Behavioral health environments are specialized medical facilities that provide care and treatment for individuals struggling with mental health conditions such as anxiety disorders, depression, bipolar disorder, and more. Even prior to the uptick in mental health problems caused by the pandemic, patient access to these facilities was woefully inadequate, the need for beds far outweighs the availability. To shine light on this crisis, OpenSquare recently hosted a panel of behavioral health experts for a discussion with an audience of healthcare professionals, architect/designers, contractors and suppliers who support these facilities. The discussion focused on the mission critical design of behavioral health environments which have direct impact on patient recovery, safety, comfort and well-being.
Sondra Nielsen, Director of Facilities & Asset Management for DESC, shared an overview of Hobson Place, a combined housing and healthcare clinic specifically designed to meet the complex needs of people living with disabilities who have experienced the longest periods of homelessness. The Clinic at Hobson Place is a partnership with Harborview Medical Center. Sondra’s thoughtful remarks addressed “housing first” as a proven intervention to homelessness, the humane benefits of integrated access to all necessary resources, and encouragement to provide environments designed to be welcoming, cheerful and safe, using easy to clean durable materials. Her recommended considerations and best practices laid the foundation for the following discussion, including the need for intentional integration with both healthcare services and the broader community.
Balancing Welcome and Safety
Expert practical applications, design challenges and solutions were reviewed by Charity Holmes, RN, UW Behavioral Health Administration, Jim Wolch, Principal, BRCA and Lori Epler, Sr Medical Planner, SRG Partnership in a conversation moderated by Laura Fussman, Creative Lead, OpenSquare. Safety is a vital consideration in designing behavioral health spaces. Patients going through mental health treatment can be vulnerable and unpredictable, making safety features critical. And creating calm and welcoming environments offering patients some choice and control over their daily activities can minimize patient anxiety and enhance wellbeing.
All panelists agreed that behavioral health facility design and physical environments should always be designed to reduce the risk of self-harm or harm to staff, family and visitors. Provider protocols, training and wellness were addressed as other critical components for success.
Design features ideally enhance transparency and visibility for safety; in the past these might have included glass walls, doors, and sidelights to allow patients to be regularly monitored, while current design solutions recommend more open gathering areas to encourage better socialization. Visibility still allows clear sightlines for staff to supervise patients and to ensure safety for all. Access control tools and protocols help manage who can enter and exit specific areas of the facility and anti-ligature measures are universally required.
Comfortable Welcoming Spaces
Behavioral health treatment is often stressful. To increase patient comfort and provider wellbeing, all the speakers encouraged the creation of welcoming, home-like environments where patients had some choice over their location. Spaces to support activities that promote relaxation, such as yoga, meditation, or art classes, with design elements that enhance comfort like warm, bright, and earthy tones to create a soothing atmosphere, and soft furnishings that exude coziness such as armchairs and throw pillows. Recommendations for private rooms with ensuite bathrooms to provide a comfortable and private space for patients, and access to outdoor spaces that offer a connection to nature and outdoor activities reminded many folks of hospitality design.
Creating spaces that safely connect patients to the outside world are proven to have a positive impact on their mental and emotional wellbeing and support more successful reintegration into community. Introducing natural light and views of nature into the environment helps stimulate the senses and reduces feelings of anxiety and depression in everyone.
The patient recovery journey is expedited by healing environments, spaces that promote the healing process and support the patient in achieving emotional and mental stability. These might include quiet spaces for meditation or relaxation, and a variation of lighting sources and qualities to promote a calming setting, help balance the patient's mood and promote better sleep. Artwork and music also promote a sense of wellbeing, engage all the senses, and lift a patient’s mood.
Flexibility in spaces that promote social interaction, such as communal areas where patients can interact with each other and participate in group activities mentioned earlier, can be achieved with furniture pieces able to be moved (but only with concerted, obvious effort.)
Well-designed behavioral health environments are an essential component of patient care and recovery. By prioritizing safety, comfort, and healing environments, patients can receive the care they need in an environment that promotes their well-being and providers can offer their best services. And it is crucial to work with a specialized team that has the experience and expertise in designing these environments to ensure you create spaces that are both functional and conducive to the patient's recovery journey.
More to Come
Our conversation concluded where we began, recognizing the lack of behavioral health resources to support the State of Washington, with positive encouragement to be aware of pending legislation and support additional resources whenever possible.
OpenSquare Health + Wellness team members are available for consults and conversations. Please reach out with questions any time. And stay tuned, we will continue the conversation.
Hero image: Civil Center for Behavioral Health at Maple Lane by BCRA