Bringing integrated healthcare into the inpatient environment is essential to help keep safe the 20% of all adults who are currently on a mental health medication. The Joint Commission has reported that 25% of inpatient suicides do not occur on psychiatric units. Designing for suicide resistance must be extended to all inpatient rooms and toilets.
FGI_CommonMistakesPsychiatricHospitals_1505This white paper was originally published by the American Institute of Architects in their Academy of Architecture for Health Journal in 2009. We continue to be asked to help hospitals with newly constructed facilities correct the mistakes that were designed into their buildings. This UPDATE provides insights into the current best practices in Psychiatric Hospital Design and is published by the Facility Guidelines Institute (FGI). Download Free, CLICK HERE
Preliminary meetings involving architects, psychiatric hospital management, and unit staff members often result in decisions that crystallize into critical details of facility design very early in the planning process. These can be very difficult, if not impossible, to change later on.
During these sessions, it is not unusual for psychiatric hospital staff to state any number of time-honored platitudes that, through sheer repetition, have come to be “known” as unchallengeable facts of psychiatric facility design. Typically, staff comes to “know” such things because they have heard them during their education and throughout their professional lives in the facilities in which they have worked. But using such “common knowledge” while designing new psychiatric facilities can be very problematic and very costly.
Former baseball great Satchel Paige explained the problem best when he said,
“It‘s not what you don’t know that will hurt you; it’s what you ‘know’ that just ain’t so.”
And so it is, I find, with the design of psychiatric hospitals. The intelligent and highly educated people who are brought together in preliminary design meetings frequently fail to consider whether what they have come to “know” about psychiatric facility design is now (or ever was) valid. Let’s look at the data available from some credible sources to see if some of these “known” statements are actually correct.
Behavioral Healthcare recently presented top experts with a design challenge, asking for advice on what facility upgrades they might prioritize if they had a budget of only $50,000. While it’s easy to make improvements with $1 million in hand, not all centers have that luxury.
The term “Integrated Care” is being used a lot these days, but little is being said about the physical environment in which this will take place. Perhaps we need to start defining what Integrated Healthcare Design will be developed.
Current thinking among some leaders in the field of behavioral health care design is now that curtains of all types should be eliminated from the patient environment. This includes curtains at windows, showers and privacy curtains in multi-patient rooms.
BH Magazine May/June 2014
DOORS AND HARDWARE MAGAZINE – March 2014
Doors and Hardware March 2014Behavioral Healthcare facilities present a number of very unique challenges for door hardware specifications. Studies by the American Psychiatric Association have indicated that there are 1,500 psychiatric inpatient suicides in the US alone in 2003. The Joint Commission reports have shown that 75% of inpatient suicides on psychiatric units are by “hanging” and that the majority of those involve doors. In addition, patients can barricade in-swinging doors to delay staff entrance to rooms and allow time for undesirable activities to take place.