title: Overcoming the Challenges Inherent in Conducting Design Research in Mental Health Settings: Lessons from St. Joseph's Healthcare, Hamilton's Pre and Post-Occupancy Evaluation.
abstract: OBJECTIVE
  Conducting high-quality design research in a mental health setting presents significant challenges, limiting the availability of high-quality evidence to support design decisions for built environments. Here, we outline key approaches to overcoming these challenges.
  
  
  BACKGROUND
  In conducting a rigorous post-occupancy evaluation of a newly built mental health and addictions facility, St. Joseph's Healthcare, Hamilton, we identified a number of systematic barriers associated with conducting design research in mental health settings.
  
  
  METHODS
  Our approach to overcoming these barriers relied heavily upon (i) selecting established measures and methods with demonstrated efficacy in a mental health context, (ii) navigating institutional protocols designed to protect vulnerable members of this population, and (iii) designing innovative data collection strategies to increase participation in research by individuals with mental illness. Each of these approaches drew heavily on the expert knowledge of mental health settings and the experiences with mental health, facilities management, and research of a research team that was well integrated within the parent institution.
  
  
  CONCLUSIONS
  Engaging multiple stakeholders (e.g., care providers, patients, ethics board, and hospital administrators) contributed their trust and support of the research. Traditionally, post-occupancy evaluation researchers are independent of the facilities they research, yet this is not an effective approach in mental health settings. We found that, in working toward solutions to the three obstacles we described, having team members who were well "networked" within the parent institution was necessary. This approach can turn "gatekeepers" into champions for patients' engagement in the research, which is essential in generating high-quality evidence.
authors.affiliation: St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada catherine.ahern@gmail.com.
authors.forename: Catherine
authors.initials: C
authors.lastname: Ahern
authors.affiliation: St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada McMaster University, Hamilton, Ontario, Canada Homewood Research Institute, Guelph, Ontario, Canada.
authors.forename: Margaret C
authors.initials: MC
authors.lastname: McKinnon
authors.affiliation: St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada McMaster University, Hamilton, Ontario, Canada.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Bieling
authors.affiliation: St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada McMaster University, Hamilton, Ontario, Canada.
authors.forename: Heather
authors.initials: H
authors.lastname: McNeely
authors.affiliation: St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada.
authors.forename: Karen
authors.initials: K
authors.lastname: Langstaff
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration; D005069:Evaluation Studies as Topic; D005160:Facility Design and Construction; D006778:Hospitals, Psychiatric; D006801:Humans; D001523:Mental Disorders / Q000523:psychology; D009864:Ontario; D010361:Patients / Q000523:psychology; D010564:Personnel, Hospital / Q000523:psychology; D000070263:Sleep Hygiene
keywords: EBD; POE; behavioral health; mental health; pre–post design; research methodology