Improving Lives by Design: Serving Behavioral Health Patients in the Emergency Room + Understanding BH Levels of Supervision

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 today.



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