Healthcare Design - June/July 2020 - 21

The great room at
Kaiser Fremont Medical
Center's first inpatient
medical/psychiatric
unit, designed by TEF
Design, can accommodate a variety of
simultaneous uses for
staff and patients. The
room features extensive
glazing to support access to fresh air and the
outdoors via a private,
secure courtyard.

projects ranging from inpatient hospitals to crisis units to pediatric specialty
centers. Some of these facilities are designed to reflect new patient-centered approaches to mental health services while
others aim to help divert behavioral health
patients from emergency departments. Tony
Breitlow, senior project manager and associate
at Eppstein Uhen Architects (EUA; Milwaukee), says a lot of work on the inpatient side is
focused on updating facilities with a focus on
aesthetics, while on the outpatient side he's
seeing more new construction as the need for
care grows. "There's an opportunity to get rid
of the white box and sterility of the past and
make it more comforting and warmer," he says.
Additionally, as there's been a reduction in
stigma around the topic of mental health and
growing recognition of the importance of early
diagnosis and treatment, facilities are no longer isolated in rural or suburban settings but
given more prominent locations. "You certainly see a more general discussion in the public
about mental health, and it's not as much in
the shadows anymore," Breitlow says. "We're
also seeing that in built form, too. Behavioral

health departments and treatment areas don't have to be buried in the
basement or down the hallway behind an ominous door."
The state of Indiana recently completed its first mental hospital in
more than 50 years, opening the NeuroDiagnostic Institute and Advanced Treatment Center (NDI) in Indianapolis in March 2019. The
159-bed facility, designed by BSA LifeStructures, is located on a tight
footprint on an existing medical campus, driving the building's vertical
design and a new connector to the existing hospital. Other recent examples include Kaiser Permanente Northern California's renovation of an
existing medical/surgical unit at the Kaiser Fremont Medical Center in
Fremont, Calif., into its first inpatient medical/psychiatric unit.
While most early behavioral health projects were focused on adult populations, Scott Holmes, principal at BWBR (St. Paul, Minn.), says within
the last five to seven years, he's seen an increase in both child and adolescent facility projects that are geared to different age groups. "Traditionally, anything you saw related to pediatrics was all the same, but you
really need to break down that population because there are big differences physically, mentally, and emotionally between a 6-year-old and a
17-year-old," he says.
For example, BWBR renovated and expanded UnityPoint HealthMeriter Child & Adolescent Psychiatry Program in Madison, Wis., which
provides both inpatient and outpatient community-based psychiatric
services for children ages 6-18, to include a 10-bed children's unit with
common support spaces and a 12-bed adolescent unit with another eight
beds converted to serve tweens exclusively.
With mental illness and substance use disorders involved in one out
of every eight emergency department visits by a U.S. adult in 2007, according to a Statistical Brief by the Agency for Healthcare Research and
Quality, there's growing discussion about the continuum of care for behavioral health patients and increased recognition that there needs to be
crisis resources for mental health patients in communities, as well. McMurray acknowledges that strides have been made, with some EDs having dedicated psychiatrists on staff and adding observation units with ligature-resistant design features. "But we're not anywhere close to where
we need to be across the country with treating crisis care and figuring out
what that looks like outside the hospital," she says.
On the clinical side, Pitts says that means figuring out how to operationalize models around early detection and treatment that minimize
the number of people who end up in an ED. "There are people all over the
country working on how to solve this problem of the overstretched emergency department," with models looking at community intervention
combined with crisis centers as part of an ED, co-located with an ED, or
as a separate facility, he says. (To read more about behavioral health crisis
stabilization units, read "Decompression Space" on page 33.)
M O D E R N - D AY E N V I R O N M E N T S

While in the past, sterile facility designs reinforced a stigma associated
with mental health treatment, today's light-filled, open, and welcoming environments are sending a different message, says Justin Brooks,
principal at ZGF (Portland, Ore.). "It tells patients that they're welcome here and that this is just part of normal healthcare treatment.
And it also makes patients feel more inclined to come back and finish
their treatment, which leads to better outcomes," he says.
As such, conversations with clients are moving beyond the importance of safety and ligature-resistant devices to how patients interact
within the space and what design strategies can help reduce agitation and

J U N E /J U LY 2 0 2 0

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Healthcare Design - June/July 2020

Table of Contents for the Digital Edition of Healthcare Design - June/July 2020

Healthcare Design - June/july 2020
Editorial
Show Talk
Homeward Bound
Take Five With Tammy Felker
First Look
Into the Light
Difference Maker
Planning and Operations Decompression Space
Staff Spaces Building Alignment
Productspotlight Behavioral Health
Product Spotlight Artwork
The Center
Face Time
Healthcare Design - June/July 2020 - Healthcare Design - June/july 2020
Healthcare Design - June/July 2020 - Cover2
Healthcare Design - June/July 2020 - 1
Healthcare Design - June/July 2020 - 2
Healthcare Design - June/July 2020 - 3
Healthcare Design - June/July 2020 - 4
Healthcare Design - June/July 2020 - 5
Healthcare Design - June/July 2020 - 6
Healthcare Design - June/July 2020 - 7
Healthcare Design - June/July 2020 - 8
Healthcare Design - June/July 2020 - Editorial
Healthcare Design - June/July 2020 - Show Talk
Healthcare Design - June/July 2020 - 11
Healthcare Design - June/July 2020 - 12
Healthcare Design - June/July 2020 - Homeward Bound
Healthcare Design - June/July 2020 - 14
Healthcare Design - June/July 2020 - 15
Healthcare Design - June/July 2020 - First Look
Healthcare Design - June/July 2020 - 17
Healthcare Design - June/July 2020 - Into the Light
Healthcare Design - June/July 2020 - 19
Healthcare Design - June/July 2020 - 20
Healthcare Design - June/July 2020 - 21
Healthcare Design - June/July 2020 - 22
Healthcare Design - June/July 2020 - 23
Healthcare Design - June/July 2020 - 24
Healthcare Design - June/July 2020 - 25
Healthcare Design - June/July 2020 - Difference Maker
Healthcare Design - June/July 2020 - 27
Healthcare Design - June/July 2020 - 28
Healthcare Design - June/July 2020 - 29
Healthcare Design - June/July 2020 - 30
Healthcare Design - June/July 2020 - 31
Healthcare Design - June/July 2020 - 32
Healthcare Design - June/July 2020 - Planning and Operations Decompression Space
Healthcare Design - June/July 2020 - 34
Healthcare Design - June/July 2020 - 35
Healthcare Design - June/July 2020 - Staff Spaces Building Alignment
Healthcare Design - June/July 2020 - 37
Healthcare Design - June/July 2020 - Productspotlight Behavioral Health
Healthcare Design - June/July 2020 - 39
Healthcare Design - June/July 2020 - 40
Healthcare Design - June/July 2020 - 41
Healthcare Design - June/July 2020 - Product Spotlight Artwork
Healthcare Design - June/July 2020 - 43
Healthcare Design - June/July 2020 - 44
Healthcare Design - June/July 2020 - 45
Healthcare Design - June/July 2020 - 46
Healthcare Design - June/July 2020 - The Center
Healthcare Design - June/July 2020 - Face Time
Healthcare Design - June/July 2020 - Cover3
Healthcare Design - June/July 2020 - Cover4
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