It should come as no surprise that the built environment has a vital impact on the human psyche. In healthcare projects, we place a great deal of importance on the effects surroundings can have on the well-being of the patient, both mentally and physically. Access to natural light can influence length of stays and various colors can affect different outcomes in patients. The built environment can have both adverse and positive effects on mental well-being. This applies especially to individuals with behavioral health diagnoses, who often spend hours and days in surroundings most people would not want to spend more than a few minutes.
When we think of behavioral health facilities, visions of highly sterile, institutional spaces are what typically come to mind. Time and again, materials and design for safety and durability are where building priorities are placed. While safety and durability are important, other components such as spatial quality and a therapeutic atmosphere may be overlooked. The fabric of our built environment is made of many threads, each of which have the ability to influence how we feel within a space.
The layout of a space or wayfinding in a building can alter our sense of control. If the space consists of many inner rooms or corridors that twist and turn, the user can feel disoriented or anxious. With a behavioral health diagnosis, this feeling can be significantly amplified. A simple plan with a clear wayfinding path gives the user a sense of freedom and control within the space, because they are always aware of how to get back to the exterior.
Access to nature, such as windows or skylights can help to orient building occupants as well as provide a therapeutic atmosphere. If windows or skylights are not feasible, even perceived access to natural light, such as cove lighting to mimic a skylight or etched glazing can be beneficial to how users experience a space.
Sensory stimulation is especially important. In the same way hospital patients find it difficult to rest and recuperate in a loud or chaotic nursing unit, behavioral health clients can find it difficult to be at ease in settings that arouse too many senses. As designers, we can transform details of spatial settings to elicit a calming and palliative atmosphere. Being able to regulate noise and light within a space offers the users a small sense of power over their environment, which can help to calm individuals who may be overstimulated.
Recently, Stanley Beaman & Sears had the opportunity to be involved in the design and construction administration for renovation projects of two public facilities owned by the state of Georgia and managed by the Department of Behavioral Health and Developmental Disabilities (DBHDD): Georgia Regional Hospital in Atlanta and West Central Georgia Regional Hospital in Columbus. An environment, based on the elements described above, was of the utmost priority for both projects – an environment to foster a sense of humanity and dignity in the building’s occupants.
Each campus was in need of a revamped treatment mall facility. Treatment malls are classroom-type buildings in which services are offered to consumers who have been admitted to the campus inpatient units. Staff members provide small and large group classes on a wide-variety of topics including stress management, relaxation skills, conversation skills, recovery planning, and recreation, among other things.
Increasingly, treatment malls operate on the recovery concept, as opposed to the medical concept of rehabilitation. The recovery concept focuses on patients’ strengths, goals, skills, and their ability to achieve personal goals, rather than targeting each individual’s deficiencies. A primary feature of this method is a focus on self-directed treatment. The patient is engaged and participates in his or her own treatment and care. The treatment mall is instrumental in this concept as it provides spaces that accommodate adult mental health therapies, both individual and group therapy.
A key benefit to the treatment mall model is that patients are able to leave their residential units for treatment. This allows for greater interaction and provides a change of scenery, both of which can play a positive role in enhancing a patient’s morale and motivation to improve their mental health. Participating in such a model of care also helps to prepare the patient for a more active role in their surroundings upon transition back into the community.
These two projects were modest renovations, but even what seem like superficial changes such as finishes and furniture can have a far-reaching effect on patients.
The Georgia Regional Hospital Treatment Mall renovation, in Decatur, Georgia was completed in September of 2014. This project includes the complete interior renovation of an existing 1-story brick veneer building that is approximately 17,000 SF. The building previously served as an inpatient unit and was completely renovated to provide classroom and therapy space in an academic, rather than institutional atmosphere.
A primary desire of the Clinicians and Therapists was to provide an uplifting atmosphere that could inspire confidence and self-assurance in the clients as they work towards assimilating back into society. The layout of the space places a focus on thresholds and a circular path, indicative of the fact that treatment is not a linear process; an individual may cross the threshold into recovery many times. The project also includes a feature wall that places an emphasis on how our minds influence who and what we can become. Highlighted on the wall are Ludwig Von Beethoven and John Nash, both of whom felt they could not have achieved such creativity had their minds functioned ‘normally’. Their ingenuity in both music and mathematics respectively, came because of, not in spite of their behavioral diagnoses.
The West Central Georgia Regional Hospital Treatment Mall renovation, in Columbus, Georgia was completed in June of 2015. This project includes 16,000 interior square feet of renovation to an existing one-story building. The building houses the gymnasium for the campus, around which classrooms were added. The existing gymnasium now functions as a common room and eating space during class sessions.
The treatment mall at West Central serves both Adult Mental Health and Forensic populations; therefore a high priority was placed on maintaining security while affording the individuals the dignity of a serene academic setting. Both Treatment Mall projects provided an opportunity to develop design focused on tangible aspects such safety and durability, as well as sensitivity to the physical and emotional impact the built environment has on the behavioral health population.
– by Rebecca Karlowicz