Designs that Support

By Rachael Farrell & Nathan Howell | November/December Issue 2023 | MCD Magazine

Now more than ever, the world is calling for compassionate care toward patients struggling with mental health conditions. Architectural interventions are key to this movement. Interest in non-invasion de-escalation strategies is at an all-time high. As sensory therapies that support these strategies advance, behavioral health facilities have an increased need for sensory rooms. Spaces to support evolving interventional psychiatry platforms and treatments are increasingly important, as well. And while providers continue to grapple with staffing challenges, they are realizing an ancillary benefit to sustainable design: operational savings they can reallocate toward attracting and retaining qualified staff. The following design strategies support the overarching goals of today’s behavioral health projects.

Sensory therapies

Spaces designed to accommodate individual patients’ sensory needs are critical in behavioral health facilities. In addition to treating sensory disorders, environments designed to help physicians understand and address patients’ sensory challenges can help diagnose other, potentially hidden, conditions.

At HKS, the designers and researchers work closely with psychiatrists and occupational therapists to create customer-designed sensory room solutions for pediatric, adult, or geriatric populations. Examples include the sensory well-being hub at Lane Tech High School in Chicago, Illinois, a pro-bono project to help students with learning differences independently de-escalate and self-regulate.

High-fidelity physical mock-ups and prototypes have been developed with custom-curated sensory tools and design features that can personalize the patient experience. These include tactile features, project imagery, sounds and smells to support patients’ emotional management and improve daily sensory processing.

On other projects, they have researched and created spaces for patients to explore healthy ways to experience self-induced and externally generated forces during treatment for vestibular system dysfunction – a disturbance in the body’s balance system. These spaces include features such as slides, swings, and workout equipment. Mirrors and video monitoring enable a broader care team to provide feedback on symptoms, such as head tilting or eye movement, and track individuals’ progress over time.

The proprioception system is the body system that enables people to sense their own bodily movement, force, and position. Many patients who experience proprioception disorders are largely unaware of the root cause of their challenges. They may be heedless of their own strength, have an unusually high pain threshold, or fail to observe the personal space of others.

HKS sensory therapy prototypes have shown that patients struggling with proprioception can benefit from spaces that support deep-pressure activities and resistance exercises with consistent intensity. These environments promote tranquility and mitigate patients’ desire to seek unhealthy sensory inputs elsewhere.

Interventional psychiatry

Soothing spaces that incorporate virtual reality technology with TMS treatment are also on the rise. TMS treatment, which uses magnetic pulses to stimulate the brain, has been proven to render promising results for regulating dependence behaviors and treating trauma-and-stressor-related disorders, such as post-traumatic stress disorder.

Design features, such as dimmable lighting, comfortable recliners, and ensuite bathrooms, support the comfort and psychological safety of patients receiving TMS treatment. Cameras are included in the design of these rooms to augment staff observation and review.

Enhancing TMS therapy with virtual reality and ketamine infusions can help patients learn coping mechanisms that mitigate fear responses. Environments and tools that help people identify and move through stressors support cognitive longevity and stress resilience. This can help save the lives of people struggling with debilitating stress from anxiety disorders and obsessive-compulsive disorders.

Sustainable, supportive environments 

Sustainable and resilient design is seeing and resurgence in behavioral health. In the U.S., this is due in part to the federal Inflaction Reduction Act, which makes funding available for clean energy and climate mitigation and resilience measures. Care providers are thinking critically about the first and second costs of facility design and operations, especially as the costs relate to operational and staffing efficiency.

Staffing efficiency is an ongoing concern in behavioral health. Providers are recognizing that sustainable facilities help reduce ongoing operational costs, freeing resources for staffing and staff retention.

Other recent HKS projects demonstrate how behavioral health clients are increasingly prioritizing staff well-being. BasePoint Academy opened new facilities for outpatient adolescent mental health and substance abuse treatment in Arlington, Texas, and McKinney, Texas. During the design of the new facilities, client leadership expressed that staff spaces were a top concern because happy, quality staff lead to better patient outcomes. The new facilities feature vibrant colors and large, comfortable offices and staff lounges. BasePoint reported that since the new sites opened, the organization has had no trouble attracting top-notch staff.

The built environment is integral to advances in behavioral healthcare. As care platforms, treatment, technology, and equipment progress, designs to support care delivery are also moving forward.

About the authors: Rachael Farrell, LEED AP BD+C, IASSC, EDAC & RELi AP, is a senior medical planner at HKS. Nathan Howell, AIA, NCARB, is a senior project manager at HKS. 

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Written by Anne Holden