Designing for Mental Health

  • Aug 21, 2019

This column is featured in D CEO Healthcare

By Alison Leonard, AIA, EDAC 

The only thing constant in the healthcare market is change, which is why it is hard to believe that the stigma associated with mental health treatment and hospitals remains after all these years.

The challenging goal for designers of healthcare spaces is to create a patient care environment and experience that allows for clinical success.  For behavioral and mental healthcare spaces, designers must understand how one’s surrounding area affects the five senses and triggers an emotional response. Can designers actually manipulate the healing process and overall patient experience with good design?

Scientists have said that more than half the brain is devoted to processing visual images. Visual stimulation comes in many forms, but when sight combines with hearing, they help with perception and understanding scale within a space.

Specific colors and natural light influence mood. Listening to music provides refuge and for some, while textures, whether rough or smooth, soothe anxiety or peak curiosity. Scent is capable of influencing attitude and when connected with taste, provides comfort with food. The human senses and building elements together shape experience and can have a powerful emotional effect.

Influencing the healing process and patient experience with sound design

To reduce the stigma around mental health treatment, we must change the way we see and judge healing spaces.

Behavioral and mental healthcare facility design has come a long way in recent years. The new treatment models are no longer synonymous with asylums and prisons. They pay close attention to the layout and flexibility of spaces while incorporating key design elements such as abundant natural light, views, access to the exterior, unique therapy spaces, and a delicate balance between safety and aesthetics.

For example, the design of a lobby and entry progression in a mental healthcare unit should focus on empathy and hospitality.  Arrival in a mental health care space shouldn’t feel any different than arriving at another hospital or better yet, any other place. Privacy, natural light, and adequate space for conversation will help welcome a patient and build trust.

Form Follows Function

This specialized building type requires a “form follows function” design. Planning layouts that thoughtfully manage safety concerns for both a patient and staff is vital. The specific population type dictates the appropriate number of patient rooms per unit, the shape of the layout, and length of corridors. A direct line of sight to patient spaces from decentralized nurse care stations affords more patient choices and control and can discourage certain negative behaviors.

Open nurse stations encourage transparency between staff and patients to help develop mutual trust and enable communication. Single occupancy patient rooms are preferred. They can be personalized, offer partial privacy for quiet reflection, and respect dignity; especially for patients not identifying with a specific gender.

While large group spaces are essential for different social activities, it’s also important to provide areas for quiet interaction outside the patient room.  Small built-in benches or window seats along the corridor throughout the unit ensure a spot for impromptu conversation.  Unique therapy spaces for music, art, gardening, or meditation allow patients to express themselves, and a gym provides a space for much-needed exercise and activity- especially for pediatric and adolescent populations.

A sensory room creates an immersive environment for a patient that needs to de-escalate independently. A therapeutic room is an alternative to placing a patient in seclusion and incorporates music, lighting, tactile elements, comfortable finishes, and projected images amongst other technology – all safely customizable for the patient’s needs.  Views of the landscape and direct access to the exterior with secure walking paths and gardens are invaluable to the healing process.

The strategic use of materials

Part of human-centered design is including natural materials with other impactful design elements. Texture and color can soothe anxiety and energize curiosity. Wood inherently feels rich and warm, and bold colors support a positive attitude.

Durable, cleanable surfaces are essential, but keeping comfort in mind helps to support to a home-like environment. Impact-resistant surfaces make it difficult to control sound levels and may require a supplemental acoustical product. Ceilings shall be at least 9’-0” high and contiguous. The lighting selected should enhance the spaces. Tunable white lights that are sensitive to the circadian rhythm are becoming more popular and are more affordable.  A continuous sheet flooring with an integral base makes the best choice for inpatient areas because it avoids a separate wall base that can be peeled off and used as a weapon.

Designing for safety and security

While selections of colors and textures vary from pediatric to adult populations, one thing that doesn’t change is the importance of safety and security. Understanding the risks associated with standard design elements in behavioral health spaces is imperative.

Eliminating everyday items that can be used to loop, wedge, or create a point of ligature is necessary to create a safe environment for patients who have a mental illness. Within the last ten years, the market has grown tremendously with alternative product solutions that are both ligature resistant and aesthetically pleasing.

In many cases, built-in-furniture and millwork, custom enclosures with sloped tops, and careful attention to fixture installation details will provide the highest level of safety for patients and staff. Some of the items that cause concern in high-risk areas include door hardware, glazing, plumbing fixtures, closet rods, soap dispensers, and other toilet accessories, and lighting.

The role of design In reducing stigma

Part of deinstitutionalizing care is innovation- in both designs of facilities, fixtures, and in thought.

As healthcare designers, we must lead in reducing the stigma around behavioral healthcare design by normalizing the built environment for care. While measuring the impact of this gesture seems impossible, we must assume that a positive patient experience will lead to faster recovery, a shorter length of stay, and encourage a return to wellness.