeping and eating disorders. Home like environment is preferred.
Natural sounds have calming effect. Sounds of water flowing, birds chirping, leaves rustling promote
relaxing effect , thereby improving sleep quality and work quality. Music also relaxes the mind and
stimulates the positive vibrations.
iii. Temperature:
Uncomfortable ambience disturbs the work efficiency and hinders the mental ability. Natural
ventilation is one of the major factors which helps regulate the temperature inside the health care setting.
Climatologically sensitive design provokes healing.
iv. Environmental complexity:
A variety of thermal environments are beneficial for improving mood and function. Environment
with greater complexity leads to the cognitive functioning of the office workers. Variation in
environment is associated with reduced depression levels. The sense of interest created in the walk ways
and transition spaces can stimulate positive responses in the brain.
v. Fresh air and Ventilation:
Fresh air is beneficial to the mental health. Natural air can improve the indoor air quality and
thereby reducing the indoor air pollution. Indoor air quality is one of the top five environmental risks to
the public health. Operable windows are more important. In work spaces, free flow of air helps relieve
the workers from stress. But opening the people to the direct open nature is also not advisable.
Students’ performance is seen to increase by 7-8 percent faster when exposed to natural ventilation.
(Schweitzer et al. 2004)
vi. Light:
Eyes and skin are the two accepted pathways for light’s biologic effect. Visible light has an effect on the
physical and mental health. A natural rhythm of light exposure affects health by regulating the melatonin
production in the brain and influencing the production of few hormones which help fight stress and
depression. Depressed patients in psychiatric units recovered faster when exposed to natural light. It has
an effect on the night sleep quality. (Shochat, et al., 2009) Negatively designed space for day lighting
results in glare and fatigue and hinders concentration in the work places and study places.
v. Color:
Different colors affect moods and different behaviors. Certain colors encourage activity while
others promote passive behavior. Ambient colors affect the indoor environments. For ex. Pink walls

9. 9
calm prisoners. Use of colored light as the treatment modality is rapidly increasing. Esogetic color
puncture is the therapy used for treating Attention Deficit Disorders, learning disorders and depressions.
Ocular light therapy is the method through which light is projected into the eyes which enhances the
brain activity and open up neural pathways.
vi. Viewing nature:
To provide access to nature and other positive distractions improves mental health and thereby
reduces stress. Views of nature, comedy, laughter, caring or smiling human faces, music and companion
animals etc. reduce stress. Workers having a window with a view of natural setting are found to work
more effectively and have reported less levels of stress. The views and direct contact with nature is said
to reduce stress and muscle tension. Activity in natural setting and playing in green areas stimulate
active reactions in brain. With distant views, internal view corridors with interesting focal points, design
of vertical surfaces promote cognitive tranquility which helps mental functioning properly. (Kuo &
Sullivan, 2001)
vii. Arts, Aesthetics, Entertainment:
The mechanism for impact of arts is lowering the stress levels and anxiety and promotion of
restoration from stress and improvement in mood. Images of nature reduce anxiety and reduce the intake
of pain killers. Abstract art contributes to less favorable ways of healing. Visual arts should contain
positive content and should convey a sense of safety and security.
Uncertainty, emotionally negative, closely spaced repeating, forms that are optically unstable should not
be used. Images showing landscape and animals are to be used to reduce anxiety. They have calming
effect on the disturbed persons.
viii. Music:
Music decreases use of analgesics and hastened the recovery. Music subsides the pain and takes
the person into a state of trance where the disturbed soul can be nurtured and healed. Music administered
during times of high stress is observed to increase patient comfort and lower heart rate and anxiety.
ix. Humor and entertainment:
There are health benefits of good laugh including greater optimism, socialization and cooperation among
patients. They reduce the use of tranquilizers. Laughter therapy is used in the alleviation of moods.
Animal therapy is also used to reduce stress and anxiety. (Kaneda & Oyama, 1999)

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Table-1: Spatial parameters that promote healing
HEALING SPACES
Space Form Light Color Sound/
Music
Safety Arts
Personal
space
Providing
single rooms
and private
space. (Shantz
2014)
Warm light,
glazing cells
with blue or
violet lights
promote
soothing and
calmness(Ano
n n.d.)
Warm colors,
cozy, inviting
(Shantz
2014)
Blue, Pink,
magenta
Classical
music
No
custodial
treatment.
(Shantz
2014)
Painting,
visual arts,
Transition
space
Huge corridors
with walkways,
semi-open
colonnades and
arcade
construction
promote a
sense of order.
(Marchand &
Wicki 2011)
Uniform light
has to be
avoided, light
that provides
shadows is
suggestible
(Shantz 2014)
Yellow, red - Clear
way
finding,
proper
signage
and self-
leading
spaces.
(Shantz
2014)
Visual arts
Open spaces Barrier free,
secured setting,
merged with
landscape
- Green Natural
sounds
No hiding
spots
(Shantz
2014)
Sports,
Theatre arts,
exercise,
yoga
Community
spaces
- Semi- open
space with
diffused
natural light
Gold,
Orange,
Turquoise,
Green,
Relatively
peaceful
and
melodious
music
Built-in
furniture,
accident
prone and
aggressiv
e prone
and self-
learning
environm
ent.
Tai chi,
dance, clay
molding,
painting,
drumming,
animal
therapy,
Spiritual
spaces
Multi- faith
spaces,
Hugeness of
the spaces
(Shantz 2014)
- Indigo,
Magenta
Soothing,
instrument
al music
- Meditation,
yoga

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Table-2: Comparitive analysis:
Parameters Mentally stressed Mentally ill
Space
Safety is not a major issue. Can
provide open and semi- open
spaces with more flexibility and
complexity of the spaces.
Safety is the major issue. Personal
but not completely custodial spaces.
Simple, self-directing and learning
spaces.
Color
Red Cures Depression, Negativity,
Shyness
Cures depression Increases anger,
and irritability
Orange Helps treat depression, negativity,
stress
Reduces negativity, trauma and
feeling of loss, promotes self-esteem,
optimism, inner strength
Gold Heals stress, anxiety, depression Heals depression, increases wisdom
and provides balance of thoughts and
feelings.
Yellow Heals depression, despair, fatigue,
sensitivity to criticism, lack of
confidence.
Promotes Self-confidence, ability to
rationalize, mental stimulation but
increases hyperactivity
Green Reduces stress, anxiety, self-pity,
confusion
Promotes balance, personal
development, self-acceptance, social
compassion, retreat
Turquoise Helps heal Stress, anxiety, anger Promotes calmness, healing,
personal relationships, community
values, resilience
Blue Heals stress, anxiety, over-
excitement, anger
Promotes calmness, peace of mind,
relaxation, slowing down, creativity,
self- expression
Indigo Heals anger, obsessions, anxiety,
but promotes depression
Promotes wisdom, intuition,
understanding, spirituality, peace,
calmness, inspiration and promotes
loneliness
Violet Reduces stress, anxiety, severe
depression
Promotes inspiration, imagination,
empathy, sense of belonging, helping
others, dignity.
Magenta Reduces aggression Helps let go the past or anxiety
thoughts, and helps move on and
spiritual understanding
Pink
Heals anger, aggression, over-
sensitivity(Shantz 2014)
Promotes calmness, clarity of
thought, kindness, nurturing,
resolving. (Shantz 2014)
Light
Reduces seasonal and non-
seasonal depressions.
Light therapy is best for mood
disorders.
Sleep disorders are cured with light
therapy
(Hedaya 2011)

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Short wave length light (blue part
of the spectrum) is the most active
part of the light spectrum which
keeps the sleep and wake cycles
in order.(Hedaya 2011)
Sound
Continuous exposure to loud
noises leads to sleeping and
eating disorders, increases anxiety
Sounds of nature decreases stress
levels .(Birds chirping, water
flowing, leaves rustling)
Noises increase the sense of fear and
insecurity.
Sounds of nature aids in speedy
recovery.
Music
Relaxes brain and stimulates
peptin hormone production.
Alleviates the mood
Decreases anxiety
Relaxation and music therapy
reduce stress
Evokes emotional responses
stimulates symbiotic representation
Classical music that has lived
through time is preferred for famous
music.
Art
Visual arts help focus on positive
life experiences.
Enhance emotional expression,
spirituality
Molding clay workshops help people
powerfully express their
feelings.(Malchiodi 1981)
Reduces hospital stay
Movement based
creative expression
Movement of mind and body
relieves from stress and anxiety.
Dance reduces stress
Tai chi helps community healing
Expressive writing Improve depressed mood.
Writing about negative
experiences help reduce stress.
Improve control over pain
Nature Landscape merged with the
working environment will
enhance the mood and reduce
stress levels.(Cohen 1979)
Views of nature promote healing.
Natural setting to be submerged with
the built form to provide holistic
healing.(Peters 2008)
Source: author
Conclusion:
The physical environment is one of the most important factors which play a key role in the healing of
the mentally ill promoting harmony. Behavioral patterns and perception of spaces of the mentally ill are
different from that of the mentally stressed. Openness is the main criteria in designing the framework for
the healing spaces for the mentally stressed, while safety becomes the prime factor for that of the
mentally ill. There are chances of aggressive response from the mentally ill towards the surroundings but
it is not prevailing in the case of mentally stressed. Nature is used to enhance the healing for both the
categories. Personal spaces are to be customized for both the categories. Different social and

13. 13
recreational spaces, walk ways and transition spaces are used to enhance the healing qualities of a space.
Further studies on healing spaces can explore the psychological effects of parameters temperature, sound
and built form for varied functional spaces.
Acknowledgement:
Mrs. Prashanti Rao, Assistant Professor, Dept. of Architecture, School of Planning and Architecture,
Vijayawada
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