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  • Publication
    Accès libre
    Urban remediation: a new recovery-oriented strategy to manage urban stress after first-episode psychosis
    (2019-10-9)
    Baumann, Philipp S.
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    Abrahamyan Empson, Lilith
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    Söderström, Dag
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    Golay, Philippe
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    Birchwood, Max
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    Conus, Philippe
    Purpose : Urban living is a major risk factor for psychosis. Considering worldwide increasing rates of urbanization, new approaches are needed to enhance patients’ wellbeing in cities. Recent data suggest that once psychosis has emerged, patients struggle to adapt to urban milieu and that they lose access to city centers, which contributes to isolation and reduced social contacts. While it is acknowledged that there are promising initiatives to improve mental health in cities, concrete therapeutic strategies to help patients with psychosis to better handle urban stress are lacking. We believe that we should no longer wait to develop and test new therapeutic approaches. Method : In this review, we first focus on the role of urban planning, policies, and design, and second on possible novel therapeutic strategies at the individual level. We review how patients with psychosis may experience stress in the urban environment. We then review and describe a set of possible strategies, which could be proposed to patients with the first-episode psychosis. Results : We propose to group these strategies under the umbrella term of ‘urban remediation’ and discuss how this novel approach could help patients to recover from their first psychotic episode. Conclusion : The concepts developed in this paper are speculative and a lot of work remains to be done before it can be usefully proposed to patients. However, considering the high prevalence of social withdrawal and its detrimental impact on the recovery process, we strongly believe that researchers should invest this new domain to help patients regain access to city centers.
  • Publication
    Métadonnées seulement
    Emplacing recovery: How persons diagnosed with psychosis handle stress in cities
    (2017-7-19) ;
    Söderström, Dag
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    Abrahamyan Empson, Lilith
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    Conus, Philippe
    The background of this study is recent work on the correlation between urban living and psychosis. It is part of a larger interdisciplinary research project using an experience-based approach to the city-psychosis nexus. The aim of this paper is to investigate how, soon after a first episode of psychosis, patients manage urban factors of stress. Methodologically, it is based on video-elicitation interviews of urban walks and ethnographic observations in a community care centre in the city of Lausanne, Switzerland. It shows that patients use three tactics: creating sensory bubbles; programming mobility; and creating places of comfort. On the basis of these findings, the paper discusses how the approach and results of our study can inform strategies of recovery that are both user-driven and take into consideration the importance of places and situations in the city in the phase following a first episode.
  • Publication
    Métadonnées seulement
    Unpacking ‘the City’: An experience-based approach to the role of urban living in psychosis
    (2016-11) ;
    Abrahamyan Empson, Lilith
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    Söderström, Dag
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    Baumann, Philipp S.
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    Conus, Philippe
    Primarily on the basis of epidemiological studies, recent research in psychiatry has established a robust link between urban living and psychosis. This paper argues first, that an experienced-based approach, moving beyond epidemiology, is needed in order to enable more fine-grained understandings of the city/psychosis nexus. The second part of the paper presents preliminary fieldwork results based on video-elicitation sessions with first-episode patients with psychotic disorders. These results lead to the generation of a series of hypotheses for further research on the role of density, sensory overload and social interaction as factors in the onset of non-affective psychoses. The conclusion discusses the insights gained from viewing the city as an experiential milieu rather than as a set of substances. We argue that such insights enable, on the one hand, observation of the role of specific places and situations - and thus to unpack ‘the city’; and, on the other, to envisage the urban milieu as a nexus of possible sites of recovery.