Advancing Behavioral Health Through Design.
Mental health is a subject that can be very personal, and historically has a stigma associated with needing these types of services. It also affects more people than you know – according to a study completed by SAMHSA (1), it is estimated 1 in 5 adults in the U.S. have a clinically significant mental health or substance abuse disorder. The severity of mental health conditions among children and teens has quietly increased significantly in recent years.
As a result of the pandemic, social media represented a major source of human contact people had for a year or more. A level of disengagement from the world and people in their community has become a concern. Research published in The Lancet, stated that teen suicide rates during the pandemic increased and are still higher than pre-pandemic (2). Psychological distress related to subjectively perceived stressful life events and to circumstances that may contribute to suicidal ideation and to suicide are increasingly expressed on social media (3-6).
More emphasis has been placed on understanding how to provide better behavioral health resources to those in need. Behavioral health refers to mental, and health and substance use disorders, life stressors, and crises, and stress-related physical symptoms. Behavioral health care refers to the prevention, diagnosis, and treatment of those conditions. It encompasses a wide range of mental health and substance abuse conditions, including depression, anxiety, bipolar disorder, schizophrenia, substance abuse, and others. Behavioral health also includes the behaviors and habits that promote well-being, such as exercise, healthy eating, and sleep hygiene. It is an integral component of overall health, and research has shown that there is a close relationship between physical and behavioral health.
Given the importance of behavioral health to overall health and well-being, it is critical that individuals have access to quality services and support, including prevention, diagnosis, treatment, and recovery services. The goal is to help individuals manage their behavioral health conditions, promote positive behaviors and habits, and improve their overall well-being.
• Stigma and discrimination. Despite the widespread prevalence of behavioral health disorders, there is still a significant degree of stigma and discrimination associated with these conditions, which discourages individuals from seeking help and support.
• Access to care. Access to care is a major challenge in the field of behavioral health, with many individuals facing barriers to accessing the services they need, such as lack of insurance, limited availability of services in some areas, long wait times, and the lack of providers.
• Quality of care. The quality of behavioral health care can be inconsistent, with some individuals receiving high-quality care while others receive care that is inadequate or even harmful. This is often due to factors such as lack of training and resources, and lack of standardization in care delivery.
• Integration with physical health. Despite the close relationship between physical and behavioral health, there is often a lack of integration between the two, with behavioral health care being delivered in isolation from physical care.
• Funding and resources. The behavioral health system is often underfunded, with limited resources available for research, training, and support. This can limit the ability of the system to respond effectively to the needs of the individuals and communities.
• Workforce shortage. The National Council for Behavioral Health reports that 77% of counties across the country have a severe shortage of trained and qualified behavioral health professionals. This shortage can limit the ability of the system to provide adequate care and support to individuals in need.
These challenges highlight the need for continued efforts to improve the delivery of behavioral health services and support, including the development and implementation of innovative solutions and the strengthening of the behavioral health system.
By understanding the items above, the right design team, in tandem with the care team, can help to positively shift outcomes for patients and families. Design of the physical spaces and creation of healing environments enhances the delivery of care, enhances behavioral well-being, and provides safe and accessible care.
Combining key principals with unique project considerations and application of best practices is the baseline for yielding the best results. Below are a few key design considerations for behavioral health:
• User-centered design. Design should be centered on the needs of specific patient groups, their families, and healthcare providers. Each group will naturally have unique needs and challenges. The built environment should reflect those needs to maximize the potential for healing.
• Safety and security. The safety and security of patients, healthcare providers, and staff should be a primary consideration in the design. Understanding “behavioral health zones” ensures that appropriate measures are put in place to minimize the risk of harm.
• Support for well-being. The design of the environment should support and enhance behavioral well-being, using appropriate colors, lighting, and other environmental features.
By starting first with best practices, the basis for care is established and the design can shift towards innovation. Innovation will be inspired by the latest industry research and learning but also will be strongly influenced by the care model and staff input. Crafting the right environment of care is imperative in behavioral health.
• Natural Daylight: Access to natural light promotes healthy circadian rhythms. Similarly, access to nature via views and outdoor access have a calming effect on patients.
• Care Models: Various care models exist, but many are shifting towards providing customized open and secure staff stations. The patient cohort must allow for this solution to be effective. Staff must always be able to maintain clear and unobstructed site lines from a single point of observation.
• Corridor Styles: Avoiding long, double-loaded “one-way” corridors in patient units is a positive. Racetrack designs allow patients to ambulate more freely while feeling like they are not reaching a terminus, which in turn helps channel nervous energy associated with many illnesses.
• Ideal Layouts: Ideal layouts avoid vertical circulation to access key elements of the healing program such as group spaces or dining halls. As always, in more densely populated spaces, design should seek to limit and mitigate viral spread.
HFG’s specialized healthcare team is on the front edge of healthcare trends and design. We are proactively looking at all aspects of delivery of care and the evidence-based practices that promote health and healing. Our staff puts in the time to become certified specialists and provides design solutions to achieve the best care environment possible.
For nearly three decades and thousands of completed healthcare projects we have refined a comprehensive process to guide you through your next pursuit. We can assist you in all aspects of healthcare planning and design, ensuring your building or space is the most effective tool in delivering world-class healthcare.
For more information, contact John Adams 316.262.2500 x102
(1) Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health (HHS Publication No. SMA 18-5068, NSDUH Series H-53). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www. samhsa.gov/data/
(2) Goto R, Okubo Y, Skokauskas N. Reasons and trends in youth’s suicide rates during the COVID-19 pandemic. The Lancet Regional Health – Western Pacific. 2022;27.
(3) Elayan S, Sykora M, Shankardass K, Robertson C, Feick R, Shaughnessy K. The Stresscapes Ontology System: Detecting Measuring Stress on Social Media. ECSM-2020 - 7th Eur Conf Soc Media, Larnaca, Cyprus. (2020).
(4) Kumar M, Dredze M, Coppersmith G, De Choudhury M. Detecting Changes in Suicide Content Manifested in Social Media Following Celebrity Suicides. In: the 26th ACM Conference. ACM Press (2015). Available online at: http://dl.acm.org/citation.cfm?doid=2700171.2791026 (accessed March 31, 2022). doi: 10.1145/2700171.2791026
(5) Carlyle KE, Guidry JPD, Williams K, Tabaac A, Perrin PB. Suicide conversations on InstagramTM: contagion or caring? J Commun Healthc. (2018) 11:12–8. doi: 10.1080/17538068.2018.1436500
(6) Tadesse MM, Lin H, Xu B, Yang L. Detection of suicide ideation in social media forums using deep learning. Algorithms. (2019) 13:7. doi: 10.3390/a13010007