Building better behavioral health care facilities

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The psychiatric medical unit at Mercy Health Saint Mary’s, Grand Rapids, Mich., is serene and welcoming. Daylight fills the open floor plan, which is warmed by natural wood tones, and a large aquarium brightens one wall. “There’s a lot of natural light, a lot of room to move about,” says Carrie Mull, the unit’s clinical services manager.

It’s a marked difference from the previous location, which she describes as having been dark, institutional and crowded.

The new 28-bed unit was created by renovating a traditional racetrack design to fit the physical space with the hospital’s model of care. Mull says, “You have to have the unit design integrated with the unit culture. I’m pretty passionate about saying that you can’t have one without the other.” Prior to the new design, she says the hospital’s care team saw some improvement in patients after establishing a collaborative, non-paternalistic approach to treatment. “But then when we combined it with the unit design, that’s when we really saw the outcomes soar,” she says.

Opening the layout

The new design at Mercy Health Saint Mary’s cuts through the existing unit from east to west to open up the layout, bringing in sunlight and creating a variety of open common spaces, says James M. Hunt, AIA, co-founder, Behavioral Healthcare Architecture Group, a specialty firm with offices in New York and Topeka, Kan. Hunt served as a consultant on the project for lead architecture, engineering and interior design firm Progressive AE, Grand Rapids.

Hunt explains that behavioral health patients generally are encouraged to spend time out of their rooms, participating in activities with other patients. “So the whole layout and flow and use of space is entirely different” from general acute care, where most activity takes place in the patient room, he says.

The open plan at Mercy Health Saint Mary’s keeps staff and patients visible to one another. Instead of a central nurse station, there are built-in benches throughout the unit where nurses can chart using workstations on wheels. “There’s never a time a patient can’t find a nurse,” Mull says. This reduces anxiety on the unit and the risk of patient falls.

Like any health care project, safety was paramount in the design and material selection. The aquarium, for example, is housed behind a protective layer of polycarbonate. The unit as a whole is meant to help people feel comfortable and amenable to treatment. According to Mull, patients experience less frustration in an environment that honors their humanity. “If you design a unit that’s respectful to them, you have a reduction in aggressive behavior,” she says.