From Sterile to Serene: How Dunaway's Design is Humanizing Behavioral Health Care

FORT WORTH, Texas, April 10, 2024 /PRNewswire/ -- The stars at night may be big and bright in the Lonestar state, but deep in the heart of Texas - 36.8% of adults reported symptoms of anxiety and depressive disorder, compared to 32.3% of adults in the U.S., and 61% of those Texas residents in need of mental health treatment are not receiving any. Why is that?

As the Texas State of Mind reports, "Even though over three-quarters of Texans say they have a close friend or family member who has experienced a mental health issue, nine in 10 say it's harder to talk about mental health than a physical disorder." Furthermore, 88% acknowledge that the true epidemic facing Texans is not mental health but the stigma surrounding it.

As a result, healthcare systems are realizing the importance of design - enlisting the help of professional design services to address aging facilities and ensure that the next generation of behavioral health facilities prioritizes the well-being and comfort of patients, staff, and the community. Dunaway, a multidisciplinary planning, design, and engineering firm, has a long history of delivering comprehensive solutions to healthcare clients throughout Texas. In this article, we speak to one of Dunaway's design professionals, Senior Discipline Lead and Associate Principal, Anita Beard, PLA, ASLA to learn more about how modern behavioral health facilities are being designed to reduce stigma and prioritize comfort for those who need it the most.

Design considerations for patient populations include:

Plants and Natural Materials: It is important that all patient types feel close to nature. While we typically refrain from having plants inside these facilities, outdoor plants and living materials can help to de-institutionalize what might be a cold environment, and aid in making patients feel inspired and comfortable. However, Anita notes, "It is important to ensure they are safe, maintainable, and not a tool for harm at any point. For example, we do not specify plants that may attract bees, cause stomach upset or rash, or produce a spike or thorn."

Adolescent and Pediatric Patients: When it comes to adolescent and pediatric patients, designing for different ability levels is crucial. Care for children exists on a spectrum, just as it does with adults. Providing activities for more acute and autonomous patients is vital in their treatment and care. As Anita notes, "This can be done by incorporating inclusive features, such as accessible musical instruments and sensory panels, which allow for freedom of play and a pleasant exercise in creativity."

Adult and Geriatric Patients: Adult and geriatric patients also need a balance of calm respite and activity space. Where you have independent play areas in the younger units, modern spaces in adult and geriatric units may have a small nook for reading, observing art in the landscape, or an intentional view into the adjacent landscape. The addition of playful colors to surface materials (I.e., stained, or patterned concrete, poured-in-place rubber) or site furniture also helps enhance and activate the space. Exploring these material combinations, in collaboration with interior designers, can aid in wayfinding, and bring a sense of whimsy without creating triggers or negative thoughts.

According to NAMI (National Alliance on Mental Illness), 3,347,000 adults in Texas have a mental health condition. In February 2021, 43.4% of adults in Texas reported symptoms of anxiety or depression -26.4% of who were unable to get the counseling or therapy needed. According to the Bureau of Labor Statistics, the need for behavioral health is not slowing down anytime soon - projecting that it will grow 22% by 2031. As the need for staff increases, tailored amenities contributing to reduced staff stress and absenteeism are becoming essential.

Specific design interventions for behavioral health staff include:

Adaptable Site Furniture: Gone are the hard, cold chairs one would expect to find in a behavioral health facility. Loungers in the sun and dining tables with moveable chairs give staff the options to have different experiences - to either be alone or socialize. In the staff-designated spaces, furnishings should be resilient while delivering comfort and healing to those providing care.

Staff Respite Areas: Outdoor courtyards throughout the design of modern behavioral health centers should be designated for staff use only. As Anita notes, "These staff courtyards differ from patient courtyards and usually include a program of small dining and seating areas, elongated and uninterrupted views of nature, and a mix of textures (both hardscape and softscape)." They can also be placed strategically - allowing patients to have a partial view of green space without being able to see back to the staff area - providing privacy for staff while presenting something of visual interest to the patients.

Lighting: Artificial light brightens dark spaces and ensures safety for staff and patients. Having adequate light is also vital for face recognition throughout these centers. Soft lighting in exterior staff spaces provides security while allowing for views of the night sky, minimizing light bleed into patient areas.

No live plant material indoors: "Mental health professionals are busy caring for people," explains Beard. This is why the interior staff areas we design are intentionally free of live plants, resulting in an inside area that is maintenance-free and maintainable in the short and long term for the Client." Though it is encouraged to refrain from living plants indoors, it is also vital to work closely with architectural design partners to make sure the indoor clinical spaces take as many advantages to connect to outdoor green spaces as possible.

The face of healthcare is changing - for the better. Through evidence-based design, tailored amenities transform even the starkest of spaces - creating a feeling of biophilia for all who enter these facilities. Coined by the Harvard naturalist Dr. Edward O. Wilson, the term 'biophilia' describes humanity's "innate instinct to connect with nature and other living beings." Thanks in part to thoughtful planning and an eye for detail, the design details, plantings, and artistic elements featured in modern behavioral health settings go far beyond pure aesthetics to provide something even more important - a reminder to those within them that with proper care they too can bloom.

Anita Beard, PLA, ASLA is an Associate Principal and Landscape Architect at Dunaway, a multidisciplinary planning, design, and engineering firm with a long history of delivering comprehensive solutions to healthcare clients throughout Texas.

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