There is a growing demand for mental and behavioral health care services and facilities worldwide. It’s no longer someone else’s issue, it’s a real-life conversation that is happening in our local communities. The pandemic has been the single largest accelerator of mental illness and disorders, where reports estimate that anxiety and depression have increased by up to 25%. To accommodate the demand for diagnosis and treatment of patients across the entire spectrum, a holistic approach must be taken to provide a continuum of care from community clinics to emergency departments to long-term facilities.
In this Insight Article, we provide our perspective on key drivers and considerations of our approach to mental and behavioral healthcare design and how adaptive design can be used to benefit patients, practitioners and caregivers at all levels of treatment.
Destigmatizing Mental and Behavioral Health
Destigmatizing mental and behavioral illness is critical to seeking treatment. We talk about normalization in our design process where small but impactful steps are taken to create segregated, small flex spaces where a patient can be assessed without feeling stigmatized. It’s about creating an experience where they feel comfortable and can seek the help they need. Patients often feel a sense of hopelessness creating a serious barrier to diagnosis and treatment.
How do we help people with mental illness before they reach an emergency department? By building up an infrastructure that is equipped to treat patients at the earliest signs of mental illness. While the pandemic stressed our healthcare system to new levels, it also led to innovative methods of care. Virtual health and telehealth consultations granted access to those who may otherwise not have sought help, and online outreach programs were created to normalize treatment. The implementation of online systems involves user consultation and space planning providing design that adapts to the usage of telehealth equipment and the workflow process. Every discussion with our healthcare clients probes the current and future integration of telehealth into their respective environments to ensure technology and process are considered in the design.
Family and community clinics play a vital role in the early diagnosis. Design can help normalize the experience at a local level by providing more private spaces, STC (Sound Transmission Class) rated doors and walls, better sound attenuation and adaptive spaces. Implementations as simple as using the same entrance but offering a zone for specialized behavioral health consult rooms can be effective by normalizing the use of a multi-service facility for mental health visits.
Creating Safe Spaces
Mental illness emergency visits have surged since the beginning of the pandemic, and while those levels have begun to decline, the lessons have remained. Designing a welcoming environment is critical to helping the increase in patients experiencing a mental health crisis. We can reduce sensory overload by designing mental health zones that provide safe and flexible spaces to separate patients who need psychiatric help. Using ligature resistant materials, reducing auditory and visual stimulation and providing clear sightlines are critical to creating a safe environment not just for the patient, but for the staff as well.
By separating patients immediately after triage into safe spaces, practitioners can search for comorbidities in a protected environment. Giving these same patients autonomy is also critical to a healing environment. Designing safe drinking, eating and washroom areas allows patients to move freely without the risk of harm to anyone in the vicinity. At the Queen Elizabeth University Hospital in Glasgow, UK, special consideration was given to accessibility of oxygen and vacuum points without compromising reduced ligature requirements in Clinical Decision Wards.
Normalizing Long-Term Healing Spaces
At the far end of the spectrum are long-term healing facilities. These specialized facilities consider tremendous design consideration to improve the level of care for patients, and to maintain safety for caregivers and family members. The design process is truly collaborative and considers elements such as:
- Electrified glass to provide opacity rather than curtains
- Ligature resistant and durable finishes for sinks, lights, windows, etc.
- Biophilic elements to evoke feelings of nature and the outdoors
- Bright and contrasting colors to create unique spaces
- Weighted, colored and safe furniture for patients, staff and families
- Murals using “bus wrap” to remain cost-effective if damaged or worn
Normalizing long-term healing spaces also has a profound effect on families and loved ones. The introduction of transition flats and apartments at acute mental health facilities facilitates long-term institutionalized patients’ transition back into the community, creating a positive outcome for the patient and their families and loved ones. By creating a welcome environment that feels no different than a typical long-term care environment, we can reduce the often-stressful nature of visits as well.
Achieving the Right Objectives
The conversation around mental and behavioral health care design is one that requires clear objectives from health systems and clients. Before any design starts, defined objectives are required to achieve the desired patient outcome.
- Where are you or where do you want to be on the spectrum of care?
- What are you trying to solve?
- What is the desired patient outcome?
- What are the biggest challenges?
- What are the biggest opportunities?
- How is success measured?
Our greatest strength is embracing evidence-based research and applying knowledge and experience across the spectrum of mental and behavioral health care design.
Change does not happen without open conversations – and by asking the right questions. Our role is to continue to drive the conversation forward for the benefit of patients, practitioners and caregivers at all levels of treatment.
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