Destigmatizing Spaces

/ Project Overview

Designing Destigmatizing Spaces: Affording Social Supports at Safer Consumption Sites
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Key Words: Opioid overdose crisis, safer consumption sites, environmental design, harm reduction, social support, health promotion, supportive design theory

Objective: 
Stigmatized persons deplete their socio-psychological resources when facing barriers to accessing health and substance use care services. Under these demanding conditions, people could also benefit more from the health promoting effects of supportive environments.​

This paper views social support as a health promotion asset that needs to be explicitly designed for within SCS. Architects and designers can play a key role in facilitating clients’ access to social supports, through the design of socially supportive environments.

/ Collaborators

Chieng Luphuyong - Research Associate / Quality & Enterprise Risk Management Coordinator
MDes, Design for Health, OCADU

/ Abstract

Although legal and medically supervised consumption sites have been around since the late 1980s and early 1990s in Switzerland, Germany and the Netherlands, safe(r) consumption sites (SCS) is a relatively new spatial typology in Canada. As such, there is a dearth of resources to guide design decisions and approaches for the emerging field of harm reduction architecture and design.

Since 2016, the number of SCS across Canada increased from 1 to 39, making this is a critical moment to consider future designs and adaptations. So, how might the next generation of sites be designed to maximize their benefits for clients?​

Many clients of SCS face major stress and instability from experiences of stigmatization, which can produce deleterious effects on their mental health and well-being. SCS are trusted community touchpoints where engagement with caring staff has been reported to disrupt stigmatization processes, manifesting positive transformations in clients. Fostered trust in staff helped clients feel more comfortable communicating their needs and this increased acceptance of other self-care services such as harm reduction counselling, food and housing programs, and medical care - thus, staff functioned as repaired bridges to health and social systems.

/ Research Process

Using Ulrich’s Theory of Supportive Design as a conceptual framework, this paper explores the critical questions:

• What does social support mean for clients of SCS?
• How might architects and designers create environmental affordances to foster social support among clients and staff?​​

The first question is explored through an analysis of recent qualitative literature involving client interviews on their experiences and perceptions of the social supports they received at SCS. The second question is addressed through the analysis and adaptation of Ulrich’s theory, presented as a Social Support Design Model. Lastly, this paper links the insights from the analysis of qualitative research with the adapted model, and offers a set of design considerations.

/ Results

Informed by Ulrich’s Theory of Supportive Design, this paper presents a social support design approach and offers design considerations for further exploration (and validation) with SCS clients and staff, to establish guidelines and recommendations for architects and designers of SCS.​

Further participatory research and co-design (involving clients and staff of SCS) are needed to co-produce a contextual evidence base links environmental affordances and features to the facilitation (or hindrance) of social support within SCS.

Above is a system map created with Ruslan Hetu, during the Discovery Phase of the project. Tim Rhodes’ (2009) “Risk Environment Framework '' informed our problem framing of substance use harms and harm reduction, as it relates to the interactions between individuals, their environments and social contexts.

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