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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.