Long-Term Inpatients’ Physical Hospital Environment and Mental Health Outcomes: Evidence-Based from Panzi General Referral Hospital, Bukavu, DR Congo

This study investigates the influence of the hospital physical environment (HPE) on the mental health outcomes (MHO) of long-term inpatients (LTPs) at Panzi General Referral Hospital. Using a mixed-methods, convergent parallel design, data were collected from 84 participants (60 LTPs, 10 relatives, 14 healthcare providers) via census and random sampling, employing surveys, standardized tests (the WHO-5 or Subjective Well-Being Index and the K10 or Kessler psychological distress scale), and semi-structured interviews. Quantitative results revealed a complex relationship as a clean and safe HPE was significantly associated with reduced psychological distress (HPE → K10, β = -0.343, p = 0.016), but not with improved subjective well-being (HPE → WHO-5, β = 0.310, p = 0.545). Qualitative findings clarify this discrepancy, indicating that while the HPE is perceived positively, its benefits are overshadowed by a lack of privacy and amenities, carceral-like conditions, and exposure to daily trauma. The study concludes that while a functionally adequate HPE is necessary to mitigate distress, it is insufficient alone to promote patient well-being. Therefore, we propose a holistic model that integrates targeted improvements to the physical environment with essential social and relational interventions, such as cultural activities, shared spaces, and accessible amenities, to effectively support the mental health of LTPs.