Thesis Thinking 02

It’s official, my thesis will be a drug and alcohol rehab center.

With this fact as established as it can possibly be at this early stage I need to start thinking about how to direct my research and find what will be relevant to the development of this work. My first research ventures on the internet have uncovered interesting issues about the topic. It seems that like so many necessities in life, in this country rehabs are divided by income brackets and social status. In fact, just like much else, there is hardly much access to anything worth much for those who need it the most. Conversely, for those who can afford more than they need, there are slews of institutions that cater not only to their needs but to their whims. Clusters of rehabs along the coast in Malibu, California are making the locals worry about the kinds of people they bring to their neighborhood, seemingly unaware of the fact that the kind in question is the one that can afford upwards of forty thousand dollars for a month’s stay. This is not the type of place I am interested in designing. For a fascinating glimpse inside that world, there is this wonderful article from the New Yorker writer Amanda Fortini.  I have my issues with the idea of luxury playing a role in recovery and designing it is the last thing i’d want to spend time on.

A recent article in the New York times by Benedict Carey states “Every year, state and federal governments spend more than $15 billion, and insurers at least $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental healthparity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels.”  The topic is relevant and current. It is also controversial and will remain so as long as addiction is not fully accepted as a chronic disease.

I’m not sure how much I will want to get into this aspect of the issue… probably not at all, regardless of how strongly I feel about it. It’s not related to design. What is related is the fact that funding will hopefully enable more facilities to be built and no matter how well funded these programs may become, savings are always welcome. Perhaps determining which architectural elements are fundamental and which are less so could be interesting…

Very basic first steps : site location.  I would like to find a place that is outside of NYC , that feels remote but is easily accessible so that friends and family can visit and patients can reach it on their own. I would like a good parcel of land because there should be opportunities to engage with nature and the physical world through construction, farming, gardening or tending to animals. The high-end rehabs mentioned in the New Yorker article offer arts and craft classes and other summer camp type activities. I don’t believe in those having any benefits, they are self indulgent and infantilizing. Plowing a field, picking tomatoes or milking a cow on the other hand can have meaning. Doing things that are “real” and that are done by others can create a connection to the real world, something that alkies and druggies desperately need.

For myself another basic step is to understand how the regular rehab world works. What do you get if your insurance covers a reasonable amount and what if you do not have any insurance at all. 

For a great glimpse at the issues related with stigmatizing the disease, Malcolm Gladwell’s piece Million-Dollar Murray is a brilliant read.