Place and memory are strongly intertwined based on the human experience. So what can a new place become in the mind of an individual who has garnered distressing perceptions of one’s current environment due to trauma? How can the environment support or facilitate periods of transition caused by a traumatic event? The aftermath of abuse that occurs in romantic relationships of late adolescence leads to a rocky crisis stage that often results in isolation, loss of identity, and social stigma. It is a period of transition in which recovery can be a long journey. This is where concepts of acceptance, mental alleviation, and appreciation of the present moment evoked by a nonjudgmental architecture can come into play. A space with the purpose of evoking a mental and emotional respite is of great need, especially when considering the current severity of today’s fast paced society. An architecture of this nature holds relevance and importance on campuses of higher education when considering the specific demographic. In order to reverse the perception of one’s surroundings as tarnished spaces and override the sensations to which distrust and exhaustion have claimed ownership, this center of healing should be integrated into an individual’s life as a facilitator of comfort. In short, it should provide the ability and opportunity to take a breath.

The Intermission is a healing space located at Arizona State University in Tempe, specifically where Forest Mall and Orange Mall meet. Abuse in intimate relationships is the most prevalent amongst college-aged individuals and those of late adolescence. This architecture exists specifically for the survivors of this particular traumatic experience, but welcomes all of the student body. It takes into consideration the general sensory overload placed on today’s youth who are existing in a specifically stressful and challenging developmental phase of life. The intention lies in eliciting a reprieve through the use of nature as an enclosure and an undulating platform as a labyrinth, which ultimately offers up a positive form of both a sensory and traversing experience. It offers the discovery of stimuli that users are able to easily adapt to and appreciate. It allows for and calls one to take part in deceleration. The goal is to bring the users to the awareness of themselves, their surroundings, and that of the present moment through spatial means. With this, the environment is able to support and facilitate a period of transition through the re-building of identity and memory. Ultimately, The Intermission is architecture as pause from a harsh and sometimes unforgiving life. It is an in-between moment for the in-between individual— an alternate, but necessary route (as well as pit stop) in the loop of daily life.

Polypharmacy among psychiatric patients is a concerning trend. From 2007-2010, 58.2% of women and 41.8% of men reported taking five or more prescription drugs within the last 30 days (CDC, 2014). Negative outcomes include prescription drug abuse, side effects, interactions, treatment failure, patient dissatisfaction, and lack of treatment control. The associated practice challenges have led to the following PICOT question. In persons with mental health issues receiving care at an outpatient mental health clinic, does engaging in mindfulness practice versus no mindfulness practice change polypharmacy use over a 3-month period?

The project purpose was to evaluate the effectiveness of Insight Timer mobile mindfulness app at helping patients self-manage distressing symptoms and reduce polypharmacy. Over three weeks, mental health clinic nurse practitioners (NPs) voluntarily recruited patients (n=12) over age 18 using as needed prescriptions (PRNs), and agreed to use Insight Timer mobile mindfulness app for adjunct symptom management. Consenting participants downloaded the mobile app, and completed a brief questionnaire measuring PRN use at the start of app use, and PRN use at their next visit. A Wilcoxon signed-rank test indicated a 10-week mindfulness app trial did not significantly lower total PRN doses compared with pre-app dosing (Z = -.534, p = .593). Paired t-tests revealed no significant change in pre (M = 65.17, SD = 28.64) versus post (M = 67.75, SD = 20.22) OQ45 life functionality results (t(11) = -.420, p = .683) (d = .121) as a result of app use.

Clinically relevant results illustrated 83.33% of participants taking greater than nine PRN doses over the study period used the app six times or more in place of medication. High PRN users employed the app frequently in place of medication regardless of total PRN doses taken. Practice implications and sustainability recommendations include incorporating mobile app use in treatment plans for high PRN users and educating NP’s on the tangible benefits of mindfulness apps in reducing polypharmacy and easing symptom distress on an ongoing basis.
Keywords: mindfulness, mhealth, mobile apps, mobile smart phone, online, RCT, behavior change, polypharmacy.