Designing an effective, safe and aesthetically pleasing behavioral healthcare facility can be a delicate balancing act. While safety measures are imperative for eliminating risk among patients, moving away from the institutional feel has also become a priority. The industry continues to adapt, modernize and focus on the needs of both patients and staff.
This overarching teeter-totter effect became evident when a jury of four industry experts convened to discuss the 13 design projects submitted for the 2015 Behavioral Healthcare Design Showcase.
All submissions for the seventh annual competition received scores from the jury qualifying them for publication in this issue. Facilities were rated on a five-point scale. Of these high-ranking projects, two Awards of Merit were extended—the highest honor among the facilities judged.
The Next Door, in Nashville, was applauded for being well-executed with the designers completing their work pro bono, and it received an Award of Merit. The Southwest Centre for Forensic Mental Health Care in St. Thomas, Ontario, Canada, also earned an Award of Merit. Honorable Mentions were awarded to The Laureate Psychiatric Clinic & Hospital Eating Disorder Expansion in Tulsa, Okla., and the Parkwood Institute Mental Health Building in London, Ontario, Canada.
Among the five highest-ranking facilities, each exhibited potential safety concerns raised by our jurors. Ligature hazards, dangling light fixtures and decorative resin panels were all deemed potentially hazardous. While the use of glass windows to let in natural light was viewed favorably by the jurors as an exterior feature, glass-incorporated interior aesthetics—like glass tiles and glass countertops—raised concerns about material cracking with a jagged edge that could cause injury.
Reflecting the balance between safety and function, the biggest question raised was regarding custom handrails implemented in certain clinical spaces to assist an aging mental health population. While one juror said the addition improved the look and function of the space, the general worry stemmed from their custom design. “If they haven’t been through the same level of testing, there could be some risk,” a juror said. Ultimately, jurors agreed that more information on design strategies for the specific population was needed.
Another commonality noticed by the jurors was the frequent use of high-contrast flooring, or groupings of dark colored tile. Among certain patient populations, this aesthetic could be perceived as a physical barrier or even a “black hole,” which could cause some individuals anxiety, stress or confusion while moving around the facility.
“We, as designers, like to emphasize three dimensionality on the floor, but we have to take this into consideration,” one juror said.
Another juror added that it’s okay to have color differentiation when it’s well-executed and used as a deterrent. For example, using a thick-colored band in flooring around a nurse’s station could keep patients from crossing into staff territory.
“It’s important to understand and consider levels of contrast so you don’t throw off depth perception,” the juror added.
Outlined by the jurors in their discussion, the following trends highlight the dos and don’ts of our top five facilities and are organized to help industry leaders improve current and future facility designs.
Plan smart: Decentralized nursing stations positioned closer to patient rooms, overall proximity to transitional housing, and effective zoning were seen as positive planning elements by the jurors. Spaces that had adjacency of services, good flow and a strong emphasis on flexibility were also ranked highly. One juror said that flexibility is “valuable in all buildings but seems to be priceless in BH facilities that change a lot and often need to make efficient use of space.”
Be innovative: Contemporary, atypical designs were applauded by the jurors. Not only is an attractive, innovative space important for patients and families, but it also plays heavily into staff recruitment and retention, they said. “In order to not only recruit but retain, you need a higher-end space,” one juror added.
Offset clinical by incorporating color: Warmth was also deemed a valuable design quality in residential treatment because it provides comfort, feels inviting and seems “homelike” to patients and families. However, jurors noted that using natural wood for this purpose might leave a space feeling bland.
In contrast, the jurors noted that spaces built on a gray color palette often seemed sterile or institutional. But a mostly-grey dining room with a nice piece of artwork incorporated into the space can seem more visually interesting. Incorporating a brightly-colored accent wall in a patient residential room can help distract the eye from any clinical aspects of the space.
Avoid disconnect: Facilities were also scored lower by the jurors if there was an aesthetic disconnect between the front-of-house spaces and back-of-house spaces. Carrying front-of-house design elements throughout the facility not only makes the facility look more cohesive, but it also cuts through any potential plainness in clinical spaces.