Behavioral and mental health (BMH) conditions affect one of five adults in the U.S. each year, and are even more common among patients receiving care for medical conditions. Up to 45% of patients admitted to the hospital for a medical condition or presenting to the emergency department with a minor injury also have a concurrent BMH condition. These BMH comorbidities increase the risk of psychological harm associated with care. Providing these patients with a healing, therapeutic environment should be an important goal for health design. Design interventions aimed at improving the psychological well-being of patients with BMH comorbidities may be more cost-effective than they initially appear, because they can be leveraged to support improved well-being for other populations as well, including other patients, staff, and visitors.
For many years, legal precedents have spoken to the need for quality environments for behavioral health patients. Behavioral health facilities span a wide range of care environments including psychiatric hospitals, psychiatric neuropsychiatric nursing units of general hospitals, facilities for the psychiatric medically infirm, neuropsychiatric units, alcohol and drug addiction retreatment facilities, mental health clinics, day hospitals, and day treatment centers. The wide variety of setting and diagnosis is one of the major impediments to creating evidence based design guidelines for behavioral health facilities.
Behavioral health settings guided by strict safety design measures often result in spaces that are stark, plain, and isolated - potentially exacerbating environmental stressors and escalating already difficult patient situations. Acute care emergency settings have a particular set of challenges as EDs are predicting increased visits from behavioral health patients. Faced with the challenge of designing a behavioral health care setting in the Emergency Department at UnityPoint Health in Rock Island, IL, the project team hypothesized that the creation of a Crisis Stabilization Unit (CSU) with a “Living Room Concept” would provide a higher quality of care to patients while assisting in the staff’s ability to quickly consult and treat a diverse set of patients entering the ED.