In a 2005 study, an alarming 79% of homeless women seeking treatment for mental illness and substance abuse reported experiencing a past traumatic event such as physical or sexual abuse. More recently, a 2020 study showed that nearly two-thirds of homeless women and almost half of homeless men reported that they were homeless because of trauma. Shelter design can affect homeless people’s ability to recover from past trauma and to battle addiction and other mental health issues that perpetuate cycles of homelessness.
For example, one woman who currently lives in CASS told us about trying to get a full night’s sleep while living in a day room where the lights were kept on around the clock and there was constant activity. Because she had several bags of personal items that were too big to store in the dormitory, she could not get a bed there.
“When they don’t turn the lights down at night, I start to feel like my body is vibrating,” she said. “I start to see people walking around, and I’m not sure if they are even really there.”
Routinely sleeping less than seven hours per night can be harmful to health. It lowers immune function, increases chronic pain and raises the risk of heart disease, high blood pressure, diabetes, stroke and death. For homeless people battling mental health challenges, addiction and past trauma, rest and recovery are essential to getting back on their feet.
CASS staff have tried to create healthier sleep spaces, such as dorms that remain dark, quiet and cool at all times. Priority access goes to people with jobs. These sections can house only about a third of CASS’s residents, leaving others to sleep in dorms where there is more noise and light.
Simply feeding people and providing them with places to sleep is a major challenge for shelters in cities where homelessness is rising. But some have found ways to think more broadly.
In San Diego, Father Joe’s Villages, a nonprofit network with a central campus and scattered-site programs, houses more than 2,000 people nightly. San Diego’s more temperate climate makes it less urgent to maximize the number of people they shelter indoors, so staff at Father Joe’s can use its decentralized design to create shelters with private and quiet spaces.
The Father Joe’s network includes multiple smaller-scale facilities where clean bathrooms are easily accessible and homeless people can use basic amenities like laundry and storage. One example is Mary’s Place, a collection of diverse shelters that provides emergency and long-term support in smaller facilities modeled after the simplicity and comfort of a home.
People experience less stress and can more easily navigate the challenge of ending their own homelessness when they can get a restful night’s sleep in a quiet environment, with spaces that allow them some privacy. We are encouraged to see other U.S. shelters moving in this direction – but there’s a long way to go.
To address the lack of privacy at CASS, we have proposed subdividing the day room into more private spaces to accommodate activities like online telehealth appointments, counseling and job interviews. To tackle long-term impacts of overcrowding, we also have recommended introducing sanitation amenities, such as laundry facilities, “hot boxes” to sanitize clothing and bedding, more bathroom facilities and reliable trash removal to reduce the spread of infection and pests such as bedbugs and lice.
For new facilities, designers could consider small changes, such as increased storage and more diligent regulation of temperature, light and noise.
Hospitals, nursing homes and retirement communities have found many ways in recent decades to use design to support patients’ health. Many of the same concepts can be applied to emergency shelters and help turn these facilities from institutional warehouses into spaces of health and opportunity.
This article is republished from The Conversation, an independent nonprofit news site dedicated to sharing ideas from academic experts. If you found it interesting, you could subscribe to our weekly newsletter.
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Heather Ross receives funding from the Arizona Alzheimer's Consortium and Public Interest Technology - University Network. She is affiliated with the Arizona Democratic Party and multiple healthcare professional organizations including American Nurses Association, American Association of Nurse Practitioners, and American College of Cardiology.
Natalie Florence does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.