When you gather a group of designers and architects together in the same room, there are bound to be lively debates and discussions. That’s exactly what happened when the four jury members convened to discuss the projects submitted for the 2014 Behavioral Healthcare Health and Human Services Showcase.
For the 6th annual competition, the facilities submitted could have been in any of the following building/construction categories:
- New Construction
- Remodel/Renovation (modifications to an existing facility)
- Addition (new construction added to an existing facility but with little or no change to original facility)
- Conversion (adaptation of an existing structure into a new facility)
- Project in Progress
- Unbuilt/Conceptual (Design only)
There was one Award of Merit, the highest honor among the facilities judged, and it went to the Centre for Addiction and Mental Health in Toronto, Canada. The judges unanimously agreed that this project, which was completed in June 2012, deserved the highest rating. They liked the facility plan and praised the organization’s placement of community connected amenities at street level to promote an image of “good neighbor.”
Among the many areas jury members considered in evaluating submissions, safety of the patients and the staff were at the top of their lists. One of the jurors said, “A space can be beautiful but that means nothing if it’s deemed unsafe.”
Ligature hazards are a major element to consider in building and design. Judges considered “legged chairs” a ligature hazard and called out a few of the projects for placing them in patient bedrooms. Additionally, bars in bathrooms or bedrooms or any other items that could easily be broken and used as a weapon were frowned upon. Sharp edges on bedroom furniture also found disapproval from one judge who pointed out the potential to cause serious harm to patients.
Soft furnishings, such as shower curtains, window coverings, and duvet covers, which can be used as a noose for a patient to commit suicide, were also considered negative aspects of the project plans. Alternative solutions, as recommended by the judges, include:
- Windows: Mini-blinds installed behind security glazing.
- Windows: Roller blinds, which have the roller secured in a tamper-resistant enclosure and include features to minimize tampering by patients and that limit the hazardous nature of pieces if the operating assembly or shade are damaged.
- Showers: A design in which the shower stall has a short wall that will help contain the water from the shower, or by mounting the shower head on this wall so that the water sprays away from the opening through which the patient enters the stall.
When assessing a treatment facility’s construction and design, the jurors say they typically start with the safety elements and then move on to a variety of other aspects. For example, one juror said it’s important to make sure that the space is designed as “a healing environment.”
Others were interested in the floor plan and how patients and service functions will move throughout the building. Judges commented on the openness of floor plans as well as adherence to zoning restrictions. The nurses’ station was another area of focus among the projects. Concerns focused on corridor areas having visibility from the open nurse station, and how, when the rooms were organized around the nurse station, the patients could feel supported but not controlled.
Overall design and aesthetic is most important to one of the interior designers on the panel—and the first aspect to be assessed. “I believe first impressions are very important,” the juror said. In some projects, the judges thought the waiting rooms “looked dated” and in others the patient bedrooms looked institutional. Other important aspects of interior design included color palettes, furniture and floors. There was agreement that the color palette should be fresh, vibrant, warm, and inviting.
Natural light in a psychiatric facility was deemed very important—more is always better, the judges agreed. Finding the balance between safety and light can be difficult in behavioral healthcare facilities, but judges thought some windows in the bedrooms and other patient areas were too high and restricted the view of nature.
Current trends in design
As policies and procedures change in behavioral healthcare, so do the concepts of facility design. The jurors agreed that the field is moving toward a less institutional type of building, but agreed that further work needs to be done. For example, one juror noted that higher-level visual elements can have a great impact on the feel of the space, which supports patients’ sense of being valued and appreciated.
Although the place in which treatment occurs is an “institution,” it’s crucial for the community to understand the positive aspects of the work being done and break the stigma associated with mental illness. A handful of projects in this year’s showcase demonstrate integration and involvement within their communities by providing spaces for the public and patients to interact on a daily basis. These public spaces offer individuals non-threatening opportunities and will hopefully be effective in breaking the stigma.
Another trend in design is toward vibrant colors within the facility—and away from cold gray and other dull, neutral colors