Design strategies to reduce stigma, elevate care, and help patients.
Posted Feb 18, 2020 Psychology Today
Mental health treatment facilities are commonly stereotyped in popular culture as unremarkable buildings in isolated areas where patients are locked away and every aspect of their life, from what they eat to who they can talk to, is intensely controlled.
In truth, modern, well-designed mental health treatment spaces contribute to healing and expand the therapeutic benefit provided by a skilled team of mental health professionals. And the need for mental health treatment spaces may be rising — one in five Americans will experience a mental illness in a given year, and only 41% of Americans with a mental illness actually receive treatment.
As a result, healthcare systems realize it is paramount to create treatment spaces that ensure patients are cared for with the respect and dignity they deserve.
It is vital that designers and healthcare staff work closely together when designing or renovating mental health treatment spaces. This partnership allows architects to better understand the patient experience and create spatial solutions that improve it. Here are four critical challenges patients who seek mental health treatment face—and how design can advance the patient experience.
Mental illness doesn’t discriminate. It can affect anyone regardless of gender, age, race, or socioeconomic status. Despite the increased number of people experiencing mental illness, there is still a great deal of stigma involved in acknowledging mental illness and seeking treatment. This stigma can be further exacerbated by the environments where people seek treatment.
First, visiting treatment spaces that are dark and isolated from society creates an inherent negative stigma. Moreover, if interior environments don’t provide any comforts of home or opportunities for rejuvenation, this stigma is only compounded. Designers can help health systems, public and private, better design spaces that make patients feel less “institutionalized” and more dignified throughout the treatment process.
For example, the VCU Medical Center Virginia Treatment Center for Children is designed as a “pavilion in the park,” an inviting space with natural landscapes for children and adolescents. Importantly, it doesn’t feel unfamiliar from other buildings in the city—it’s integrated as opposed to isolated, which may help mitigate stigma in the community. Other design opportunities include rooms faced with wooded areas or interior courtyards that offer well-lit spaces and capitalize on the healing effects of nature.
Relaxation rooms, quiet spaces, and sensory rooms where patients can de-escalate and find peace can be important elements to incorporate as well. In these spaces, patients can self-soothe and learn other skills that can help them succeed.
Another design strategy to reduce stigma is creating shared use spaces within a behavioral health facility the community can use. This enhances a care facility’s value as a community asset. The Waypoint Centre for Mental Health in Ontario, Canada, for instance, allows the public to safely use its swimming pool for recreational swimming at certain times while the Essex County Hospital Center in New Jersey opens its conference rooms and rec spaces to the public when not in use by patients.
Dining and Dietary
For many, mealtimes are innately therapeutic. They are times for families to gather, reflect on their day, and talk. To maintain that sense of community and engagement, it is important that dining and dietary spaces encourage those everyday shared activities and cultivate a sense of inclusion and foster community.
Design can help ease this challenge by helping health systems think through material selection, kitchen organization, security access options and more. For example, food carts can be utilized to increase patient satisfaction with food temperatures and selection, provide more “in the moment” food options, as well as improve food quality and presentation.
Dining and dietary design challenges are more easily tackled in long-term care facilities as opposed to acute-care facilities where safety challenges and medically necessary diet restrictions can be more prevalent. However, when design considerations are implemented strategically, facilities can ensure balanced dining and dietary spaces that actively work to support mental health treatment.
Privacy and Wellness
When patients stay in a care facility away from home for any period of time, the lack of privacy can be overwhelming.
Design solutions can create opportunities for personal space for patients who may feel like they have none. Simple steps by offering private patient rooms with their own private, safety-oriented bathrooms, can help offer moments of reprieve.
Designing safe storage spaces for personal belongings that can be accessed by patients or staff members also enhances privacy and dignity.
Another key step is designing facilities with private garden spaces where patients, families, and staff can spend time. One new Sheppard Pratt hospital set to open in 2021 (of which author Harsh Trivedi is the President and CEO) is oriented so that most patient bedrooms and all of the on-unit therapy and activity spaces directly face the surrounding landscape and have access to walking paths, benches, and reflection areas to offer privacy.
Mental health treatment can be an inherently isolating experience. For those who are inpatient, being able to see and spend time with loved ones can create hope and aid in the healing process. Historically, mental health facilities did not prioritize these spaces and often designed them to be areas where lots of people could meet at stark tables for short periods of time. This diminished privacy and community for the patient.
Today, designers are helping mental health treatment spaces infuse more “living-room-like” spaces within units that enhance privacy and allow patients time to privately connect with their loved ones. At the Lindner Center of HOPE in Mason, Ohio, a window bench is incorporated into patient rooms that can be converted into a bed that allows family to stay overnight with their loved one. As with every decision in mental health care facilities, balancing these increased options with safety and dignity is paramount.
In other instances, mental health facilities can be orchestrated to foster internal community. For example, the Margaret and Charles Juravinski Centre for Integrated Healthcare of St. Joseph’s Healthcare in Canada offers patients access to a hair salon, gym, clothing store, coffee shop, and library, letting patients create a routine of their own and engage others. Outpatient services are also available in the building, softening the invisible boundaries between those temporarily living in the building for care and the community at large.
It’s critical for today’s health systems to address the needs of patients’ physical and mental well-being.
Thankfully, many see design as a tool for advancing care delivery and outcomes, and they are considering these challenges and trends in their planning and design. As we create more mental health treatment spaces to meet America’s growing need, design can be a tool for ensuring every patient receives a dignified, compassionate, and patient-centered experience.