By Eric M. Kern and Antoinette Ayres
As understanding of the wellness benefits of nature and community outreach evolves, best practices in behavioral health facility design offer new ways to enrich the lives of patients and employees. The patients in these buildings are among society’s most vulnerable, and staff members face heightened levels of workplace safety and stress.
The good news is that proper design considerations can instill hope and improve the quality of life by humanizing and destigmatizing these environments. Architecture that blurs the lines between the building and nature while welcoming members of the community is shifting the paradigm for today’s behavioral health facilities.

Accessing The Outdoors
All clinicians know the therapeutic benefits of natural light, fresh air, and access to the outdoors. The problem is that balancing the desire to see nature with patient and staff safety in mind can lead to compromised architectural solutions.
In the past, outdoor spaces were designed in areas that were remote from the patient living units, so patients had limited options to go outdoors. When they did go outside, they were often taken in groups to large courtyards because there were no private areas for independent choosing.
Modern design trends solve this problem. Building owners, designers, and clinicians now understand the need for easily accessible outdoor space. When combined with the benefits of reduced vertical circulation, they are opting for one-or two-story design schemes that encourage connecting with nature.
For example, the newly constructed Nixon Forensic Center in Fulton, MO, is a single-story building that offers patients plentiful access to the outside through several outdoor access points to multiple courtyards and grounds options.

Similarly, at Saint Elizabeths Hospital in Washington, DC, patients can access individual courtyards and other types of outdoor amenities throughout the day. There are also large outdoor spaces reserved for group sessions and recreation.
Bringing Nature Inside
Bringing nature into behavioral health centers is the focus of modern interior design. Today’s hospitals provide ample natural light in both corridors and patient spaces. Many rooms feature skylights that allow residents to regulate circadian rhythms. These designs are a vast improvement over the dark corridors of older facilities.
The key to creating a familiar and home-like atmosphere for patients is by intentionally using natural materials with distinct colors and textures. For example, wood finishes on floors and walls can create calm and homey spaces.
Patients are often at risk of isolation and disconnection from the outside world, which can undermine the quality of life and impede recovery. Health care designers who integrate these biophilic strategies into their work will help promote healing.
At Nixon Forensic Center, the corridor promenade simulates a walk in the park, with full- height glazing spilling sunlight onto the interior passageway. These panoramic windows offer ample views of outdoor courtyards and recreation areas.

The facility’s designers also embraced humans’ innate tendency to seek connections with nature. There are nature-inspired images at the entrance to each program area, and natural light enhances the design aesthetic while promoting safety. Staff work in open-plan administrative areas that are adjacent to windows to help reinforce natural circadian rhythms.
But patients and employees aren’t the only people who need access to nature inside hospitals. The community as a whole can also benefit from biophilic design.
Engaging The Community
Historically, mental institutions had a social stigma symbolized by a gated building at the top of a hill. But today’s facilities aim to tell a different story by inviting the community to come inside.
Brightly lit lobbies and open facades convey that one is entering a therapeutic place where positive changes occur. Designers want to show that these institutions support staff and uplift patients by offering quality care that reflects the values of the community.

At Nixon Forensic Center, the front of the building offers an unobstructed view of the light-filled lobby and adjacent auditorium. The entrance also features a colored reflective glass art screen of a dragonfly wing, which symbolizes the hospital’s mission of recovery.
It’s also vital for the public to celebrate the progress of these facilities, and mental health in general. Nixon Forensic Center has a “history wall” in its lobby, displaying artifacts that tell the story of the hospital and the rural community it serves.
Similarly, a small museum in the lobby of Saint Elizabeths recaps 170 years of psychiatric care and offers a glimpse at the innovative therapies to come.
Successful modern behavioral health facilities allow patients and staff to live and learn in a park-like atmosphere that uses biophilic design approaches. These hospitals are open and welcoming to the community, showing the public that mental health is no longer a scary or distant discipline. Designers who take these principles to heart can help all parties live healthy, more vibrant lives, and contribute to the hope and recovery of the patients they serve.
Eric M. Kern, AIA, is Sr. Project Director, Behavioral Health, Principal, EYP Architecture & Engineering. Antoinette Ayres is Lead Interior Designer, Associate Principal, EYP Architecture & Engineering
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