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Creating 'therapeutic landscapes' for mental health carers in inpatient settings : a dynamic perspective on permeability and inclusivity

Wood, V.J.; Curtis, S.E.; Gesler, W.; Spencer, I.H.; Close, H.J.; Mason, J.; Reilly, J.G.

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V.J. Wood

W. Gesler

I.H. Spencer

H.J. Close

J. Mason

J.G. Reilly


Although there has been a shift toward treatment in the home and the community, in the UK, inpatient facilities are still important in modern mental health care. ‘Informal carers’, including family members, often play an essential role, not only in providing care in the community but also in care of patients during periods of hospitalisation. UK National Health Service policies increasingly consider the position of these carers as ‘partners’ in the care process, but relatively little attention has been paid to their position within the hospital settings where treatment is provided for inpatients. This paper contributes to geographical work on carers experiences, by reporting how this issue emerged through a study focused on perceptions of a newly built hospital, compared with the inpatient facilities it replaced. We draw on qualitative research findings from discussion groups and interviews with informal carers. The material considered here focused especially on carers' views of aspects of the hospital environment that were important for wellbeing of carers and the people they look after. The carers' views were supplemented by relevant material drawn from other interviews from our wider study, which included service users and members of hospital staff. These accounts revealed how informal carers experienced the hospital environment; we interpret our findings through a conceptual framework that emphasises carers' experiences of a ‘journey’ along a ‘caring pathway’ to and through the hospital space. This perspective allows us to make a connection between three bodies of literature. The first relates to phenomenological interpretations of one's environmental perception, formed as one moves through the world. The second derives from the literature concerning ‘permeability’ of hospital institutions. Bringing these ideas together provides an innovative, dynamic perspective on a third strand of literature from health geography that examines hospitals as ‘therapeutic landscapes’. The analysis helps to explore the extent to which carers in this study were positioned as ‘outsiders’ in the hospital space.


Wood, V., Curtis, S., Gesler, W., Spencer, I., Close, H., Mason, J., & Reilly, J. (2013). Creating 'therapeutic landscapes' for mental health carers in inpatient settings : a dynamic perspective on permeability and inclusivity. Social Science & Medicine, 91, 122-129.

Journal Article Type Article
Publication Date Aug 1, 2013
Deposit Date Jan 11, 2013
Publicly Available Date May 12, 2014
Journal Social science and medicine
Print ISSN 0277-9536
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 91
Pages 122-129
Keywords North East England, UK, Mental health care, Managed permeability, Psychiatric hospital design, Informal carers, Therapeutic landscapes, Phenomenology.
Public URL


Accepted Journal Article (550 Kb)

Copyright Statement
NOTICE: this is the author’s version of a work that was accepted for publication in Social Science & Medicine. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Social Science & Medicine, 91, 2013, 10.1016/j.socscimed.2012.09.045.

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