Hospital news

Progress in mental health facilities

By Charles A. Michelson, AIA, ACHA, LEED AP

Healthcare workers around the world have long realized the additional need for behavioral healthcare providers and clinics. With the ongoing pandemic, a significant layer of stress has been added to the public, on top of the general polarization we are seeing across the country. The results of stress, anxiety, and other mood disorders reverberate on the daily news with needless attacks and crimes that are incomprehensible under most circumstances.

The need for more mental health care providers and new facilities has never been greater. The increased need for this type of health care now consists of long wait times for those who are in critical need. Waits of up to three months for psychologists and longer for psychiatrists are now the norm, not the exception.

Existing mental health facilities quickly became overcrowded and outdated. Modern facilities must respond to this as well as new philosophies and medications in the treatment of mental illness, such as psychedelic therapy which are guided experiences prescribed by clinicians. Careful consideration should also be given to the acoustics of the behavioral health clinic, as emotional conversation can be loud, maudlin, and sometimes hostile in the therapy setting.

The design of behavioral health facilities must also consider caregivers. Safety features should be built into the design and appropriate barriers should be in place to protect caregivers and other staff in the event of a potentially violent situation. Caregivers need to feel safe in their center, knowing that they will not be trapped.

Additionally, the design of a behavioral health center should have the appropriate spaces, as much natural light as possible, and outdoor spaces for caregivers to decompress and prepare for their next client.

As with any other healthcare modality, changes and advancements require appropriately designed facilities to better serve our community, requiring updated facilities from those designed in the past. Telemedicine in mental health is also a component of improving treatments. Better ambulatory care facilities should be provided that offer a variety of treatment options under one roof. From one-on-one sessions, group therapy activity rooms, to medical or drug therapies, the design of new facilities will enhance care through a warm and soothing environment.

As an architect, I have always believed that good design can contribute to positive clinical outcomes. Our mental health outpatient facilities should be warm and welcoming spaces, conveying a sense of respect for the clients of the facility. The interiors of these facilities must allow for the safety and comfortable movement of people without bottlenecks. As much natural light as possible should also be incorporated into the space, as the benefits of all biophilic architecture have been well documented.

Charles Michelson is president of Saltz Michelson Architects. For more information, visit

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