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Michael Bullen is a resident at the Sanderson Apartments in Denver. Sanderson utilizes “trauma-informed design”—elements that aim to help people with recovery from past trauma, substance abuse and mental health issues. Photos by James Chance


Using Trauma-Informed Design, Buildings Become Tools for Recovery

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It’s less than 30 degrees outside early on a December morning, and the temperature isn’t expected to rise much higher. Just a few years ago, Michael Bullen would have been doing everything he could to stay warm and survive while living on the streets in the Athmar Park area, a backpack as his only possession. Divorce initiated what he calls a “downward spiral,” a decade-long period during which he roamed between states with no place to call home.

Today, though, the man who prefers to go by Ducky (a childhood nickname bestowed by his mom) is swigging coffee in a pair of khaki shorts and black Nike sneakers, comfortable inside Sanderson Apartments, a 60-unit permanent supportive housing project where he’s lived since October 2017.

Bullen, like others in similar situations, never felt safe staying at shelters, which reminded him of jail. During the six years he was unhoused in Denver, Bullen, originally from Minnesota, preferred the autonomy of the streets and tree-lined parks, where he wasn’t bothered by others and could live by his own schedule. Changing his circumstances seemed impossible. Even walking into a Burger King to pick up a job application was a stretch, covered as he was in dirt from sleeping on the ground.

“It’s hard to stay physically clean when you’re living on the street,” Bullen said, adding, “I couldn’t [see] myself getting a job because I was either sick or drunk all the time.”

When Mental Health Center of Denver (MHCD) staff approached Bullen in a park a few years ago about an apartment at Sanderson, he was dumbfounded. As part of an initiative financed by the city’s social impact bond for supportive housing, people experiencing homelessness for more than a year, and who were frequent utilizers of services like police, jail and emergency rooms, were added to a list that was assigned to various contracted providers, including MHCD, who then went into the community and located them.

“I wasn’t looking for housing—it seemed so out of reach,” Bullen said. “I haven’t had my own place for over 10 years.”

Sanderson, though, is different. Designed by Davis Partnership Architects of Denver, it was built specifically to house people like Bullen—people experiencing chronic homelessness who regularly interact with both the criminal justice system and emergency medical services and are dealing with substance use and/or mental health issues. The architects and MHCD considered the traumas associated with people’s past experiences and responded to them with a layout, colors, furniture and building materials intended to make them feel safe, dignified and supported.

Experts say Sanderson is one of the first buildings in the nation to employ an innovative approach called trauma-informed design: transforming the built environment from a place where people are housed into a tool that can help with the recovery process.

“We know there’s a strong link between people’s physiological states and their emotional states and their physical environments,” said Jill Pable, PhD, project lead at the Florida-based nonprofit Design Resources for Homelessness and one of a small number of people around the country researching this topic. “Trauma-informed design involves creating environments that affect people’s sense of identity and worth, their dignity and their empowerment.”

Bullen has certainly experienced those impacts, even if he can’t point out specific design details. Since moving into Sanderson, Bullen said he’s been drinking less, and cooking and socializing more. While his disability case is pending, Bullen is involved in vocational rehabilitation and building an art portfolio to show potential employers.

“I feel secure and relaxed,” he said. “I have a little bit more confidence. It feels good paying a little rent, putting a key in the keyhole. You feel like a person.”

More than half a million people are considered homeless in the United States. On any given night, around 200,000 of them are unsheltered, sleeping in parks and cars and on sidewalks in cities and towns across the country. The numbers are smaller—but no less stark—when narrowed down to just metro Denver, where nearly 5,800 people experience homelessness on a single evening.

For years, service providers have been shifting toward a trauma-informed approach when working with unhoused people and others with violent, unstable or otherwise troubling backgrounds. That is, recognizing the signs and symptoms of trauma and responding with policies and practices that avoid retraumatization. According to the Substance Abuse and Mental Health Services Administration, 61% of men and 51% of women in this country have been exposed to at least one traumatic event in their lifetimes (such as suffering physical abuse as a child, or having a family member incarcerated), while 90% of people interacting with public behavioral health care settings have experienced trauma.

Trauma-informed design is an extension of that practice, rooted in the belief that an unfriendly built environment—dark stairwells, clinical-looking spaces, black metal bed frames—can be triggering for people with a history of trauma.

“Housing is not as simple as it sounds,” says Jennifer Wilson, a social worker and research associate with the Center for Housing and Homelessness Research at the University of Denver. “You don’t just take someone from the experience of homelessness and give them an apartment and a key, and that’s the end of it and stability has arrived. The trauma of homelessness and whatever the lived experience might have been for that person is so significant that that apartment, that key, that front door, those noises, the lights—they pose their own set of challenges.”

Trauma-informed dwellings don’t solve all of those concerns, but they can help soften the impact. “We mitigate triggers for past traumas with well-lit, wide hallways and open staircases. We mitigate anxiety by using color and wayfinding,” said JoAnn Toney, MHCD’s director of housing and residential services. “It’s all about mitigating [adverse] life experiences any way we can by providing a secure environment that’s open, safe and inviting.”

These venues are deliberately designed to be deinstitutionalized and appear barrier-free (though plenty of protective features are in place) and to instill a sense of control and self-worth in residents. They are also intended to provide privacy while simultaneously fostering a sense of community. That means addressing everything from designing flexible, easy-to-navigate spaces to the selection of colors and lighting to the use of natural materials.

“Well-designed built places can help people’s perceptions of themselves, perceptions of other people, and certainly their perceptions of their situations,” Pable said. “When you have a space that looks better, it sends a very understandable message of, ‘People care.’ If people care, that’s sending a message of, ‘People really do want me to get better.’”

At Sanderson Apartments, that message is imparted in countless ways. Wider-than-usual corridors, lined with windows, create open sight lines, so residents and staff can quickly get a sense of who’s around. The 440-square-foot units don’t have doors to the bedrooms, and there’s a cutout in the wall between the bedrooms and living spaces so residents can immediately see if the space is secure upon entering. Community, dining and exercise rooms offer places to congregate and are all located near the front desk, where staff sit.

One of the communal areas at Sanderson Apartments.

Adjusting from living outside to a closed-door apartment is difficult for many residents (some of whom choose to sleep outside for days or weeks before ever spending a night in their new apartments), but a thoughtfully designed building can help, often subconsciously, ease the transition. Toney sees a direct correlation between Sanderson’s design and residents’ success. “Eighty-five percent of the people who live here are engaged in vocational activities or are employed,” she said. “That’s not typical in all of our apartment buildings.”

Four miles north, Arroyo Village offers another example of trauma-informed design. Run by The Delores Project and Rocky Mountain Communities, the development, which encompasses a shelter (exclusively serving women and transgender people), low-income permanent supportive housing and affordable workforce housing for individuals and families, opened in March 2019.

Couches in its permanent supportive-housing units are extra wide so that those who aren’t yet ready to sleep in a bed have another option. Among other amenities, the shelter offers lockers for storing personal belongings, privacy walls between the bunks, outlets and reading lamps at every bed, and a bathroom with vanity mirrors where the women like to congregate. Soothing paint colors were chosen, in hues of sage and lavender.

“We really wanted to deinstitutionalize a shelter and make it more of a home-like environment,” said The Delores Project CEO Stephanie Miller. “When our guests… come through the doors, it really does look like a living room. There’s no intake desk or check-in desk. You come in and there are big sofas and lounge chairs. A flat-screen TV. Rocking chairs for self-soothing. Lots of windows.”

The paint and furniture colors in the rooms at Arroyo Village in Denver purposefully include hues like sage and lavender.

Sandy Barrows moved from Arroyo Village’s shelter into a supportive housing apartment in July.

“I’m reconnecting with who I was—now that I came home,” the 59-year-old said, snug on her couch, a side table to her right barely visible under dozens of stuffed animals (her “babies”). “I feel safe. I know when coming in [my apartment] that no one’s going to be in here.”

It took a while for Barrows to stop carrying her backpack everywhere and checking that all of her belongings were precisely where she left them. Barrows experienced homelessness for five years after suffering a mental breakdown; she slept mostly in her 1992 Chevy truck, learning over time where to park to avoid being woken by police flashlights in the middle of the night. Now, she’s on disability and taking her medications and seeing a therapist regularly; she finds joy in paying her rent every month. Her packed apartment is on the fourth floor, a quarter she likes to refer to as the “penthouse area.”

The community was designed by Denver-based Shopworks Architecture, a leader in this area that has worked on more than a dozen trauma-informed projects. Arroyo Village was the group’s first intentional, versus intuitive, effort in this space.

“Some of the process of designing around trauma really involves a phase before there’s even the idea of a building, saying, ‘What are we trying to accomplish here? Who’s it for? What does success look and feel like?’” said Chad Holtzinger, president and architect at Shopworks, adding that those questions need to be asked both of the residents or future clients and the providers. “Then you make informed decisions, not just lucky ones.”

These projects aren’t just happening in Colorado, though. More planners, architects, developers and interior designers across the country are considering trauma-informed design in their work. An affordable housing project for formerly homeless veterans that integrated-design firm Mithun is working on in San Francisco will be structured around a central courtyard filled with trees to provide both a visual and physical connection to nature. In other projects, the team’s trauma-informed design strategies include reducing noise from elevators and other equipment, and lessening the cognitive load on residents by, for example, choosing carpets with more mild patterns.

“They’re not major changes to design,” said Erin Christensen Ishizaki, a partner at Mithun. “Small details can make a big difference in how people perceive space and their control over it.”

Research into the efficacy of trauma-informed design is still in the nascent stages, so much of what proponents point to as successes are anecdotal; and much of what has been accomplished thus far has been based on instinctual understandings of how people use and respond to the built environment.

Yet Shopworks, in conjunction with DU’s Center for Housing and Homelessness Research, has conducted some initial point-in-time data collection at three sites. (They’re also working on a white paper and a preliminary model for trauma-informed design that includes what they’re calling the “four Cs of building for dignity”—choice, control, comfort and community.) The groups are still sorting through the numbers, but what they’ve found so far is promising. For example, of the 29 people who moved into Arroyo Village’s permanent supportive housing between March 20 and April 24 last year, five gained part-time employment within three months, two earned promotions or pay increases, and four who entered with employment have maintained that employment.

Conscious, thoughtful design can also have an impact on staff. When Shopworks renovated the Laradon School for children with intellectual and developmental disabilities in Denver’s north Globeville neighborhood, the firm added an employee break room. Subsequently, staff turnover dropped by 25%. The kids benefited from the updated design, too. Larger windows, the addition of soft-walled breakout rooms for youth who need to relieve stress, and new acoustic panels to soak up noise helped lead to a decrease in crisis behavior and incident rates.

Still, “we need more research,” admitted Shopworks COO (and former Delores Project deputy director) Laura Rossbert. “I think those numbers are impressive, but it’s not something I can claim is solely because it was a trauma-informed design building.” Rossbert did point out, however, that the Laradon improvements occurred only after a new building came online, with the same program, children and staff involved.

Elsewhere, after renovations at Craig Hospital in Englewood, which specializes in spinal cord injury and brain injury rehabilitation, were completed, there was a 10% average overall reduction in length of stay among patients. Among the changes were the addition of a sensory healing garden; updated hallway lighting that uses warm, indirect light so patients in wheelchairs aren’t looking up into glaring ceiling lights; and widened hallways to create more sitting and interaction areas for patients and their families.

“In a few different areas across the country, we’ve heard reports saying patients have been less agitated, more willing to participate in their therapy sessions, and they’ve needed less pain medication,” says Brenna Costello, principal and health care studio leader for SmithGroup, a national design firm that worked on the Craig project, and board member for the Academy of Architecture for Health.

In Vermont, the Daystation serves up to 75 people lunch each day in the winter. Jonathan Farrell, facilities director for the Committee on Temporary Shelter, which operates the daytime drop-in shelter, said socialization is much more common in the trauma-informed, recently renovated space. People tended to sit quietly and keep to themselves in the previous venue—a crowded, lower-level room. The updated Daystation has taller ceilings, contains round tables and is flooded with natural light. It’s much livelier, Farrell said, with clients chatting, playing games and building relationships, an important part of trauma recovery.

There is, however, a price to generating those results. While The Delores Project’s Miller said the organization didn’t bear any additional financial burdens when building Arroyo Village, MHCD’s Toney noted that Sanderson Apartments was costlier because details like enlarged hallways and a glassed-in stairwell are more expensive. In addition, about 40% of the building is devoted to engagement or community space—space that could have been used to add rentable units.

But there are long-term returns to consider, too. According to the Urban Institute, a Washington, D.C.-based think tank, there is a high price tag associated with people experiencing homelessness who access “safety-net services”: about $29,000 per person per year. That’s much more than the $18,000 it costs on average to provide that same person with supportive housing.

Trauma-informed design is not yet an officially recognized building certification, like LEED or WELL, but Enterprises Community Partners, a nonprofit focused on affordable housing, just added credits for “healing-centered design” to its updated 2020 Enterprise Green Communities Criteria. As homelessness and concerns over affordable housing grow in Colorado and beyond, proponents of trauma-informed design see this as positive momentum and say service providers and planners should push forward even as research continues.

“I’m not willing to wait for empirical science to absolutely validate these things,” Pable said. “We have too much need out there.”

The first night that Arroyo Village opened, Rossbert gave guests a tour of the shelter. Months of investment—work, money, time—had gone into learning about and implementing this newfangled idea of trauma-informed design. She wasn’t sure how the new residents would respond.

When they sat down to dinner, Rossbert got her answer. One of the women turned to her and said, “I don’t feel like I’m in a shelter. I feel like I’m home.”

Daliah Singer

Freelance writer and editor
Denver, Colo.

See all stories by this author

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