Magazine article Behavioral Healthcare Executive

Design Practices Contribute to Stabilization Unit Safety: Providing Safety and Dignity in Facility Design Can Be Beneficial to the Healing Process

Magazine article Behavioral Healthcare Executive

Design Practices Contribute to Stabilization Unit Safety: Providing Safety and Dignity in Facility Design Can Be Beneficial to the Healing Process

Article excerpt

Designing a mental health facility requires special considerations to protect the safety and dignity of patients in a fragile psychiatric state as well as ensure the security of staff. Previously, designs focused on safety restricted freedom, further stigmatizing patients. Today, we recognize that providing both safety and dignity are not only possible but beneficial to the healing process.


The demand for inpatient behavioral health beds often exceeds the available supply, leaving patients who are in crisis in emergency departments for up to several days while awaiting placement. Emergency department crisis rooms are designed for immediate intervention and safe holding rather than treatment and recovery and can exacerbate an at-risk patient's situation. One innovative way some hospitals meet the demand for behavioral health beds is by creating an inpatient stabilization unit (ISU).

The ISU provides the opportunity to begin evaluation and treatment of arriving behavioral health patients immediately. Where possible, the patient's condition is stabilized within the unit, and the patient is released back to their community. If continued treatment is required, patients can be transitioned into a behavioral health unit within the hospital. An ISU offers a therapeutic environment for patients experiencing a behavioral health crisis, rather than just a safe holding space.

The design of facilities for behavioral health has traditionally focused on maintaining the safety of patients and caregivers. While safety remains an important design criteria, the opportunity exists to go well beyond this single focus to provide behavioral health environments which focus not only on function but also on the recovery process.

The need for a safe environment begins before admission. An enclosed sally port offers a secure entry area for patients arriving via ambulance or police cruiser not only preventing elopement but shielding patients in crisis from passersby during a trying and vulnerable point. Privacy continues with a confidential admitting unit. A corridor from admissions into the hospital provides a clean, direct circulation path to an ISU or existing unit in the hospital as well as staff offices. Patients receive a private and dignified experience, while staff benefit from an improved workflow and circulation.

The use of building information modeling (BIM), or 3D technology, can help communicate the design to all stakeholders early in the design process, allowing management and staff to fully visualize the finished project before construction begins. Design layout may be revised in real-time. The advantages of using BIM during the design process include reducing the number of costly changes during construction, enhancing communication and coordination between project team members, and reducing project delays.


In recent years, research has shown the therapeutic benefits of incorporating elements found in nature--air, water and earth--into the built environment to create a more comfortable setting that is soothing to the soul and promotes healing. By incorporating these healing design concepts, which are now expected in the design of most medical facilities, behavioral health centers can provide safe and efficient delivery of care while also conveying expectations of healing and recovery. Making a space feel less institutional reduces anxiety and contributes to a comfortable healing environment. Thoughtful color choices in soft palettes of earthy beiges, blues and greens and the use of natural materials, such as wood, generate a calming, soothing effect. …

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