Architecture and design goals for behavioral healthcare facilities typically have the same universal thread: create a space that is safe, calm and inviting for patients and their families. But, the way those goals are achieved can vary greatly based on where a project is located.
Geography is often a key factor in shaping the design of a behavioral healthcare facility and can influence design choices such as color, materials, lighting or structural elements of a building. A behavioral healthcare facility in a rainy suburb of Seattle may look nothing like a facility in a hot desert like Arizona.
Architects say design is influenced by the physical attributes of a location, like its climate, topography and site features, but is also influenced by the social attributes of an area as well, like its culture, industry, design style or history.
It’s important to honor and incorporate the physical and social aspects of a region into the design or remodel of a behavioral healthcare space, allowing the cues help to ground the patient and create a sense of authenticity.
“You want to try to keep it real because when you start to manipulate an environment in an artificial way, it reinforces a disconnect. And we’re trying to establish a connection with the patient,” says Rick Dahl, AIA, a principal at BWBR, an architecture firm with offices in St. Paul, Minnesota and Madison, WI.
While architects say every region has its own unique climate and culture, there are some trends more common in the North and others more likely in South.
Design trends in the North
1. Place an emphasis on lighting
Long winters are a regular part of life for residents in the upper half of the country, making proper lighting an essential aspect of design. Dahl says incorporating natural light whenever possible is important in northern regions of the country, but it might not always be enough. Artificial light may also be needed to supplement the natural light in a building.
At the Swedish Medical Center’s Inpatient Behavioral Health Unit near Seattle, ZGF Architects created a lighting solution in the common area and corridors of the facility designed to support a patient’s circadian rhythm—that is, the body’s natural sleep and wake response to night and daytime. The lighting quality changes throughout the day to mimic the color and intensity of the sun and can help combat the short days in the winter at the 22-bed facility.
“This lighting can help counteract that, although it doesn’t necessarily in the wintertime mimic the solar cycle outside of the window, it enhances what is absent," says Ed Clark, LEEP AP BD+C, the sustainable designer on the project.
2. Select colors and design features that reflect the region
Interior designer Kari Thorsen, LEED AP, says the colors within a facility should reflect the colors outside the building. This was the case for the Swedish Medical Center's inpatient behavioral health unit, which incorporated greys, blues and creams for finishings throughout the renovation.
The corridors of the building were designed so it feels like patients are walking through a forest, with changes in color and scale along the walls of the hallways. The common area is designed so that it feels like patients are walking into a clearing, with brighter and lighter features and mosaic tiles along cylindrical columns.
“Why we really like to get back to nature and especially local nature is that people usually live in an area they want to be in, and it feels like home for them,” Thorsen says.
3. Bring fitness indoors
When temperatures drop, so do the opportunities for outdoor exercise. Architects and interior designers say one way to ensure patients can continue to enjoy the benefits of physical exercise throughout the year is by incorporating space for exercise inside.
For instance, the Swedish Medical Center’s inpatient behavioral health unit has an indoor exercise room with bikes—a common fitness hobby in the Pacific Northwest. In the upper Midwest, Dahl says the University of Minnesota Masonic Children's Hospital chose hard surface floors for its corridors so that its young patients could use small seated scooters to ride on for large-muscle exercise. Due to the site’s narrow footprint and inability to have outdoor space, teams had to get creative.
But exercise isn’t always restricted to the indoors. CannonDesign was able to help its client in Northern Ontario find a way to embrace its cold temperatures by building an outdoor hockey rink for patients to use.
4. Add a vestibule or mudroom
To accommodate freezing temperatures and snowy days, Dahl says many of the projects his firm has worked on in the Northern Midwest have incorporated vestibules. These transitional areas provide a way to prevent cold air from entering the building or allowing heat to escape on days when temperatures drop.
Dahl says a mudroom was even incorporated into the pediatric wing at Avera Behavioral Health in South Dakota, connecting the outdoor play space with the building. Patients were able to stop in the mudroom, which was set up with lockers where residents could place their things or discard muddy or snowy boots, before entering the rest of the building.
Design trends in the South
1. Be prepared for natural disasters
Climate is often a big influence in building design and construction and although safety is a priority in all regions of the country, special considerations are often necessary in parts of the country where natural disasters are more common. For instance, Dahl says that buildings near the Gulf Coast or Atlantic Ocean need to be designed to withstand the strong winds of a hurricane or tropical storm, while those states in the southern Midwest may need to be designed with tornado shelters.
2. Use outdoor space
Warmer temperatures often translate to more opportunities to be outside and architects say many projects located in warm climates often take advantage of the outdoor space on a site.
For instance, Tim Rommel, AIA, MRAIC, principal and lead of CannonDesign’s behavioral health design studio, says the outdoor environment was made a central component of the design at the Arizona State Hospital.
“There’s no main corridor system in the facility,” he says. “It’s all outdoors, but because of sun, we created a shade structure over the main circulation system.”
Even on days where temperatures top 100 degrees, Rommel says it’s pleasant outside because of the shade and low humidity associated with the area.
3. Limit solar gain
Natural light is an important aspect of most projects, but in warmer climates allowing natural light into a building can also increase the building’s internal temperature. For that reason, limiting the amount of solar gain that enters a building is an important consideration for buildings in hot climates.
To negate the effects of the sun, CannonDesign used a specially designed metal screen when designing a county behavioral health hospital in Tuscon, Ariz., that stands off the face of the building to collect and dissipate heat.
Dane Danielson, director of educational projects for the architecture firm Gould Turner Group PC, says it’s also possible to apply a different coating to southern facing windows to either prohibit or attract low-angle sunlight.
4. Adopt a warm palette
Much like facilities in the North, architects and designers say buildings in the south should also reflect their environment. This translates to the use of a warmer color palette in many projects. For instance, Rommel says CannonDesign used more buff colors in its design of the Arizona State Hospital to mimic the desert landscape.
Some might argue that there are East and West design considerations that facility owners might identify for specific projects as well. Ideally, the visual cues in any environment should be subtle enough to integrate with the architecture but obvious enough to have impact on the attitude and energy of a space.
Jill Sederstrom is a freelance writer based in Kansas City