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From intake to therapy to discharge, Behavioral Health treatment transpires in a variety of different settings. Depending on the level of need and the severity of the diagnosis, patients also require varying levels of supervision in different phases of therapy — and therapy itself can vary from patient to patient, impacting how often the patient interacts with peers, as well as how much security and observation are needed to keep the patient safe.
 

As such, Behavioral Healthcare spaces typically fall into one of five different general levels of supervision — each informing its own specific setting type and corresponding standards for products supporting it. These levels were originally developed by James M. Hunt, AIA, founder of Behavioral Health Facility Consulting, and referenced by Kimberly McMurray, AIA, principal with BHFC Design. At Stance Behavioral Health, we follow these levels as our guide to determine what types of Stance furniture fits best in each type of space.   
 

Maximum Supervision, or Level I: These spaces are restricted, staff-only areas that the patient never enters. These could be staff rooms for respite or collaborative spaces for consultation and meetings. Stance Behavioral Health offers a variety of durable and well-designed product lines that can fill out these rooms and fit any aesthetic. Our Accent Chairs, Disc Base Tables, Trumpet Base Tables, Valet Lounge Chairs, and Verity Lounge Chairs are great for Level 1 spaces and help provide the perfect mix of form and function for the healthcare staff to enjoy.

High Supervision, or Level II: These areas, in which patients are highly supervised, are found behind self-closing and self-locking doors. Patients are not to be left alone in these spaces, which can include counseling rooms, activity rooms, interview rooms, group rooms and corridors where staff are regularly present. The furniture in these spaces is typically lighter weight and easily moveable. In equipping them, behavioral and mental health providers should select furniture appropriate for the unit location and the patient population served there. It’s not uncommon for lighter-weight furniture to be moved from lower-risk areas to higher-risk areas, so care should be taken to be conscious of this and minimize any unnecessary risks.

Stance Behavioral Health offers a wide range of Level 2-compliant furnishings, from seating and tables to bookcases and cabinets. Our Legend, Oasis, Vista II, and Onward product lines offer unweighted seating options with open arms and legs. For high-quality steel and plastic chairs used for seating at tables, our Accent, Jax, and Flo chairs provide a high-end look with practical durability. Our Valet, Carson, Cassia, and Verity lines of upholstered lounge chairs provide a residential feel that is often preferred in Level 2 spaces.

The tables in our Pier line have individual legs at the corners to accommodate a number of uses and activities — helping provide safe surface areas for behavioral health patients in Level 2 spaces. Our Fortress and Liberty lines of laminate casegoods offer storage options like bookcases and cabinets.

Low Supervision, or Level III: These areas are spaces that are not behind self-closing and self-locking doors, where patients may spend time with minimal supervision. Some of these areas include lounges, day rooms, open nurse stations, and corridors where staff are not regularly present.

For the seating in these areas, closed-arm and closed-leg chairs that are weighted or securely fixed are preferred. The Jensen Lounge, Onward Lounge and Bench, and extended-arm Verity lounge chair are all great options for Level III areas. High-quality plastic chairs for use at tables, like our Flo Chair, are also acceptable.

It’s suggested that the tables in these spaces do not have individual legs at the corners. Our Disc Base multi-purpose tables, Flo tables, and a variety of Drum tables work well in these spaces since they have a pedestal instead of legs. They are also weighted for added safety to prevent them from being thrown or stacked. Our Gibraltar line of laminate casegoods offers bookshelves and cabinets for Level III spaces, keeping patients’ needs, safety, and wellness in mind.

Minimal Supervision, or Level IV: These areas are places where patients spend a great deal of time alone with minimal or no supervision, such as patient rooms (semi-private and private) and patient toilets. It’s important for furniture in these areas to be safe, comforting, and secure, minimizing the potential for patient harm. Stance Behavioral Health offers a variety of thoughtful seating, storage and bedding options to fit the needs of patients in these spaces.

Our Flo Chair and Frontier Chair + Desk set give patients a place for rest in the privacy of their own room, while the Frontier Wardrobe and Frontier Cabinet provide safe, secure, and versatile storage options. The Frontier Mattress is designed specifically for behavioral health spaces and helps provide a safe, comfortable place for rest and respite in Level IV areas. 

General Areas, or Level V: These are areas where staff interact with newly admitted patients who present potential unknown risks, or where patients may be in a highly agitated condition. As a result, these areas fall outside the parameters of the environmental risk map and require special considerations for the safety of patients and staff. Level V areas include admission rooms, seclusion rooms, and restraint rooms.

Stance offers a variety of safe, inviting lounge seating for these spaces with its Onward, Jensen, and Verity Lounge Chairs. We also offer high-quality metal seating options like our Legend and Oasis chairs, which can have weight added or can be bolted down to the floor for added security. For the safety of everyone in these areas, we recommend the staff replace their desk chairs with a chair that has smooth, rounded edges and can be bolted to the floor, like our Caliber Chair. For storage and surface needs in these high-risk areas, our Fortress and Liberty cabinets and desks provide weight, security, and durability where it’s needed most.

While patient safety and well-being are always top of mind in everything we do, it’s increasingly important to understand what that means in the different areas of a Behavioral Health facility. The solutions above reflect general recommendations found in the Behavioral Health Design Guide, and none are free of risk. While there are no official guidelines for Behavioral Health facilities, it is up to each facility to determine its level of risk and specify the appropriate furnishings for its needs. To learn more about all of our different furniture options available for Behavioral Health spaces, visit stancebh.com today.

Today’s options for where and how healthcare is delivered continue to evolve, and that means facility planners, architects, and interior designers can collaborate in more ways than ever to create truly unique spaces for care environments. When it comes to specifying furniture for General Healthcare and Behavioral Health facilities, a range of best practices should apply to each category, and help guide decision makers.

From playful pediatric offices to supervised Behavioral Health therapy zones, every aspect of a medical setting should be designed with its specific type of patient, visitor, and care provider in mind. As research continues to surface, our Behavioral Health Interior Design Consultant, Suzanne Fawley, shares a few best practices that differentiate between the two design realms. Below are three key differences between designing for General Healthcare and Behavioral Health settings:

• Room layouts meet standards for broad application in general healthcare, and are personalized for Behavioral Health. All who enter an outpatient specialist’s office or waiting area in a hospital can expect the same options for seating, from the distance between seats to the quality and feel of the actual furniture available to sit in. The furniture and materials are typically carried throughout the facility, often pre-determined by general furniture evaluations that turn into a furniture standards program. That consistency leads to ease in future purchasing and budgetary control. With Behavioral Health, there are no guidelines or “typicals” because all behavioral care environments are different, treating varying levels of crises, and as such, might have varying needs for seating and interaction (or isolation). Because of that, BH spaces should include “spaces within a space,” which features vignettes that are not one-size-fits-all.
   
• Intentional design patterns speak in general healthcare and soothe in Behavioral Health. In a primary care practice or pediatrician’s office, the wall covering might feature multiple colors or patterns that add liveliness to the space, or are used as zoning indicators. Behavioral Health settings, by contrast, should feature soothing, simple, earth-inspired tones that assist relaxation and do not distract or feed anxiety. Stance is proud to offer many high-performance fabrics in soothing tones.
   
• Materials often prioritize aesthetics in general healthcare and performance in Behavioral Health. Doctor’s offices can have their own personalities when it comes to finishes and textures in furniture, whereas in Behavioral Health, we should be mindful of materials prone to picking or tearing, such as popular textural tweeds or laminates often found in general healthcare environments. A few safe, long-lasting material selections for Behavioral Health furniture include Forbo Marmoleum, Corian solid surface, and newer textiles like CF Stinson high-performance fabrics. Proper environment specific specification of materials is most important.
   

Though a much bigger conversation, by keeping these differences in mind, facility planners and interior designers can create General Healthcare and Behavioral Health treatment spaces that support all patients, visitors, and care providers. As a trusted furniture supplier in both industries, Stance will continue to evolve and produce furniture that helps achieve these unique experiences for all.

When it comes to furniture for healthcare, today’s evolving medical settings require something different from room to room. For example, a counseling office might prioritize comfort, while other facilities encounter more at-risk patients, and as a result should emphasize safety and durability. At Stance, we accept the challenge to create products that perform in any environment, from emergency departments (EDs) to therapeutic facilities — and our broad offering of features, textures, and specifications reflect that range.

In recent years, our expertise in Behavioral Health product development specifically has grown alongside rising global demand for mental and Behavioral Health services. And in just the past couple of years of the “COVID era” in particular, this demand has impacted emergency departments. That is at a time when specialized BH facilities might be at capacity, lack the security or protocols to provide support for psychiatric crises, or be otherwise inaccessible to patients. For facility planners, and the healthcare product suppliers like Stance that support them, this uptick in mental and Behavioral Health patient traffic presents a timely opportunity to apply Behavioral Health standards to today’s ERs.

Above all, emergency departments should strive to support the safety and well-being of patients and staff experiencing Behavioral Health treatment. We can help achieve that end with products that are comforting and strong, and placed with intention throughout the environment. However, furniture is just one of several elements that work together to provide a supportive, efficient Behavioral Health intake in emergency settings.

In addition to the products in such a space, facility planners and designers should consider the end-to-end experience of the patients, care providers, and visitors who use the space. Some key considerations include:

• Making intake simple. Behavioral Health patients can become more stressed or agitated when attempting to navigate through confusing healthcare settings. ERs can prevent this by placing clear signage with easy-to-understand directional cues throughout the space, starting from the parking area. In addition, they should have a smooth and subtle system for evaluating BH patients specifically; and if possible, facilities should assign a room for physicians to meet with family members, as well as a designated patient assessment area.
   
• Conjuring calm. In addition to selecting furniture with a soothing aesthetic and comfortable design, emergency departments should consider the other aspects of a BH patient’s sensory experience in the space. Can stark lighting be replaced with something more subtle? Are the flooring patterns or wall decor distracting, or do they invite a sense of rest and relaxation?
   
• Prioritizing dignity. This is a core approach to the way we approach furniture development here at Stance, and it translates well to supporting Behavioral Health environments in emergency rooms as well. When accounting for BH patients in an emergency setting, facilities should “walk the halls” with these patients in mind, examining every aspect of the experience for potential triggers, unpleasant visual encounters, or discomfort, perhaps in the form of furnishings or seating orientation.

By applying these principles to emergency room settings, these departments are well positioned to best serve the growing number of Behavioral Health patients looking for treatment in EDs.

Beyond the ED: Levels of Supervision for Behavioral Health Environments

From intake to therapy to discharge, Behavioral Health treatment transpires in a variety of different settings. We just discussed what the intake and evaluation of such patients can look like in an emergency department setting. Depending on the level of need and severity of the diagnosis, patients require varying levels of supervision in different phases of therapy — and therapy itself can vary from patient to patient, impacting how often the patient interacts with peers, and how much security and observation is needed to keep the patient safe. As such, there are generally five different levels of supervision that Behavioral Healthcare spaces fall into — each of them informing their own different types of settings and corresponding standards for products supporting them. Using these levels as our guide, we can help determine what types of Stance furniture fits best in each type of space.   

• Maximum Supervision, or Level I: These spaces are restricted, staff-only areas where the patient never enters. These could be staff rooms for respite or collaborative spaces for consultation and meetings. Stance Behavioral Health offers a variety of durable and well-designed product lines that can fill out these rooms and fit any aesthetic. Our Accent Chairs, Disc Base Table, Trumpet Base Table, Valet Lounge Chairs, and Verity Lounge Chairs are great for Level 1 spaces and help provide the perfect mix of form and function for the healthcare staff to enjoy.
   
• High Supervision, or Level II: These areas are behind self-closing and self-locking doors where patients are highly supervised. Patients are not to be left alone in these spaces, such as counseling rooms, activity rooms, interview rooms, group rooms and corridors where staff are regularly present. The furniture in these spaces is typically lighter weight, and easily moveable. Behavioral and mental health providers should select furniture appropriate for the patient population served and the location of the unit for which it is intended. It’s not uncommon for lighter-weight furniture to move from lower-risk areas to higher-risk areas, so care should be taken to be conscious of this and minimize any unnecessary risk.
  
  Stance Behavioral Health offers a wide range of Level 2-compliant furnishings, from seating and tables to bookcases and cabinets. Our Legend, Oasis, Vista II, and Onward product lines offer unweighted seating options with open arms and legs. For high-quality steel and plastic chairs used for seating at tables, our Accent, Jax and Flo Chairs provide a high-end look with practical durability. Our Valet, Carson, Cassia and Verity lines of upholstered lounge chairs provide a residential feel that is preferred in Level 2 spaces.
  
  Our Pier line of tables have individual legs at the corners to accommodate a number of uses and activities — helping provide safe surface areas for behavioral health patients in Level 2 spaces. Our Fortress and Liberty lines of laminate casegoods offer storage options like bookcases and cabinets.
   
• Low Supervision, or Level III: These areas are spaces that are not behind self-closing and self-locking doors, where patients may spend time with minimal supervision. Some of these areas include lounges, day rooms, open nurse stations and corridors where staff are not regularly present.
  
  For the seating in these areas, closed arm and closed leg chairs that are weighted or securely fixed are preferred. The Jensen Lounge, Onward Lounge & Bench, and extended-arm Verity lounge chair are all great options for Level III areas. High-quality plastic chairs for use at tables, like our Flo Chair, are also acceptable.
  
  It’s suggested that the tables in these spaces do not have individual legs at the corners. Our Disc Base multi-purpose tables, Flo tables and a variety of Drum tables work well in these spaces since they have a pedestal instead of legs. They are also weighted for added safety to prevent them from being thrown or stacked. Our Gibraltar line of laminate casegoods offer bookshelves and cabinets for Level III spaces, keeping patients’ needs, safety and wellness in mind.
   
• ​Minimal Supervision, or Level IV areas are places where patients spend a great deal of time alone with minimal or no supervision, such as patient rooms (semi-private and private) and patient toilets. It’s important for furniture in these areas to be safe, comforting and secure, minimizing the potential for patient harm. Stance Behavioral Health offers a variety of thoughtful seating and storage bedding options to fit the needs of patients in these spaces.
  
  Our Flo Chair and Frontier Chair + Desk set gives patients a place for rest in the privacy of their own room, while the Frontier two- and three-shelf units provide safe, secure and versatile storage options. The Frontier Mattress is designed specifically for behavioral health spaces and helps provide a safe, comfortable place for rest and respite in Level IV areas. 

• General Area, or Level V: These are areas where staff interact with newly admitted patients who present potential unknown risks, or where patients may be in a highly agitated condition. Due to this fact, these areas fall outside the parameters of the environmental risk map and require special considerations for the safety of patients and staff. Level V areas include admission rooms, seclusion rooms and restraint rooms.
  
  We offer a variety of safe, inviting lounge seating for these spaces with our Onward, Jensen and Verity Lounge Chairs. We also offer high-quality metal seating options like our Legend and Oasis chairs, which can have weight added or be bolted down to the floor for added security. For the safety of everyone in these areas, we recommend the staff replace their desk chairs with a chair that has smooth rounded edges and can be bolted to the floor, like our Caliber Chair. For storage and surface needs in these high-risk areas, our Fortress and Liberty cabinets and desks provide weight, security and durability where it’s needed most.

While patient safety and well-being is always top of mind in everything we do, it’s increasingly important to understand what that means in the different areas of a Behavioral Health facility. The solutions above reflect general recommendations found in the Behavioral Health Design Guide, and none are free of risk. It is up to each facility to determine their level of risk and specify the appropriate furnishings for their needs. To learn more about all of our different furniture options available for Behavioral Health spaces, visit stancebh.com today.

At Stance Healthcare, we make Behavioral Health furniture products that are designed not only to be durable and long-lasting, but also supportive of caring environments that nurture patients back to mental wellness and stability. This commitment to quality has never been more timely than in today’s post-COVID era, given the rise in demand for Mental and Behavioral Health services. In addition to the uptick in need, we’ve also experienced monumental changes to the way care is being delivered – including through telehealth spaces when in-person consultations present risks or are otherwise difficult to access.

With more and more patients taking advantage of virtual therapy sessions, how can Stance continue to support these new types of care environments? Suzanne Fawley, our Behavioral Health Interior Designer, offers the following tips to create comfortable, calming environments for telehealth appointments:

• Go multi-dimensional: “Zoom culture” has mainstreamed meetings that literally put us head-to-head with the other person in the virtual room. This dynamic can be especially intimidating for a patient who is experiencing a crisis or is simply nervous about beginning therapy. An immediate way to alleviate this concern and instead create a welcoming setting for patients is to open up the camera view to show the full room. Ideally, this will reveal a comfortable-looking seating area that includes a chair, such as Stance’s Verity seating, in which patients may imagine themselves relaxing during the session. By taking in more than just a face in their view, patients might more easily envision themselves in an actual therapy session, rather than being unnerved by the up-close shot of a care provider.

• Project humanity and relatability: As we think about other ways to expand outside of this one-dimensional setting, care providers and healthcare designers should consider displaying familiar objects in the space to put patients at ease and instill their confidence in the process they’ve just virtually stepped into. Some ideas for this include displaying aesthetically soothing or recognizable works of art, including paintings; arrangements of flowers and other living plants; or academic or industry insignia.  

• Conjure a sense of calm: We always focus on supporting healthcare spaces like hospitals and therapeutic areas with color, texture, and products that encourage patients, providers, and visitors to relax and feel at ease. In our virtual settings, we should strive to replicate this impact. One example of how to support such a space is selecting soothing tones, such as earth-inspired or spa-like hues, for the walls and furnishings – similar to many of the color palettes we use on Stance’s Behavioral Health website. Another is choosing soft lighting and conducting trial appointments to test the lighting’s display on different devices. Halo lighting is also recommended to bring life to the care provider’s face and remove any shadows.

• Ditch “the desk” and invite the patient to sit in comfort: In the first point, we mentioned showing patient seating in view during a telehealth appointment. Doing this allows patients to envision themselves in the room – and while we’re thinking about that, let’s reframe the way we depict the provider’s seating area, too. Typically, a therapist will sit behind a desk in Behavioral Health settings, but the current trend is leaning toward a more conversational seating arrangement. This may include a settee and lounge chair scenario or multi-use table seating, thanks to more comfortable, yet safe seating options like Stance’s Flo Dining Collection. Approachable seating options to engage at the same level with patients in a supervised in-person or telehealth setting is the goal. We can mimic this virtually by replacing the view of a physician behind a desk with that of a care provider sitting in a relaxed position that invites conversation.

“I find it interesting that, following an era of forced separation in the height of COVID, we are now living in an era dominated by virtual meetings,” says Suzanne. “Adding to the sense of separateness are the virtual backgrounds and the fuzzy filters many people use. And for telehealth appointments especially, this may convey an artificial persona and inhibit connection. But with just a few changes, we have an opportunity in healthcare to rebuild that interpersonal connection by ‘warming up’ our approach to telehealth spaces. When we support a more inviting virtual space, patients can log in and envision themselves taking a seat and becoming comfortable – more like they were there in person.”

By using these tips and working with an experienced healthcare design team, providers can achieve a supportive, trusted space for consultative therapy. We appreciate Suzanne sharing these insights with us. Want to hear more from Suzanne? You can catch her on this topic and more during her upcoming appearance at this year’s Healthcare Design Expo + Conference in San Antonio. Check out her session information here  – and make sure to find the Stance team at our booth and say hello as well!

Partnership continues collaboration between the industry-leading healthcare nonprofit and the award-winning healthcare furniture manufacturer

CHARLOTTE, N.C. – Stance Healthcare, award-winning leader in furniture design and manufacturing for general and Behavioral Healthcare facilities, announces its renewed partnership with The Center for Health Design (CHD) in 2022. As a valued partner to CHD, Stance will sponsor at least two workshops and two webinars, all focusing on Behavioral Health, this year.

The two organizations are a compatible fit, with both CHD and Stance exhibiting leadership and passion for advancing opportunities within the intersection of health and design. CHD is the go-to nonprofit for education that equips today’s professionals to support improved healthcare quality through the built environment. Stance, for its part, launched its Improving Lives by Design brand mission in 2021 – a reflection of the company’s track record producing thoughtful, intuitive furniture for healthcare spaces that encourage healing.

A 501(c)3 nonprofit organization, The Center for Health Design advances best practices and empowers healthcare leaders with quality research that demonstrates the value of design to improve health outcomes, patient experience of care, and provider/staff satisfaction and performance.

“We are looking forward to another year of learning alongside our colleagues at the Center for Health Design,” said Carl Kennedy, Stance Healthcare’s president. “They are an indispensable resource for designers and professionals in the healthcare space, and we are honored to support their informative, impactful programming as a sponsor.”

The partnership’s event programming kicks off March 17 with the Stance-sponsored CHD webinars, Designed for the Mind: Environments for Behavioral Telehealth Delivery and Day in the Life: Innovative Design for Behavioral Health. The first presentation will explore what’s next in post-COVID design considerations for telehealth delivery of Behavioral Health services; the second utilizes a case study to understand the importance of a collaborative design approach inclusive of all perspectives and disciplines – from executives to clinicians.

Those interested in attending the March 17 webinars can learn more and register below:
 

Webinar: Designed for the Mind: Environments for Behavioral Telehealth Delivery
Webinar: Day In the Life: Innovative Design for Behavioral Health

As pioneers in designing furniture for mental and behavioral health, we are proud sponsors of the Center for Health Design’s virtual full-day workshop focused on designing for the next generation of care and care spaces workshop. On September 29th the workshop will begin with a keynote on the State of Practice in Behavioral Health Care and Design, followed by expert panel discussions and case studies. It’s going to be a great day of information and will also include the opportunity to virtually mix and mingle with other attendees.

For more information, or to register for the event, visit

 https://www.healthdesign.org/events/383

In partnership with The Center for Health Design, we’re happy to sponsor 2 free behavioral health educational opportunities at the end of this month.

Webinar 1

Acoustics in Behavioral Health: A Case Study

This webinar will review two behavioral health units, one constructed with standard acoustical ceiling tile panels and one with a new acoustic gypsum wallboard ceiling assembly with noise reducing properties. This session will compare each facilities’ testing results along with security concerns, owner requirements, and possible design solutions for acoustical treatments in healthcare design.

Webinar 2
Nationwide Children’s Hospital and the Continuum of Mental Health Care

The Big Lots Behavioral Health Pavilion at Nationwide Children's Hospital demonstrates a unique and important commitment to comprehensive pediatric behavioral health care. The new building features high caliber architecture and state-of-the-art medical services for which Nationwide Children’s Hospital is known.

This webinar will share the path of this remarkable project from strategic planning through occupancy, with discussion of how the building’s siting and design breaks down the stigma associated with pediatric mental illness.

More information on registration.

Team: Alicia Stanislaw, Service Line Director Psychiatry, Women & Children Administration, Caldwell UNC Health Care; Laura Easton, President/CEO, Caldwell UNC Health Care;

Architect and Interior Design: CPL Charlotte

Furniture: Suzanne Fawley, Behavioral Health Interior Designer, Stance Healthcare

A nature-centered treatment facility nearly ten years in the making is now setting a new standard for therapeutic delivery of mental and Behavioral Health care in the US – and the difference is all in its unique “outside-in”, nature-centered design. From beautiful murals, to generous use of natural light, soft textures, tones, and sight lines,  Jonas Hill Hospital and Clinic, part of Caldwell Memorial Hospital in the UNC Hospital System in rural Lenoir, North Carolina, is a 17,500 square-foot, inpatient-outpatient integrated mental health treatment facility designed to conjure healing from the natural mountain setting that surrounds it. 

“Our patients see the stars at night and the trees and sunshine throughout the daytime,” says Alicia Stanislaw, a lead on the project team as Caldwell UNC Health Care Service Line Director Psychiatry, Women & Children Administration. “Our inpatient unit features 22-foot ceilings and clerestory windows throughout; you feel like you’re in a park, even though you’re inside.”

Background

The vision for a therapeutic-focused space for adult inpatient psychiatric care began nearly a decade ago, when Caldwell UNC Health Care President and CEO Laura Easton began scoping a project that would help provide needed mental health services in an underserved region of the state. The team was originally presented with options to retrofit a floor within an existing hospital – which would limit the facility to the design confines of a general hospital and, from Easton’s perspective, inhibit the specialized quality of care that might otherwise be possible with a separate space dedicated just to mental health treatment.

“At the start of all this, we did hospital site visits to other inpatient psychiatric units to get an idea of the space we could create within somewhere existing. What we found were corner spaces that felt dark, remote, and honestly, sad – they didn’t lend themselves to the therapeutic experience we envisioned, where patients would feel valued and have the best opportunity to heal,” says Stanislaw of the experience.

So Easton, Stanislaw and team began exploring funding options that would support a standalone facility – one that looked and felt nothing like a hospital experience – and finally delivered on that vision this past year with the opening of Jonas Hill Hospital and Clinic.

A unique design emphasis: Nature, light, safety, and freedom

Situated in the heart of the mountainous western North Carolina region, the Jonas Hill facility lets its natural surroundings set the calming tone for all who visit. Starting with floor-to-ceiling windows generously covering the peripheral of the building, soothing views of the outdoor landscape are always within view, and custom murals inspired by the Blue Ridge Mountains cover security vestibule walls that might otherwise be painted plain with disclaimer or warning verbiage in a standard mental health treatment setting.

“When selecting the textile color scheme, the team had supplied a sketch of a mountain mural that was to be painted by a local artist in the group rooms. Along with the natural surroundings of the mountains of NC, the calm of nature became the inspiration,” said Suzanne Fawley, a core team member on the project and Behavioral Health Interior Designer for Stance Healthcare, the exclusive provider of BH furniture for the space.

Nods to nature are also noted in the facility’s furnishings, from “waterfall-like” shower heads in patient bathrooms to soothing colors, including earth tones and spa-like blue-green color schemes, as well as soft, comfortable textures in the Stance Healthcare furniture collections appointed throughout the space. Cassia, Stance’s contemporary style lounge series, provides an unexpected, modern aesthetic in the greeting areas with subtle, Behavioral Health-grade features that make the series both safe and comfortable for guests as soon as they enter.

“Art welcomes our patients so the experience is soothing, private, quiet, and confidential from the start,” said Stanislaw. “We provide ‘whole person care’ here, in a setting that is not institutional, but feels residential – and that starts from the moment patients enter the door.”

Use of natural light is also emphasized throughout Jonas Hill, from the inpatient unit’s wall-length windows to smart glass windows – which can alternate between privacy mode and natural daylight – used in the facility’s two therapy rooms.

Patients and care providers are invited to tangibly experience the outdoors in their daily routine as well. The facility is centered around an enclosed, outdoor “healing commons” space, which features a unique labyrinth area designed for recreational therapy like chalk art, as well as a basketball court. This area provides the dual benefit of increasing regular access to physical activity outdoors – which has been shown to encourage and prolong healing outcomes in treatment – as well as offering care providers the visibility into patient activity that doesn’t feel intrusive or restricting.

“The leadership team was very involved in all furniture and finish materials selections. Their team approach considered the needs of not only the patients and patient support, but also the care providers,” said Fawley. “An example of this is the dual outdoor spaces: One for the patients that included a labyrinth, a space of reflection and other areas for fitness and interaction. Another for the care providers, an interior staff courtyard that serves as a break space – a place for rejuvenation.”

As both an inpatient and outpatient mental health treatment facility, safety considerations are carefully appointed in furniture and space planning appointments throughout the facility. In addition to the “outside-in” vantage point of the interior courtyard, Jonas Hill also features an open-concept nurses station with a circular desk, deliberately designed to prevent patients from directly accessing the inside. Patient bathrooms also feature magnetic, suicide-preventive doors and from the building’s lounge and therapy areas, to its patient bedrooms, Stance Healthcare provided ligature-resistant furniture selections designed to withstand wear and tear and prevent injury.

“Safety, maintenance, and durability were top of mind when selecting furniture pieces. Stance’s award-winning Resilia end tables were selected not only because they are beautiful, but because they will perform for years to come, unlike many laminated-based cylinder style tables on the market,” said Fawley. “And we chose Stance’s rotationally-molded Frontier bed for the patient rooms, as it offers a unique combination of safety coupled with a craftsman-like, comfortable aesthetic.”

Freedom to move unrestricted throughout treatment areas, including during class or individual therapy sessions, is also carefully prioritized in the facility areas. Group therapy classrooms, for example, feature a transparent wall to create privacy when needed. The facility’s meditation room also offers patients their own “private moment” when needed, and features music therapy. Even the medication administration options encourage freedom in unique ways at Jonas Hill: patients are given the option to walk to and from medication doses, empowering them to feel more ownership and humanity in the treatment experience.

“This is a special place oriented around hope and healing. The feedback about working here and experiencing inpatient treatment here has been overwhelmingly positive,” said Stanislaw. “Because this is such a natural and therapeutically soothing environment for healing, patients seem to be motivated to get up and out of bed every day and engage in their treatment.”

Jonas Hill Hospital and Clinic is located at 407 Mulberry Street SW in Lenoir, NC. Learn more about the facility at https://jonashill.org/ and explore Stance Healthcare’s collections for general healthcare and Behavioral Health settings at https://www.stancehealthcare.com/ and https://stancebh.com/. 

Lobby featuring Cassia and Resilia

Patient Room featuring Frontier Bed

Quiet Room featuring Oasis Glider and Resilia 

We were pleased to sponsor the following presentations on BH design subject matter in March. Below are links to access both webinars via the Center for Health Design site, as well as a general description and our recap of key takeaways for each. Thanks for learning with us!

Design Strategies that Reduce Aggression in Child and Adolescent Mental Health Facilities

Webinar description: This webinar shares research and case studies that explore how design can be used as a tool complementing therapeutic protocols to reduce patient stress and aggression on pediatric mental health units. Rather than space acting as a control strategy, a more spatially and socially sensitive environment improves safety by elevating patient dignity. Utilizing a human-centered approach to design, strategies examine both tangible and intangible elements and their relationships to spatial and social density that strengthen staff-patient connections, facilitate innovations, and create a safer place for staff to deliver and children to receive mental health treatment. Access the webinar here.

Stance’s Key Takeaways: 

• Design a space that shapes behaviors – not one that attempts to control them. In facilities that support children and adolescents undergoing mental/Behavioral Health treatment, the goal is to see the environment through a human-centered lens. In response, the goal is to create an inviting space that shapes behaviors, instead of an intimidating, and often less effective one that is more oriented around a behavioral-control strategy.
• Everything in design evokes a response; aim for a space that is inviting, liberating, comforting, therapeutic, approachable, and dignified. Examples include:
  • Reception areas – inviting instead of confrontational
  • Circulation space – liberating instead of scary
  • Bedrooms – comforting instead of cold
  • (Open) nurse stations – approachable instead of alienating
• Achieve these responses by considering the following aspects of the space:
  • Sight lines (open, nothing hidden)
  • Lighting (soft and/or natural)
  • Materials (comforting, not distracting)
  • Noise (create appropriate space for it in a way that does not amplify throughout the facility)
• Understand sensory sensitivities and triggers. Depression, anxiety, and BH disorders tend to also present sensory issues for patients. With an understanding of what to avoid from a visual, auditory, touch, and smell standpoint, we can design a space that calms rather than agitates. Examples include:
  • Removing visual clutter, bright lighting, and distracting patterns and using calming colors with soothing materials
  • Eliminating repetitive sounds and “sonic clutter” and reducing “running” noise like toilet flushing sounds
  • Emphasizing materials and supplies that are comforting to the touch and soothe, including weighted blankets
  • Preventing distracting outdoor smells, including trash, perfumes, cleaning products, etc. from filling a space and instead encourage fresh air and aromatherapy
  • Create “cocooning areas” in educational or treatment zones where children can take a break when feeling overwhelmed
• Prioritize natural light and spacial awareness/movement. The right light and use of space are two hugely impactful ways to design a space that feels overall less institutional. Regarding space: Studies show improved outcomes in patients who experience more physical activity during treatment. To encourage and enable this in your design, always consider balance/movement and spacial awareness of a room, so patients feel a sense of physical freedom vs. restriction. Access to other areas is also an important consideration here – access to landscaped, outdoor areas and patient rooms wrapped around an open space vs. along a narrow corridor are two design choices that can make a big impact. Regarding light, create spaces that offer patients as much access to natural daylight as possible throughout the facility, and always seek out opportunities for windows and soft lighting vs. overhead lights. 

Thank you to webinar presenters, Scott Holmes and Melanie Baumhover for sharing their insights with us!

The Future of the Behavioral Healthcare Care Team Station

Webinar description: As the treatment and model of care for inpatient behavioral health continuously evolves, so too should the physical environment in which care is delivered. With a heightened focus on patient dignity, and staff safety, along with improved technology, now is the time to re-think the future of the behavioral health care team station. Taking advantage of the collective knowledge and expertise in attendance, this webinar will offer interdisciplinary perspectives to evaluate current cutting edge design solutions, help attendees to develop solutions of their own, and inspire further research with the aspiration to transform the future of the care team station in inpatient behavioral health settings. Access the webinar here. 

Stance’s Key Takeaways: 

As patient-centered care continues to be a driving principle of modern healthcare design, Behavioral Health team care stations are one impactful way to continue this evolution. Overall, the goal here is to create a station that puts patients in the center, rather than the previous model that places a closed team station in the middle of a room – which has had the unfortunate effect of instilling an “us vs. them” dynamic. The new approach is designed to put patients at ease and on the same level as their care providers, physically and psychologically. 

How to put patients in the center of a care station zone?

• Encourage interaction between care providers and patients by removing barriers to nurse stations and offering more seating for care providers 
• Allow for therapeutic activities to take place in the care station zone by designing a layout which encourages free conversation and engagement
• Maintain safety, keeping sight lines open

Areas that inspire a more collaborative, inviting space for patients and care providers to engage include:

• The kitchen and kitchen table: Round seating arrangement, eye contact encouraged, appropriate spacing between people, all on same physical level, gathering together feels natural
• Living room: Different options for seating/engaging are available, comfortable seating, option for free movement
• Outdoor/garden spaces: Fresh air and nature naturally put both parties at ease, open space relieves stress and feeling of confinement

Thank you to webinar presenters, Brian Giebink and Stephanie Vito for sharing their insights with us!

Behavioral Health design insights from Stance’s BH Interior Designer, Suzanne Fawley

For interior designers and facility planners, the differences between Behavioral Health (BH) interior design and

general healthcare design must be considered first when beginning a BH project. With a solid understanding of

a project’s why – i.e., why must this project be treated differently than a general healthcare space, and why is a patient, visitor, or care provider going to be here? – we can then explore and apply the multi-faceted criteria needed to successfully design for Behavioral Health, ultimately best serving the end-user.

Comfort Mentally and Comfort Physically: Designing for BH starts by understanding the difference

Why are there differences in BH and general healthcare design? Typically, general healthcare design decisions must consider the masses – the influx of people in and out of medical settings for a variety of reasons. With Behavioral Health design, however, the designer must begin with a deeper and more acute understanding of the characteristics of and differences in two major differentiating points of design emphasis: Comfort Mentally and Comfort Physically. Considering both of these in tandem means prioritizing the dignity of the patient.

Connecting Comfort to Dignity

I participated in a bariatric research study years ago, where I met with over 60 bariatric candidates that averaged 100 pounds over their ideal body weight. For the morbidly obese, most also suffer from depression. One of their stories has resonated with me throughout my career. Emotionally, they shared that the most hurtful of their experiences is when the scale in a typical medical office building would be out in the hallway for all to see. When the scale would not register past 400 pounds, they were asked to go to their local Feed and Seed store to be weighed. In this case, their dignity was not considered at all.

Here is the point: Even the most beautiful, safe, functional facility will not repair the damage that was done emotionally. Though design for general healthcare benefits from this introspection early in the process, in no instance is this more important than when designing for Behavioral Health treatment facilities. Most notably, the subtle nuances of each Behavioral Health facility will define the specific needs for each environment, as one size does not fit all for BH. General healthcare and BH spaces do, however, share the goal of creating a safe, durable and comfortable experience for the patient, caregiver and patient support.

Mapping out your BH project: A Blueprint about Whom?

As a former Interior Design Manager for a large architectural firm, I can attest that interior designers are often given a healthcare project without ever meeting the client or interacting with the end-users of a space, including patients, visitors, and care providers. Pushing out projects can almost be factory-like, just getting the project done. However, understanding the who before you begin a Behavioral Health project is the difference between a “purposefully designed” BH environment and one that is based on what is assumed to be BH appropriate. 

Along these lines, below are a few framework thoughts to consider when planning a Behavioral Health project.

Building Blocks for Designing a BH Space
 

1. First, identify exactly whom the space will serve and understand the “zones of risk”. As referenced earlier, whereas general healthcare for the most part has to be designed for the masses, for Behavioral Health, each facility may have a specific specialty and must be designed per type of mental health facility and type of treatment modalities that will be used to help those with a variety of mental health issues. Find out who will be treated at the facility and what specific requirements should be considered before you begin interior design planning. Equally important is understanding the needs of the “Zones of Risk”. These areas are defined as Public Space that is supervised at all times, Patient Treatment or Consultative Space, and Patient Solitude, where the risk is heightened due to the patient’s alone time. These zones determine the type of furniture required within the facility. Additionally, rotationally molded furniture should not be the go-to for all areas of BH facilities. It is appropriate in some areas of risk, but from a “mentally comfortable” standpoint, it may appear cold and de-emphasize human dignity.
    
2. Develop a team that includes C-suite decision-makers, nurses, care-givers and facility managers. Also consider personal relationships you may have with those who have experienced the need for Mental and Behavioral Healthcare. Behavioral Health projects follow a unique design philosophy from start to finish. To ensure the needs are met from every aspect throughout the process, begin your project by first asking for a meeting with the end-user client, and form the rest of your team from there, drawing especially from the experience of those that work in the environment everyday. Recently, I assisted the Jonas Hill Hospital Team in Lenoir, NC. The project turned out beautifully because the CEO Laura Easton and Alicia Stansilaw, Service Line Director Psychiatry, developed a working team that included the architectural/interior design team as well as myself, specializing in BH furniture and Interior Design. The education that comes from working with people who are knowledgeable and passionately engaged is invaluable.
    
3. Be a great listener – and rely on what works best, not on trends. Find out from the “team” what interior finishes and furniture selections have worked in the past, and what they want to stay away from. If they don’t have a lot of feedback, it’s time to educate yourself and reach out to people in the industry that may be more experienced. Make sure you are thoughtfully selecting finishes and furniture instead of leaning on trends or what is perceived to be the best for BH. This applies to the BH color palette, pattern and artwork as well. Trend does not determine what is best for the facilities. Color and pattern can be soothing, but can also be a trigger for those undergoing Behavioral Health treatment.
    
4. And finally, understand how BH furniture is made differently. While general healthcare furniture can be used in some areas of a BH facility, BH furniture products have specific characteristics that enhance the overall criteria of safety, comfort and long-term durability. This means that BH furniture construction includes tamper-resistant attachments, ligature-resistant design, no sharp corners, weighted options and overall finishes that will withstand abuse. For example, one of the trickiest materials is laminate. Laminate splits easily upon impact, making it easy to pull and strip off to create a weapon to hurt the user or others. The Stance Resilia for BH product was intentionally designed to prevent laminate stripping by using Forbo Marmoleum on the surround. Using laminate in BH must be considered per area or “zones of risk” as referenced above. Again, research and learn about the many differences in the BH environment in order to specify appropriately.

As Stance’s Behavioral Health Interior Designer, what makes my role fun and fulfilling is assisting designers and facility managers. My goal is to encourage them to enjoy the process of Behavioral Health Design by helping them make appropriate selections that lead to facilities that are safe, comfortable, functional and most of all, consider the dignity of the guests.

Learn more about the history and motivations behind Behavioral Health design by attending Suzanne’s IDCEC accredited CEU, Behavioral Health Design: Learning from the Past to Design for the Future, sponsored by Stance Healthcare. Contact [email protected] today to inquire about your group course, worth 1.5 IDCEC credits per participant.