HOW CHANGING BEHAVIORAL HEALTH NEEDS AND AWARENESS IMPACT INTERIOR DESIGN

Our understanding of how patients with mental illness should be treated has changed dramatically over the past several decades—and so has the design of mental health treatment facilities. The design of hospitals and facilities can be critical to a patient’s recovery outlook and meaningful interior design, along with a better understanding of diagnostics and care, can have positive effects on mental and behavioral healthcare within communities. 

This year’s IIDA Power Lunch at the Healthcare Design Expo and Conference in New Orleans on November 4, 2019, revolved around the many complex ins and outs of designing for behavioral health needs, from the changing stigma landscape to taking into consideration care, recovery, and compassion. The event, hosted by IIDA and sponsored by Construction Specialties, featured an industry roundtable, which explored the intersections of design, patient outcomes, and community experiences.

Here’s what the experts had to say:

Recovery and Healing

Best practices for treating and housing patients with mental illness have shifted from custodial care to person-centered recovery. This means that modern behavioral health spaces are “challenged to meet safety and security obligations while providing humane and healing patient spaces,” says Walter B. Jones, Jr., AIA, senior vice president of Campus Transformation. 

In order to create patient-centric environments, these facilities are making design choices that promote recovery, encourage well-being, and improve treatment outcomes. This can include everything from utilizing calming color palettes and adding elements of Biophilia to creating community and family gathering places that provide both patients and families with a welcoming and transparent treatment process. Staying in an inpatient facility is often stressful, but design can serve as a catalyst for enabling patients to take control of their own healing and recovery.

NDI_Fleck_04

New Focus on Amenities

Healing and treatment in behavioral health settings are often enhanced when a healthcare environment “helps to promote a sense of community and self-care and aids in motivating patients,” says Tim Lucas, IIDA, senior interior designer at Gresham Smith. This approach to healthcare means that giving patients their choice of various amenity offerings becomes a critical component of behavioral health facility design. 

Exercise rooms, art and creativity studios, and access to healthy food choices, the outdoors, walking trails, and group and individual activities allow patients a sense of empowerment and autonomy. These options can also foster family involvement in the wellness process, and allow patients to create lasting bonds with fellow patients and their providers.

Safety Aesthetics

Within behavioral health environments, lighting, acoustic, material, and furnishing choices are strategically made in order to incorporate the safety of patients and staff into the design and functionality. 

“Successfully reaching this goal is a balance between evoking positive emotions through aesthetics, while achieving individual safety,” says Lucas. Designers can use the latest research on the state of mental health needs to help them make informed and successful design decisions. These decisions may encompass: 

    • Patterning: Flooring patterns, for example, should be kept to a minimum as high-contrast and glare can be disorienting to some patients.
    • Wayfinding: Wayfinding throughout a behavioral health space should be clear and consistent to reduce potential confusion and agitation. 
    • Acoustics: Providing access to a quiet environment is important. Certain sound absorption materials can be used to address acoustic concerns. 
    • Lighting: The use of fluorescent lighting should be limited and replaced with warmer-toned LED lighting in order to create a softer, more comforting environment. 
    • Furnishings: Furniture should be selected based on the level of a patient’s condition.  In certain cases, furniture should be weighted and immovable; in other cases, lighter weight furniture that can be moved is beneficial. 

NDI_Fleck_11

Compassion and Destigmatization

Design has the power to humanize and dignify, and in order to help combat the mental health stigma landscape, behavioral health spaces today need to convey a sense of trust. “When a patient feels stripped of their personal dignity—which often happens upon entering an inpatient unit—we find, as designers, that the small details we incorporate can empower the patient and lead to a sense of satisfaction,” says Kimberly N. McMurray, AIA, principal at Behavioral Health Facility Consulting, LLC. 

Gone are the days of facilities with sterile, impersonal rooms with anxiety-inducing austere architecture. Instead, patients and their families are offered modern design features and welcoming, soothing environments. Incorporating compassionate design aids in the destigmatization of seeking and receiving mental healthcare, and the humanization of patients. According to Sara K. Wengert, AIA, principal at architecture+, interior design, coupled with activism and changes in public policy, “can have a profound effect on the avoidance of stigma associated with mental and behavioral healthcare for members of our communities, as well as for the people receiving care.” 

Connecting the Dots in Experience Design and Community Engagement

This year’s IIDA Power Lunch at the Healthcare Design Conference revolved around the idea of “community” and the design of healthcare settings. The event, hosted by IIDA and sponsored by Construction Specialties, featured an industry roundtable, which explored the intersections of design, patient outcomes, and community experiences.

Healthcare environments are evolving to keep up with shifting paradigms of comfort, wellness, and corporate humanity. This means that healthcare systems are reconsidering how their spaces look and feel and what they offer the communities they serve.

Here’s what the experts had to say:

Healthcare Design and Community

Organizations are fast becoming more community-driven, and healthcare facilities can be designed as community hubs. “Through intentional engagement with a broader audience of community representatives and stakeholders during the design process, as well as enhanced program offerings, healthcare facilities can become destinations for health, wellness, culture, and education,” said Edwin Beltran, IIDA, Associate AIA, IIDA International Board vice president and design principal at NBBJ.

To ensure the complementary nature of the different programs and their successful viability as destination hubs, healthcare spaces need a balanced combination of civic, sports, cultural, and health offerings. Programmatic amenities could include locally-focused retail outlets, meeting rooms for community groups and civic organizations, wellness centers, healthy-eating demonstration kitchens, food outlets, and farmers markets.

Integration can also take on the form of “blurred boundaries” between patient communities and host town communities. Environments that are developed to embody the unique cultural identity of a community are those that provide true belonging and a sense of place. An example of this could be a healthcare facility with playgrounds and parks as part of its campus design. This helps present the paradigm of healthcare spaces as favoring socialization instead of isolation.

Wayfinding and Messaging
DM_Healthcare_Wayfindings

In order for a community to feel comfortable inside of a healthcare space and become truly integrated into its built environment, designers should consider how wayfinding and messaging affect visitor experiences. Sensory elements can be utilized to make a healthcare space feel inviting and welcoming: Pictures and symbols to assist with language barriers, calming colors that take into considering visual impairment, sounds that consider the hearing impaired, and words that are easy to understand and visually accessible.

Clinical spaces should also be committed to reducing the fear and anxiety that can often accompany a healthcare visit. “Community events and use of the facilities when the community is not in need of medical assistance is one way to make members of the community feel more comfortable in the space,” said Richelle Cellini, visualization specialist at Construction Specialties. “Retail spaces, yoga classes, or coffee shops within the medical space can also help reduce fear and disorientation.”

Humanizing Space

Healthcare architects and designers must walk in the shoes of patients, families, and caregivers with empathy, though this can be challenging in a world where schedules and budgets rule our frame of thinking. To create more humane, civilized healthcare spaces, designers should remember that a clinical environment does not have to look clinical. “Designing for the senses is one of the first steps to humanizing a healthcare space,” explained Suzen L. Heeley, IIDA, executive director of design and construction at Memorial Sloan Kettering Cancer Center. “Through the integration of sound domes, holistic fragrances, tactile materials, and specific colors, clinical environments can become more comfortable and healing-driven.”

Integrating Community

Embracing community means taking on new approaches to delivering services, such as working directly with members of the wider community. “Creating partnerships between health service organizations and health professionals, clinicians, patients, families, caregivers, and consumers is viewed as a fundamental precondition for effective delivery of healthcare,” said Amy Sickeler, IIDA, design principal at Perkins+Will. “Studies have demonstrated significant benefits from such partnerships in clinical quality and outcomes, the experience of care, and the business and operations of delivering care,” Sickeler explained.

The clinical benefits that have been associated with better patient experience and patient-centered care can include decreased mortality and readmission rates, and improved adherence to treatment regimes. Partnerships could look like free public health screenings, public health forums, free literature and written information, and health and wellness programs.

Facility Resources

DM_Healthcare_Rethinking_Facilities

Rethinking the standards of a healthcare facility and the kinds of resources it can provide is important in understanding how medical spaces can better serve their communities. Healthcare facilities should be designed to provide top-notch security and function while maintaining external approachability, comfort, and visual appeal.

Healthcare designers should ask themselves: How is a healthcare facility equipped to deal with unforeseen emergencies like natural disasters? Does the facility have communal, family spaces? Does it have multiple accessible entrances? Do places that allow for relaxation and breathing room beyond the waiting room exist? “Facility resources should be closer to the point of care for the patient and not just in the lobby,” said Stasia Czech Suleiman, IIDA, principal/senior project interior designer at HOK.