Behavioral Health—Strategic Design Innovations that Improve Treatment Outcomes, Safety and the Bottom Line Workshop

Stephen Verderber, Arch.D, NCARB, DP-ACSA, Professor & Director, Centre for Architecture, Design+Health Innovations, University of Toronto
Opening Keynote: "Architecture for Behavioural Health: International Trends in Therapeutic Design"

By the year 2030, the United Nations estimates the world’s population will reach 8.5 billion, a condition posing unprecedented pressure on the provision of essential healthcare services. More than sixty-six percent will reside in urban environments, a reality intensified by the deleterious consequences of global climate change and mass population migration. This will result in a critical need for expanded mental health care support services and treatment environments. The deleterious mental health consequences of sea level rise, intense weather events, drought and associated famine, wars, and over forestation will magnify. Urban stress, induced by the pressures of everyday life will result in chronic psychological diagnoses requiring a new generation of inpatient treatment hospitals and outpatient mental health counselling centres, as the unmet need for treatment of this type is likely to be acute. Will governmental and private sector care providers and philanthropic foundations rise to the challenge? In response, a comprehensive international survey was undertaken on recent trends and best facility design practices in therapeutic/psychiatric architectural and landscape environments pertaining to the diagnosis and treatment of behavioural and substance abuse disorders. This work included a design case study on the reinvention of a psychiatric hospital campus in Canada and its struggle to redevelop its existing physical infrastructure. This is followed by a typology of evidence-based design considerations-guidelines for researchers, designers, builders, administrators, direct care providers, administrators, patients and their families/significant others, community-based mental health advocacy groups, and health policy specialists.  Specific issues addressed include nurse workstation hybridity, emerging view simulation technologies, environmental stewardship, biophilic site planning strategies, and functional and aesthetic deinstitutionalization strategies.

Michele Cohen, M.Arch, OAA, MRAIC, LEED, Principal, NORR
"Safety for All: Keeping Patients and Staff Safe in Behavioral Health"

Although mental health awareness is on the rise funding for Outpatient Mental Health programs is being cut across North America. At a time when healthcare systems capacity to deliver mental health services is shrinking the need is rising.  The result of the loss of these programs is a marked increase in patients presenting at emergency departments who require treatment for mental health issues. This unique patient population has very specific needs and require environments that are safe for both the patient as well as the staff.  Healthcare organizations are creating specialized crisis beds both in and outside of the ED and short stay units. Recently there has been lots of discussion around the best physical layouts for these areas within the emergency department but very little about the actual construction and materials best suited for theses environments.  Design standards have yet to be developed. This session will review 2 case studies of built behavioral health areas within existing emergency department. We will provide an in-depth look at the materials, products and systems developed to provide safe and durable environments with special attention given to anti- ligature and durability.

Scott Holmes, RA, ACHA, LEED® AP, Principal, BWBR
"Realizing the Benefits of a Human-Centered Approach in Behavioral Health"
While an entrance can open to a world of effective mental health care for patients, the door, itself, can set a tone that either creates fear or comfort. Such non-linear connections between patient and the environment has the power to build a relationship that improves care delivery by meeting patients where they are and keeping them at the center of care. This session explores the strategies and cost implications of a human-centered approach to design that leverages tangible and intangible elements to strengthen staff-patient connections, facilitate innovations, and create a safer place for behavioral health care.

Rick Dahl, AIA, Principal & Architect, BWBR 
"Realizing the Benefits of a Human-Centered Approach in Behavioral Health"
While an entrance can open to a world of effective mental health care for patients, the door, itself, can set a tone that either creates fear or comfort. Such non-linear connections between patient and the environment has the power to build a relationship that improves care delivery by meeting patients where they are and keeping them at the center of care. This session explores the strategies and cost implications of a human-centered approach to design that leverages tangible and intangible elements to strengthen staff-patient connections, facilitate innovations, and create a safer place for behavioral health care.

David Sine, DrBE, ARM, CSP, CPHRM, Ethics Fellow, American Medical Association
"Behavior Health Design: An Update"

Mitch Goplen, FMA, EDAC, Vice President Facility Services, Billings Clinic
"The Billings Clinic Psychiatric Stabilization Unit"

Lyle M. Seavy, PhD, MS, LCPC, NCC, CCMHC, Director of Psychiatric Services, Billings Clinic
"The Billings Clinic Psychiatric Stabilization Unit"

Ric Heldt, AIA, ACHA, ASAI, COO | Principal, AE Design
"The Billings Clinic Psychiatric Stabilization Unit"