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Levels of Supervision for Behavioral Health Environments

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.

 

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