The role of design in involuntary care

Franz James is a doctoral student with many interests. In addition to his research, he works as both a senior lecturer at HDK-Valand and a product and furniture designer. As part of the work on his dissertation, he visited several institutions where involuntary treatment is provided, including prisons, special residential youth homes and forensic psychiatric care facilities, primarily in Scandinavia but in other parts of the world as well.  

“In short, it’s about what kind of impact these environments have on people’s well-being,” says James.
“These environments are loaded with underlying structures, and they act to cement residents’ behaviours and identities as criminals. It’s about how we can better design involuntary care environments to encourage movement, enhance the quality of sleep and contribute to the feeling of care and well-being – which they don’t do today. I have also looked at adaptations for neuropsychiatric diversity, which are common among the clients admitted to these places.” 

New Research Method 
The dissertation also puts great emphasis on James’s work developing ethnographic design research methods. He calls the unique method he developed in the course of his work “Sketch and Talk”. It’s adapted specifically for involuntary care environments. Locked environments have strict security requirements that limit opportunities to conduct research, and the method had to be adapted to accommodate the needs of both the institution and its residents. 

“In ethnography we’re usually borrowing other people’s experiences. I would argue that we need to have our own experiences to a much greater extent and that it’s important to ‘get out into the field’. Working on the dissertation has given me a much better understanding of the importance of ethical guidelines within certain kinds of design research, not least in transdisciplinary project groups,” says James. 
 
The studies also went through an ethical review, which is unusual in the field of artistic research 

“It requires caution and understanding researchers need to adapt themselves to the people in this unusual environment – what their day looks like, how the person is doing mentally, or if something happened in the facility that day that might be affecting them.” 

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The Role of Chance 
Franz James’s interest in the field began with a random design assignment back in 2010, long before he began his doctoral studies.  

“My first contact with involuntary care was in forensic,” he says, “when I was assigned to do a design job, which was a wall hook that would be suicide-proof. The hook had to come loose from the wall if it was loaded with the weight of a person. That job put me in contact with other institutions, including the correctional system.”  

But the idea of sketching as a method got started during a visit to a large prison in Johannesburg, South Africa. When James’s request to bring his camera in with him was denied due to the prevailing security regulations, he used sketching instead as a method for documenting what he saw.  

“Sketching forced me to stop, look and listen,” he says, “and give the process time in a way that I don’t believe I would have done with a camera. My experience is that the memory of a place is enhanced by the physical activity involved in sketching.” 

James has been working on the dissertation since 2014 and has built up a research group that includes nurses, an architect, a criminologist, public health experts and designers. He says,  

“Well-being, which is central to the life of a patient, also needs to encompass healthcare providers – after all, it’s their working environment. It has been very rewarding to be part of an interdisciplinary research group and to learn from one another’s perspectives.”   

Continued Work in the Field 

With the defence of his thesis in September, Franz James will be done working on the dissertation but not done with the research field. On the contrary, he sees a great need for more of this kind of research. He has already entered into a dialogue with the institutions that are involved in his study. That includes the Swedish National Board of Institutional Care (SiS), which stepped in during the course of the project to provide partial funding and posed questions that it took James three of the study’s nine years to answer.  

“I hope my dissertation can lead to change in two areas,” he says. “The first is about method development and research in design. I believe that we at HDK-Valand can be better at healthcare and environmental research, and it’s my hope that we can develop an interdisciplinary hub in the future. 

“The other area is about expanding our understanding of client needs, particularly in terms of neuropsychiatric disabilities. The hope is that more knowledge can lead to better environments for clients and staff alike, so they can really be the kind of healing environments they were meant to be. Part of that is also increasing awareness among architects and decision-makers of how the environment inside involuntary care facilities affects people.” 

On 22 September, Franz James will be defending his thesis, “Sketch and Talk”: Drawing Lines Between Humans, the Interior, and Stuff. Design Methodologies for Well-Being in Prisons, Forensic Psychiatric Hospitals, and Special Residential Youth Homes. The thesis will only be published in English, but it will include an extensive summary of about twenty pages in Swedish.  More about the Public Defence

Download the Thesis here