Architects work closely with behavioral health providers to address the unique needs of their patients, whether that is giving a confined patient in an inpatient setting access to outdoor space or including day care in a substance use disorder (SUD) facility.
“A lot of the principles of trauma-informed design come into play,” Stephen Parker, behavioral health planner at Stantech, told Behavioral Health Business. “So giving patients autonomy, voice and choice throughout the process[is important]so that they have dignity when entering a campus or facility.”
Stantec is an architecture and construction management firm based in Edmonton, Canada.
Design can be critical to how patients interact with staff, spend time, and ultimately recover. Modern behavioral health facilities now prioritize design with patient autonomy, cultural competence, co-location, community spaces and outdoor space in mind.
Many architects work with behavioral health providers to give patients more autonomy in their space.
“If a patient can see their role and have strength in their treatment plan, they are more likely to stick to it and implement it,” Parker said. “So giving them ownership and agency in this process means giving them choices and not just dictating to them their treatment plan, what’s going to happen to them. They become active participants.”
This could be as simple as giving patients the ability to open and close curtains without asking a nurse to do it for them. This allows patients to regulate their sleep as they see fit, which can significantly affect their stress levels.
More facilities are also looking to give patients a private or semi-private room. This also provides patients with the ability to take ownership of their own space.
Environmental psychologists have found that including social support and control and incorporating nature into design can help reduce stress.
Many behavioral health facilities are also looking to give patients autonomy over where they spend their time, including providing choices for social spaces.
“We’ve tried to figure out ways to incorporate social interaction into the resting spaces that we design,” Blima Erentro, founder and CEO of the Designers Group, told BHB. “Even in our entertainment rooms, we got creative with different furniture designs and brought in technology so that people can, for example, interact together but not necessarily sit close to each other.”
The group of designers focus on designing interior spaces for residential, commercial, hospitality and healthcare projects.
Social spaces can also play an important role in restoring behavioral health and making patients feel safe and accepted.
“When you go into one of our outpatient clinics, it’s designed in a very purposeful way that gives us an experience of belonging,” Alex Stavros, CEO of Embark Behavioral Health, told BHB. “It is the colours; It’s the furniture that makes him feel welcome, makes him feel bright, and makes him feel accepted. And all this design is bright light and natural light coming through. All of these design aspects are intentional, align with our culture, with our core values, with our healing approach, and create an environment that can be conducive to healing and an environment where you feel accepted.”
Embark, Inc., based in Chandler, Arizona, provides a network of outpatient centers and residential programs for adolescent, preteen, and young adult mental health treatment. Earlier this year, the private equity firm Consonance Capital Partners invested in the provider, giving it a controlling stake in the company.
In addition to social spaces, many behavioral health professionals prioritize outdoor space in their facilities.
For example, Parker has worked with a major academic medical center to create garden spaces outside their psychiatric units, allowing patients to decide if they want access to the outdoors.
“It was designed with psychologically safe features,” Parker said. “So it reduces the risks for individuals in crisis who are still on watch, but gives them the ability to self-regulate through choosing to go out and socialize, etc.”
It’s not just psychiatric facilities that prioritize outdoor spaces. Erentro noted that many substance use disorder treatment centers also incorporate both external and internal areas into their model. She notes that being in nature can provide a calming effect.
“There’s a lot of indoor and outdoor space,” said Erentro. “For people who can’t go outside much, we try to mimic that and bring biophilia into the design. We’ve definitely seen the benefit of sunlight which has vitamin D, and in general people really enjoy the option of being able to go outside, and if they can’t go outside too, then bring the outdoors.” for people.
Culturally responsive design
Cultural competence is an essential part of designing for specific communities. For example, Parker has helped design treatment facilities for substance use disorders for Indigenous communities in North America.
“Really looking at addressing specific cultural touchpoints by designing around a culture of care would be the main takeaway I would suggest,” Parker said. “Because I have to understand my own biases when I get into a project and (understand) the providers, patients and stakeholders.”
Instead of separating the individual seeking care from the community, this facility can bring the entire family onto campus. In this way, providers can help address generational trauma and keep patients part of the community.
In terms of design, this means that the facility needs to include a daycare for children and community areas, such as a traditional craft room and party space. In addition, the space should include clinical spaces for outpatient counseling, group therapy, and reception.
In addition to community spaces, many providers place different levels of behavioral health therapy on one campus and incorporate physical health.
Lima indicated that she works in a community center for people with special needs that offers many physical and behavioral health offers.
“There is a daily rehabilitation program, as well as an urgent care component where there are doctors’ offices and therapists, as well as a dentist,” Erentro said. “So this gives people in this community the ability to come in and have all their needs met.”
This type of holistic treatment center often means having many different stakeholders co-located on a single campus.
“Instead of having an individual come off a detox schedule…and experience homelessness, and send them to a shelter…and have their own treatment facility on the other side of town, (the idea) is to share services on what we call a recovery campus,” Parker said. “This is interesting because no single facility has this range of services.”
These campuses can often include many service providers from different parts of the community. In terms of design, this can mean creating several spaces for vastly different uses. For example, co-located recovery complexes can include behavioral health services, recreation spaces, preventive care offerings, nutritional support programs, and housing.
“Sometimes we’re literally in programming discussions because the organization that’s going to run this doesn’t exist,” Parker said.