FOSTERING RECOVERY:
Defining and Creating Therapeutic Environments in Inpatient Behavioral Health Facilities for Adolescents
Ashley Colquhoun Thesis Committee Meeting # 4 12/5/2013
INTRODUCTION
1
The intent of this study is to investigate how architecture be used to design therapeutic environments in inpatient behavioral healthcare settings for adolescents.
2
This study began with an investigation into the current state and trends within: -architecture -therapeutic environments - inpatient behavioral health facilities - healthcare settings for adolescents
3
This investigation has lead to the development of a series of design principles that will synthesize the information researched to formulate attainable, simple strategies to address the needs of this environment.
4
These design principles will then be applied to a design project that will apply the conclusions drawn from the research phase of investigation in order to create a comprehensive inpatient behavioral health facility for adolescents.
DESIGN HIERARCHY
FOSTER RECOVERY
MISSION
VISION
GOALS
GUIDELINES
Mission
RESPECT INDIVIDUAL DIGNITY
ALLOW PATIENTS TO HAVE A SENSE OF CONTROL
ORIENT FUNCTIONS AROUND CENTRAL GREENSPACE
Vision
ENCOURAGE PLACE ATTACHMENT
FILTER LIGHT ACCORDING TO FUNCTION
Goals
CONNECT TO ENVIRONMENT
PROVIDE ACCESS TO GREENSPACE
ELIMINATE THE CORRIDOR
BRING NATURAL DAYLIGHT INTO INTERIOR SPACES
CREATE CLEAR VIEWS TO/ FROM STAFF WORK AREAS
Guidelines
[RE]INTEGRATE INTO SOCIETY
PROVIDE OPPORTUNITIES FOR INTERPERSONAL INTERACTIONS
PROVIDE GROUP AND PRIVATE PATIENT ROOMS
Program
CREATE SPACE FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
Site
CREATE SPATIAL CLARITY THROUGHOUT THE FACILITY
USE “SAFE” MATERIALS AND FURNISHING
Bibliography
PATIENT DESCRIPTION:
1
Age
2
Other Characteristics: ambulant needing minor supervision continent able to have some degree of campus freedom
12-18 years old
referral
community health program
inpatient facility
community health program community
3
Place in Care Delivery Process
4
Substance Abuse Treatment Admissions criminal justice system self or individual school other community alcohol/drug abuse care provider other healthcare provider
“The Village System� http://blog.samhsa.gov/2012/03/23/defintion-of-recovery-updated/
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PATIENT DESCRIPTION:
1
Reasons for Receiving Care: felt depressed thoughts about killing self/tried to kill self breaking rules or “acting out” felt very afraid or tense problems at home/family trouble controlling anger problems at school some other reason eating problems problems with people other than family/friends problems with friends got into physical fights other diagnosed mental/neurological disorder
Breaking rules or “acting out” Eating problems Problems at home/family
Felt depressed
Felt very afraid or tense
Problems with people other than family/friends Problems at school
Problems with friends
Some other reason
Trouble controlling anger Thoughts about killing self or tried to kill self
Got into physical fights Other diagnosed mental/neurological disorder
Adolescent Mental Health: Service Settings and Reasons for Receiving Care, 2009
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PATIENT DESCRIPTION: TYPICAL AGE RANGES FOR PRESENTATION OF SELECTED DISORDERS
1
Diagnoses: disruptive behaviour mood/anxiety disorder substance abuse adult type psychosis
AGE [YEARS] DISORDER
1
2
3
4
5
6
7
8
9
10 11
12 13 14 15
16 17 18
ATTACHMENT PERVASIVE DEVELOPMENTAL DISORDERS DISRUPTIVE BEHAVIOR MOOD/ ANXIETY DISORDER SUBSTANCE ABUSE ADULT TYPE PSYCHOSIS *NOTE THAT THESE AGES OF ONSET AND TERMINATION HAVE WIDE VARIATIONS AND ARE SIGNIFICANTLY INFLUENCED BY EXPOSURE TO RISK FACTORS AND DIFFICULT CIRCUMSTANCES
“Mental Health Policy”
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PATIENT DESCRIPTION:
1
Psychosocial Interventions and Psychopharmacology:
EVIDENCE BASED PSYCHOSOCIAL INTERVENTIONS
DIAGNOSIS
PSYCHOPHARMACOLOGY
ANXIETY
ANTIDEPRESSANT MEDICATION
COGNITIVE BEHAVIORAL THERAPY TREATMENT FOSTER CARE EXPOSURE THERAPY FUNCTIONAL FAMILY THERAPY MODELING THERAPY
BIPOLAR DISORDER
MOOD STABILIZERS
MULTISYSTEMIC THERAPY PARENT TRAINING
CONDUCT DISORDER/OPPOSITIONAL DEFIANT DISORDER [CD/ODD]
BRIEF STRATEGIC FAMILY THERAPY ANGER COPING THERAPY
ANTIPSYCHOTIC MEDICATION DEPRESSION
MENTORING BEHAVIORAL THERAPY
SCHIZOPHRENIA
OTHER MEDICATION
RELAXATION THERAPY INTERPERSONAL THERAPY FAMILY EDUCATION AND SUPPORT
“Choosing the Right Treatment: What Families Need to Know about Evidence-Based Practices”, NAMI, 2007
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PATIENT DESCRIPTION:
1
2
“
During an episode of psychosis, especially psychosis associated with paranoia and so-called “command hallucinations”, the risk of violence is increased. People with SMI are up to three times more likely to be violent and when associated with substance abuse disorders, the risk may increase much further. But, mental illness contributes very little to the overall rate of violence in the community. Most people with SMI are not violent, and most violent acts are not committed by people with SMI. In fact, people with SMI are actually at higher risk of being victims of violence than perpetrators. Teplin et al found that those with SMI are 11 times more likely to be victims of violent crime than the general population.
“
Persons Persons without severe with severe mental illness mental illness
LIKELIHOOD OF BEING VIOLENT
LIKELIHOOD OF BEING VICTIMS OF VIOLENCE
http://www.nimh.nih.gov/about/director/2011/understanding-severe-mental-illness.shtml
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PATIENT DESCRIPTION
1
“
The most common form of violence associated with mental illness is not against others, but rather, against oneself. In 2007, the most recent year for which we have statistics, there were almost 35,000 suicides, nearly twice the rate of homicides. Suicide is the 10th leading cause of death in the United States. Although it is not possible to know what prompted every suicide, it is safe to say that unrecognized, untreated mental illness is a leading culprit.
“
http://www.nimh.nih.gov/about/director/2011/understanding-severe-mental-illness.shtml
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
FINANCIAL CONSIDERATIONS: CURRENT COVERAGE FOR MENTAL HEALTH SERVICES
25% of uninsured adults have a mental health condition, substance use disorder, or both No coverage for Mental Illness No coverage for Mental Illness
NoAbuse coverage for Substance Abuse No coverage for Substance Uninsured with Mental Illness Uninsured with Mental Illness Group/Individual
Group/Individual
Medicaid
Medicaid
Medicare
Medicare
Other
Other
Uninsured
Uninsured
PRIV AT EL Y
PRIV ATE LY
4
ES IC
95% of those with small group market coverage have substance abuse and mental health benefits
NTAL ILLNESS E ME VER SE ITH VIORAL HEALTH EHA S E RB RV FO
3
NTAL ILLNESS E ME VER SE ITH VIORAL HEALTH EHA S E RB RV FO
2
ES IC
1
UNIN UNIN SU RE SU D RE 33% of those currently covered have no coverage for substance abuse W THOUT COV I D W D U O E T H W T disorders C I E R O VER R AG DW RE AG NSU E U S EI N I 20% have no coverage for mental health services
“Affordable Care Act will expand mental health and substance use disorder benefits and parity protections for 62 million Americans”, ASPE Research Brief, 2013
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
FINANCIAL CONSIDERATIONS: CURRENT FACILITY PLANS FOR PAYMENT ASSISTANCE
Offer some form of financial assistance No free treatment, sliding fee scale Partial free treatment, no sliding fee scale Partial free treatment, sliding fee scale Completely free treatment No free treatment, no sliding fee scale http://www.samhsa.gov/samhsanewsletter/Volume_18_Number_2/FreeTreatmentAvailable_chart.aspx
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
FINANCIAL CONSIDERATIONS: THE AFFORDABLE CARE ACT
2
3
“Essential Benefits” Packages: 60-90% cost sharing Covers mental health and addictions treatment and rehabilitation services Expanded Medicaid Eligibility States required to cover up to 133% of poverty Includes mental health and addiction treatment Encouraging Innovation Grants to... professional and paraprofessional training in child and adolescent mental health Grants to develop innovative interventions for depression
MAXIMUM COST SHARING
FUTURE MEDICAID COVERAGE
TY RA PIC NG AL E
1
POVERTY MINIMUM COST SHARING
“Essential Health Benefits: Comparing benefits in small group products and state and federal employee plans”, ASPE Research Brief, 2011 “Affordable Care Act will expand mental health and substance use disorder benefits and parity protections for 62 million Americans”, ASPE Research Brief, 2013 “The Affordable Care Act: How it helps individuals and families living with mental illness” NAMI, 2011
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
DESIGN HIERARCHY
FOSTER RECOVERY
MISSION
VISION
GOALS
GUIDELINES
RESPECT INDIVIDUAL DIGNITY
ALLOW PATIENTS TO HAVE A SENSE OF CONTROL
ORIENT FUNCTIONS AROUND CENTRAL GREENSPACE
ENCOURAGE PLACE ATTACHMENT
FILTER LIGHT ACCORDING TO FUNCTION
http://www2.med.psu.edu/fitnesscenter/training/personal-healing-yoga/
Mission
Vision
Goals
CONNECT TO ENVIRONMENT
PROVIDE ACCESS TO GREENSPACE
ELIMINATE THE CORRIDOR
[RE]INTEGRATE INTO SOCIETY
BRING NATURAL DAYLIGHT INTO INTERIOR SPACES
CREATE CLEAR VIEWS TO/ FROM STAFF WORK AREAS
PROVIDE GROUP AND PRIVATE PATIENT ROOMS
http://tmacfitness.com/wp-content/uploads/2013/04/Beauty-of-naturerandom-4884759-1280-800.jpg
Guidelines
PROVIDE OPPORTUNITIES FOR INTERPERSONAL INTERACTIONS
Program
CREATE SPACE FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
CREATE SPATIAL CLARITY THROUGHOUT THE FACILITY
USE “SAFE” MATERIALS AND FURNISHING
http://tcpermaculture.com/site/wp-content/uploads/2013/09/community.jpg
Site
Bibliography
RECOVERY
WHAT
WHY
foster
transitive verb: to help (something) grow or develop
recovery
noun: the act or process of returning to a normal state after a period of difficulty
HEALTH
Transforming Mental Healthcare in America: The Federal Action Agenda:
community inpatient community referral health program facility health program
when mental illnesses can be prevented or cured, a future when mental illnesses are detected early, and a future when everyone with a mental illness at any stage of life has access to effective treatment and supports-essentials for living, working, learning, and participating fully in the community.
HOME
inpa facili
COMMUNITY community
“
“
community program We envision a future when everyone with a mental illnesshealth can recover, a future referral
PURPOSE
http://www.merriam-webster.com/ “SAMHSA’s Working Definition of Recovery”, 2009 http://www.samhsa.gov/federalactionagenda/NFC_intro.aspx
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
RECOVERY: TWELVE GUIDING PRINCIPLES
has many pathways is self-directed and empowering is holistic has cultural dimensions exists on a continuum of improved health and wellness is supported by peers and allies emerges from hope and gratitude involves a process of healing and self-redefinition addresses discrimination and trandscends shamecommunity and stigma referral invloves [re]joining and [re]building a life in the community health program is a reality
RECOVERY
1
HEALTH community inpatient community referral health program facility health program
HOME
inpa facili
COMMUNITY community
PURPOSE “SAMHSA’s Working Definition of Recovery”, 2009
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
BEST PRACTICE: THE WRAPAROUND MODEL 1
Individualized Approach
2
Strengths-Based Perspective
3
Persistence and Commitment to Success
4
Outcome-Based Planning
5
Family Voice and Choice in Wraparound
6
Team Support
7
Natural Supports
8
Collaboration
9
Community-Based Services and Access
10
Individual Family/Team Community
Culturally Competent Planning http://www.earlychildhoodassociates.com/wraparound-services/ “Wraparound Basics”, National Wraparound Institute, 2013
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
BEST PRACTICE: LEVELS OF INTERACTION: THE VILLAGE SYSTEM 1
1
The Village System:
Relationship with environment
Relationship with self
Relationship with other patients, staff
Relationship with community
1 2 3
2
GROUP BASIC LIVING UNIT
LODGE BASIC TREATMENT UNIT
GROUP BASIC LIVING UNIT
VILLAGE
LODGE BASIC TREATMENT UNIT
3
VILLAGE
BASIC ADMINISTRATION AND THERAPY UNIT
BASIC ADMINISTRATION AND THERAPY UNIT
VILLAGE CENTER VILLAGE CENTER
1. MEN 1. MENTALLY INCOMPETENT
Vision
2. RES
HOME HOME COMMUNITY
Bryan Hall (Village A), Columbia, SC
Mission
2. RESPONSE TO TREATMENT 3. RESPONSIBILITY TESTING
3. RES
COMMUNITY
Goals
Guidelines
Program
The Village System
Site
Bibliography
BEST PRACTICE: LEVELS OF INTERACTION: HOME>NEIGHBORHOOD>DOWNTOWN MODEL 1
Focuses on the ability to function within the community at three primary levels: Home: Nuclear family Neighborhood: Small groups Downtown: Large groups
The Village System
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
DESIGN HIERARCHY
FOSTER RECOVERY
MISSION
VISION
GOALS
GUIDELINES
Mission
RESPECT INDIVIDUAL DIGNITY
ALLOW PATIENTS TO HAVE A SENSE OF CONTROL
ORIENT FUNCTIONS AROUND CENTRAL GREENSPACE
Vision
ENCOURAGE PLACE ATTACHMENT
FILTER LIGHT ACCORDING TO FUNCTION
Goals
CONNECT TO ENVIRONMENT
PROVIDE ACCESS TO GREENSPACE
ELIMINATE THE CORRIDOR
BRING NATURAL DAYLIGHT INTO INTERIOR SPACES
CREATE CLEAR VIEWS TO/ FROM STAFF WORK AREAS
Guidelines
[RE]INTEGRATE INTO SOCIETY
PROVIDE OPPORTUNITIES FOR INTERPERSONAL INTERACTIONS
PROVIDE GROUP AND PRIVATE PATIENT ROOMS
Program
CREATE SPACE FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
Site
CREATE SPATIAL CLARITY THROUGHOUT THE FACILITY
USE “SAFE” MATERIALS AND FURNISHING
Bibliography
DESIGN GOALS: WHAT CREATES A THERAPEUTIC ENVIRONMENT?
“
Shepley, 1995
sense of control
s cultural dimensions
sts on a continuum of improved health and
“
Throughout the interview process, adolescents mentioned a desire for options in seating to fit desired activities such as group interaction, solitude, or watching television.
merges from hope and gratitude
Huffcutt, 2010
place attachment
olves addressing discrimination and transcending tigma
supported by allies and peers
olves (re)joining and (re)building a life in the
“
Warm, welcoming, and familiar environments often promote a sense of calm in patients and enhance their connection to their surroundings (often referred to as “place attachment”), rather than feel detached from or in opposition to it.
“
olves a process of healing and self-redefinition
Karlin, 2010
a reality
Mission
“
holistic
Vision
Goals
Guidelines
USE SAFE MATERIALS AND FURNISHING
LIGHT IN THERAPY SPACES
AROUND CENTRAL GREENSPACE
VIEWS TO/ FROM STAFF WORK AREAS
ELIMINA CORR
Eliminate t
“
Spatial gestures like a strategically located grand stair, open-ended corridors with views to pocket gardens, and an upturned roof element constitute intentional architectural elements that affirm the notion of lifting the spirits and instilling hope.
greenspace
Crea
Maximi
Nanda, 2009
“ “
Natural light aids performance of tasks, helps manage circadian rhythm, affects mood and perception, enables chemical reactions within the body
daylight
Clustered seating allows for conversation with adequate personal space and promotes socialization
Provide li
Provide educational space for all
Joseph, 2006
“
olves a personal recognition of the need for ransformation
Transitional zones without territorial definition, such as hallways and entries, are sites of a significant number of negative behaviors
PROVIDE GROUP AND PRIVATE PATIENT ROOMS
“
self-directed and empowering
“
spatial clarity
ny pathways to recovery
SPACE IN DAYTIME ACTIVITY AREAS
“
GUIDELINES
Maximi
Create a variety of scale in building form interpersonal interactions
levels of in
Provide central g
Gabb, 1992
Program
Site
Bibliography
CASE STUDY: MAP PROJECT NAME
Mission
1
Bessboro House Child & Adult Psychiatric Unit
2
Center for Prevention and Rehabilitation
3
Residential Care Unit
4
Lesotho Child Counselling Unit
5
Morris Village
6
Nye Vardheim Helsecente
7
STARS Sub-Acute Adolescent Treatment Facility
8
The Village
9
Worcester Recovery Center and Hospital
10
Ferndene Mental Health
11
Building #20
6 1
10
2 3
9
7
11 5
8
4
Vision
Goals
Guidelines
Program
Site
Bibliography
PROJECT NAME
LOCATION
ARCHITECT
Bessboro House Child & Adult Psychiatric Unit
Cork, Ireland
Mccullough Mulvin Architects
2
Center for Prevention and Rehabilitation
Vlaardingen, Netherlands
EGM Architects
3
Residential Care Unit
Hokkaido, Japan
Sou Fujimoto Architects
4
Lesotho Child Counselling Unit
Mazenod, Lesotho
5
Morris Village Nye Vardheim Helsecente
CASE STUDIES: 1 BREAKDOWN
6
Mission
YEAR COMPLETE
NO. SERVICES OF BEDS OFFERED 20
Inpatient-Psychiatry- All Ages
36
Inpatient-Substance Abuse- Adults
2006
20
Inpatient Psychiatry
Article 25
2008
20
Inpatient Behavioral Health-Child & Adolescent
Columbia, USA
Freeman Major
1975
Bergen, Norway
NORD Architects, 3RW Architects
competition
2011
Inpatient Substance Abuse- All Ages 50
7
STARS Sub-Acute Adolescent San Leandro, USA Treatment Facility
8
The Village
Beer Sheba, Israel
PRAUD
2013
0
9
Worcester Recovery Center and Hospital
Worcester, USA
architecture +
2012
320
10
Ferndene Mental Health
Prudhoe, UK
medical architecture
2011
40
11
Building #20
Columbus, USA
Stanley Beaman & Sears
2014
0
Vision
Goals
The Design Partnership
Guidelines
BUILDING FORM
Nursing Home, Primary Care, Behavioral Health Inpatient Behavioral Health-Adolescent
Program
Outpatient Day CareAdults Inpatient Behavioral Health- Long Term Adult, Adolescent, Forensic Inpatient Mental HealthAdolescent Inpatient Behavioral Health- Adult, Forensic, Group Therapy Spaces
Site
Bibliography
DESIGN HIERARCHY
FOSTER RECOVERY
MISSION
VISION
GOALS
GUIDELINES
Mission
RESPECT INDIVIDUAL DIGNITY
ALLOW PATIENTS TO HAVE A SENSE OF CONTROL
ORIENT FUNCTIONS AROUND CENTRAL GREENSPACE
Vision
ENCOURAGE PLACE ATTACHMENT
FILTER LIGHT ACCORDING TO FUNCTION
Goals
CONNECT TO ENVIRONMENT
PROVIDE ACCESS TO GREENSPACE
ELIMINATE THE CORRIDOR
BRING NATURAL DAYLIGHT INTO INTERIOR SPACES
CREATE CLEAR VIEWS TO/ FROM STAFF WORK AREAS
Guidelines
[RE]INTEGRATE INTO SOCIETY
PROVIDE OPPORTUNITIES FOR INTERPERSONAL INTERACTIONS
PROVIDE GROUP AND PRIVATE PATIENT ROOMS
Program
CREATE SPACE FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
Site
CREATE SPATIAL CLARITY THROUGHOUT THE FACILITY
USE “SAFE” MATERIALS AND FURNISHING
Bibliography
ORIENT FUNCTIONS AROUND A CENTRAL GREENSPACE
WHAT
WHY
A centralized open and accessible greenspace provides not only a space for physical activity and interaction with nature, but also brings daylight into the core of the design.
“views to nature create a positive distraction from the difficulties of treatments/procedures”
Akridge, 2005 “natural light aids performance of tasks, helps manage circadian rhythm, affects mood and perception, enables chemical reactions within the body” Joseph, 2006 “Improving physical well being may also well being lead to improved psychological well being and is generally accepted that physical activity may have positive effects on mood and anxiety.” Strohle, 2008
WHEN/ WHERE
Center of building design, can be used for wayfinding, improved visibility, and positive distraction. Included but not limited to medium-high level of activity. NYE VARDHEIM HELSECENTE, NORD ARCHITECTS, 3RW ARCHITECTS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
ORIENT FUNCTIONS AROUND A CENTRAL GREENSPACE
LESOTHO TREATMENT CENTER ARTICLE 25
Mission
Vision
STARS SUB-ACUTE CHILD AND ADOLESCENT TREATMENT CENTER, THE DESIGN PARTNERSHIP
Goals
Guidelines
Program
Site
Bibliography
PROVIDE DAYLIGHT ACCORDING TO SPACE FUNCTION WHAT
WHY
Choosing when and to what extent the light should be filtered allows for control of visibility both into and out of spaces according to the functions occuring within the space.
“Adolescents desire private space.”
Gulak, 1991
“Available and designated areas for privacy are necessary. Although bedrooms may be classified as designated private spaces, residents are often not allowed free access to bedrooms due to safety concerns.” Hunt, 2013 “natural light aids performance of tasks, helps manage circadian rhythm, affects mood and perception, enables chemical reactions within the body” Joseph, 2006
WHEN/ WHERE
Private spaces have indirect and/or filtered light. Primary circulation and major gathering spaces should have maximum exposure to daylight. BESSBORO HOUSE MCCULLOUGH MULVIN ARCHITECTS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PROVIDE DAYLIGHT ACCORDING TO SPACE FUNCTION
FERNDENE MENTAL HEALTH MEDICAL ARCHITECTURE
ADAMSVILLE REGIONAL HEALTH CENTER STANLEY BEAMAN & SEARS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
ELIMINATE THE CORRIDOR
WHAT
WHY
Primary circulation should be simplified to create direct pathways without awkward transitional spaces preventing poor visibility or feeling of isolation.
“Difficulties to occur as children passed from one space to another. Transitional zones without territorial definition, such as hallways and entries, are sites of a significant number of negative behaviors.” Shepley, 1995 “Minimize blind spots in corridors where patients cannot be observed from an attended nurse’s station.” Hunt, 2013
WHEN/ WHERE
Private rooms should open onto gathering spaces. Transitional spaces should remain wide and have visual access to multiple spaces at any given point. THE DESIGN PARTNERSHIP
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
ELIMINATE THE CORRIDOR
CENTRE FOR PREVENTION AND REHABILITATION EGM ARCHITECTEN
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
GIVE STAFF CLEAR VIEWS TO GATHERING SPACES AND CIRCULATION WHAT
WHY
By providing nurse stations along primary circulation and gathering spaces, the safety of the environment can be promoted.
“Patient engagement is also a critical component of patient safety. When patients feel connected to staff, they are more likely to respond to or seek out these individuals in moments of distress, which can prevent or deescalate personal crisis... facilitate staff interaction and connection with patients and discourage isolation or detachment.” Karlin, 2010
THE DESIGN PARTNERSHIP NURSING STATION
“Easy monitoring of halls requested by staff because of the sensitive nature of patients” Duffy & Huelat, 1989 “Nurse stations should provide the least possible barrier between staff and patients.” Hunt, 2013
WHEN/ WHERE
Nurse stations should be located along major circulation paths, group areas, promoting the staff’s ability to engage with patients while remaining unobtrusive and non-threatening. BUILDING NO 20 STANLEY BEAMAN & SEARS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PROVIDE SINGLE AND SHARED PATIENT ROOMS
WHAT
WHY
By providing both private and group rooms, the facility can accommodate a variety of patient needs by both giving a sense of control (private rooms) and a sense of responsibility (shared rooms). “A 2-bed room [unit] forces a social intimacy that may be intimidating and detrimental to interaction.” Wolfe, 1975 as quoted by Shepley, 2013
STARS SUB-ACUTE TREATMENT FACILITY THE DESIGN PARTNERSHIP
“Considerable research on residential settings and prisons has shown that the number of persons sharing a bedroom, bathroom, or cell strongly correlates with higher crowding stress and lower privacy, perceived control, more disagreements with roommates, more illness complaints, and social withdrawal. Ulrich, 2012
WHEN/ WHERE
A variety of group and private rooms should be provided per unit. Adolescents strictly dealing with substance abuse issues should be in separate units from those strictly dealing with mental health disorders. FERNDENE MENTAL HEALTH MEDICAL ARCHITECTURE
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
CREATE SPACES FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES WHAT
WHY
By creating a variety of form types, the functions of various spaces can be clearly expressed as districts, providing variety in the patient experience which mirrors the variety of experiences that the patient will have upon leaving the facility. “Services and supports must be individualized, built on strengths, and meet the needs of children and families across life domains to promote success, safety, and permanence in home, school,and community. The process must be culturally competent, building on the unique values, preferences, and strengths of children and families, and their communities.” Burns & Goldman, 1998 “Available and designated areas for privacy are necessary. Although bedrooms may be classified as designated private spaces, residents are often not allowed free access to bedrooms due to safety concerns.”
WHEN/ WHERE
Group gathering spaces Private patient spaces
Hunt, 2013
Daytime spaces (day room, group activity spaces, recreation areas, dining) should accommodate a scale of interactions for private (1-2), small group (37), and large group (8+) activities. FERNDENE MENTAL HEALTH MEDICAL ARCHITECTURE
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
CREATE SPACES FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
STARS SUB-ACUTE CHILD AND ADOLESCENT TREATMENT CENTER, THE DESIGN PARTNERSHIP
MORRIS VILLAGE [CLEMSON UNIVERSITY]
Mission
Vision
WORCESTER RECOVERY HOSPITAL ARCHITECTURE +
Goals
Guidelines
Program
Site
Bibliography
CREATE SPACES FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
NYE VARDHEIM HELSECENTE NORD ARCHITECTS, 3RW ARCHITECTS
Mission
Vision
FERNDENE MENTAL HEALTH MEDICAL ARCHITECTURE
Goals
Guidelines
Program
Site
Bibliography
CREATE SPACES FOR PRIVACY AND GROUP INTERACTION IN DAYTIME SPACES
PRIVATE COURTYARDS
PUBLIC COURTYARDS
THE VILLAGE PRAUD ARCHITECTS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
PROMOTE SAFETY THROUGH MATERIAL AND STRUCTURE WHAT
WHY
WHEN/ WHERE
Spaces should be designed using materials and structure that promote a safe and comfortable environment to promote “place attachment” Level 1- Staff and service areas where patients are not allowed. Level 2- Corridors, counseling rooms, interview rooms and smoking rooms where patients are highly supervised and not left alone for periods of time. Level 3- Lounges and Activity Rooms – where patients may spend time with minimal supervision. Level 4- Patient rooms (semi-private and private) and patient toilets where patients spend a great deal of time alone with minimal or no supervision. Level 5- Admissions rooms, examination rooms, and seclusion rooms where staff interact with newly admitted patients that present potential unknown risks and/or where patients may be in a highly agitated condition. Hunt, 2013 “To the extent that the environment of care in inpatient and other mental health settings is healing and recovery-oriented, it is likely to enhance patient safety” DGMH, 2010 Anchor points should be avoided. Furniture should be built-in, stationary or difficult to dissemble. FERNDENE MENTAL HEALTH MEDICAL ARCHITECTURE
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SCHEME
PROGRAM
public many users
private
DAY ROOM EDUCATION SPACE
TEAM CONFERENCE ROOM VISITOR ROOM
few users
Mission
Vision
NURSE STATION
GROUP THERAPY ROOM
NURSE WORKROOM PERSONAL STORAGE CONSULTATION ROOM
MEDICATION ROOM PHYSICIAN DICTATION PATIENT ROOM
Goals
Guidelines
Program
Site
Bibliography
SCHEME
PROGRAM
greenspace public many users
private
DAY ROOM EDUCATION SPACE
TEAM CONFERENCE ROOM VISITOR ROOM
few users
Mission
Vision
NURSE STATION
GROUP THERAPY ROOM
NURSE WORKROOM PERSONAL STORAGE CONSULTATION ROOM
MEDICATION ROOM PHYSICIAN DICTATION PATIENT ROOM
Goals
Guidelines
Program
Site
Bibliography
SCHEME
PROGRAM
greenspace public low security
private
NURSE STATION EDUCATION SPACE DAY ROOM
TEAM CONFERENCE ROOM VISITOR ROOM
GROUP THERAPY ROOM
NURSE WORKROOM CONSULTATION ROOM PERSONAL STORAGE
high security
Mission
Vision
MEDICATION ROOM
ADMISSIONS ROOM
Goals
Guidelines
Program
Site
PATIENT ROOM
Bibliography
Create districts
2.
Maximize daylight
3.
Provide living space
4.
FOR SMALL AND Provide educational space for all user types FROM STAFF THERAPY CORRIDOR Locate the site in an environment in which a connection LARGE GROUP to nature can be WORK AREAS SPACES INTERACTION Provide educational space for all user types 5. established.
5.
Maximize visibility
6.
Locate the site so that it is accessible from education, outpatient Create a variety of scale in building form to reflect behavioral health facilities, residential, and/or primary care facilities. levels of introspection districts 2. Create a variety of scale in Create building form to reflect 7.
7.
Create districts
SCHEME: SITE SELECTION CRITERIA
Maximize daylight Provide living space
E GROUP RIVATE ROOMS
USE SAFE MATERIALS AND FURNISHING
1 2
AROUND CENTRAL GREENSPACE
LIGHT IN
VIEWS TO/
2. 3. 4.
ELIMINATE THE
Eliminate the corridorvisibility 1. Maximize
6.
levels of introspection
3
Mission
Provide Maximize daylightfuture 3. Locate building so that it can accommodate growth either on sitecentral greenspace Provide central greenspace 8. or on adjacent sites.
Vision
Provide living space
4.
Provide educational space for all user types
5.
Maximize visibility
6.
Create a variety of scale in building form to reflect levels of introspection
7.
Provide central greenspace
8.
Goals
Guidelines
Program
8.
Site
Bibliography
SCHEME: SITE OPTIONS
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 1
LOCATION
Dorchester Rd. Charleston, SC 29418
INCOME
Median household income: $32,095 Population: 1,884 Households: 1,262
http://www.city-data.com/income/income-Charleston-South-Carolina.html
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 1
POPULATION
White Population: 783 Black Population: 840 Asian Population: 64 Hispanic Population: 163 Multirace Population: 33
http://www.city-data.com/income/income-Charleston-South-Carolina.html
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 2
LOCATION
Bee St. Charleston, SC 29403
INCOME
Median household income: $39,038 Population: 1,407 Households: 99
http://www.city-data.com/income/income-Charleston-South-Carolina.html
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 2
POPULATION
White Population: 1,100 Black Population: 74 Asian Population: 163 Hispanic Population: 59 Multirace Population: 11
http://www.city-data.com/income/income-Charleston-South-Carolina.html
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 3
LOCATION
Ashley River Rd. Charleston, SC 29414
INCOME
Median household income: $52,028 Population: 5,469 Households: 2,679
http://www.city-data.com/income/income-Charleston-South-Carolina.html
Mission
Vision
Goals
Guidelines
Program
Site
Bibliography
SITE NO. 3
POPULATION
Mission
White Population: 3,653 Black Population: 1,372 Asian Population: 185 Hispanic Population: 240 Multirace Population: 21
Vision
Goals
Guidelines
Program
Site
Bibliography
Subject
Title
Author
Date
ANN. BIB.
Upali Nanda, PhD, Debajyoti Pati, PhD, and Katie Neuroesthetics and Healthcare McCurry, PhD Visual Elements Design Margaret O'Connor, DN; Anthony O'Brien, PhD; Melissa Bloomer, MN(Hons); Julia Morphett, MN(Ed); Louise Peters, PhD; Helen Hall, The Environment of Inpatient MMid; Healthcare Delivery and Its Arlene Positive Healing Influence on the Outcome of Parry, MEd; Care Space Positive Healing Space Design and an excess of Drama
Mission
Vision
Richard Kobus
Upali Nanda, PhD, Assoc AIA, Cheryl
Goals
1‐Feb
5‐Dec
30‐Sep
Year Written
Results
Publication
Link
In this paper the authors share evidence that visual stimuli undergo an aesthetic evaluation process in the human brain by default, even when not prompted; that responses to visual stimuli may be immediate and emotional; and that aesthetics can be a source of pleasure, a fundamental perceptual reward that can help mitigate the stress of a healthcare environment. The authors also provide examples of studies that address the role of specific visual elements and visual principles in aesthetic evaluations and emotional responses. Finally, they discuss the implications of these findings for the design of art and architecture in HERD Journal 2009 healthcare.
https://w ww.herdj ournal.co m/article /neuroes thetics‐ and‐ healthcar e‐design
The provision of healthcare must be in a friendly, safe environment that respects individual autonomy and fosters independence (Rigby, Payne, & Froggatt, 2010; Tesh, McNutt, Courts, & Barba, 2002). Gross, Sasson, Zarhy, and Zohar (1998) draw upon Corey and colleagues, who argued that the simple redesign and renovation of a uni‐the furnishings and floor coverings and thoughtful use of color‐had a positive effect not only on staff, but also on service HERD Journal 2012 users. The environments we create for our patients and our families cannot cure, 2008 but they can heal. HERD Journal
https://w ww.herdj ournal.co m/article /environ ment‐ inpatient‐ healthcar e‐ delivery‐ and‐its‐ influence‐ outcome‐ care https://w ww.herdj ournal.co
The combination of bright colors, engaging themes, and nature content is consistently highly rated by pediatric patients. However, pediatric
Guidelines
https://w ww.herdj ournal.co m/article /pediatri c‐art‐
Program
Site
Bibliography
Subject
Title
Author
Date
ANN. BIB.
Results
Publication
31‐Jul
In this paper the authors share The combination of bright colors, evidence that visual stimuli undergo engaging themes, and nature content an aesthetic evaluation process in the is consistently highly rated by human brain by default, even when pediatric patients. However, pediatric not prompted; that responses to preferences vary significantly among visual stimuli may be immediate and the three operational stages, so one emotional; and that aesthetics can be should be careful before using the a source of pleasure, a fundamental “one‐size‐fits‐all” approach. Child art, perceptual reward that can help typically used in pediatric wards, is mitigate the stress of a healthcare better suited for younger children environment. The authors also HERD Journal 2009 than for older children. provide examples of studies that
Upali Nanda, PhD, Debajyoti Pati, PhD, and Katie Neuroesthetics and Healthcare McCurry, PhD 1‐Feb Visual Elements Design Margaret O'Connor, DN; Anthony O'Brien, PhD; Melissa Bloomer, MN(Hons); Julia Morphett, MN(Ed); Louise Peters, PhD; Helen Hall, The Environment of Inpatient Debajyoti MMid; Healthcare Delivery and Its Pati, PhD, Arlene Positive Healing Influence on the Outcome of MASA, FIIA, Parry, MEd; 5‐Dec Care Space LEED AP and Upali Nanda, Positive Healing Influence of Positive Distractions Richard PhD, Assoc on Children in Two Clinic Space Design and an excess of Drama Kobus 30‐Sep AIA, EDAC 23‐Jun Waiting Spaces Waiting Areas
address the role of specific visual elements and visual principles in aesthetic evaluations and emotional responses. Finally, they discuss the To summarize, the study objective implications of these findings for the was to examine the associations design of art and architecture in between introducing positive HERD Journal 2009 healthcare. distractions in hospital waiting areas and the waiting experience of patients. Data analyses show that the The provision of healthcare must be introduction of distraction conditions in a friendly, safe environment that was associated with higher calm respects individual autonomy and behavior and less fine and gross fosters independence (Rigby, Payne, movement, suggesting significant & Froggatt, 2010; Tesh, McNutt, calming effects of the distraction Courts, & Barba, 2002). Gross, conditions. In turn, this suggests that Sasson, Zarhy, and Zohar (1998) draw the use of positive distractions can upon Corey and colleagues, who affect the stress and anxiety argued that the simple redesign and associated with the waiting renovation of a uni‐the furnishings experience. Data also indicate that and floor coverings and thoughtful positive distraction conditions are use of color‐had a positive effect not attention grabbers. This is reinforced only on staff, but also on service by the fact that in both clinics the TV HERD Journal 2012 users. monitors attracted the second‐largest The environments we create for our percentage of attention; other people patients and our families cannot cure, in the waiting room attracted more HERD Journal 2008 but they can heal. HERD Journal 2011 attention than the monitor.
Image
Mission
Year Written
Pediatric Art Preferences: Countering the "One‐Size‐Fits‐ All" Approach
Vision
Upali Nanda, PhD, Assoc AIA, Cheryl M. Chanaud, PhD, CCRP, Linda Brown, PhD, Robyn Hart, and Kathy Hathorn, MA
Upali Nanda, PhD, Assoc Upali Nanda, AIA, Cheryl
Goals
… This is where art and carefully selected positive distractions can play a role. They can help create The combination of bright colors, environments that are experiential engaging themes, and nature content and immersive, which can go beyond is consistently highly rated by mindless distractions to creating pediatric patients. However, pediatric
Guidelines
Link https://w ww.herdj ournal.co m/article /pediatri c‐art‐ preferen ces‐ counteri ng‐one‐ size‐fits‐ all‐ https://w approach ww.herdj ournal.co m/article /neuroes thetics‐ and‐ healthcar e‐design
https://w ww.herdj ournal.co m/article https://w /environ ww.herdj ment‐ ournal.co inpatient‐ m/article healthcar /influenc e‐ e‐ delivery‐ positive‐ and‐its‐ distractio influence‐ ns‐ outcome‐ children‐ care two‐ https://w clinic‐ ww.herdj waiting‐ ournal.co areas https://w https://w ww.herdj ww.herdj ournal.co ournal.co m/article m/article /pediatri /its‐all‐ c‐art‐
Program
Site
Bibliography
Waiting Spaces Subject
on Children in Two Clinic Waiting Areas Title
in the waiting room attracted more PhD, Assoc Year attention than the monitor. AIA, EDAC 23‐Jun 2011 Author Date Written Results
ANN. BIB.
Image
It's All About Healing
Upali Nanda, PhD, Assoc AIA, EDAC 23‐Jun
Upali Nanda, Mardelle PhD, McCuskey Debajyoti Corridors Shepley Sep Pati, PhD, and Katie Neuroesthetics and Healthcare McCurry, PhD 1‐Feb Visual Elements Design Margaret O'Connor, DN; Anthony O'Brien, PhD; Melissa Bloomer, Jamie C. MN(Hons); Huffcut, Julia LEED AP, Morphett, Allied MN(Ed); Member Louise Adolescent Maximizing healing: Evidence‐ ASID, Peters, PhD; Associate Behavioral based design and adolescent Helen Hall, The Environment of Inpatient 1‐Feb Health behavioral health‐ A case study Mem MMid; Healthcare Delivery and Its Construction Arlene Positive Healing Influence on the Outcome of Mental Health Mental Health Facilities Design & Facilities Parry, MEd; 5‐Dec Care Space Facilities Guide Managemen Dec Positive Healing Healing Gardens: Therapeutic Richard Benefits and Design Clare Cooper 30‐Sep Space Design and an excess of Drama Kobus Gardens Recommendations Marcus
The Location of Behavioral Incidents in a Children's Psychiatric Facility
Data
Mission
Adolescent health epidemiology
Vision
Upali Nanda, PhD, Assoc AIA, Cheryl
Goals
HERD Journal Publication
waiting‐ areas Link
… This is where art and carefully In this paper the authors share https://w selected positive distractions can play evidence that visual stimuli undergo a role. They can help create ww.herdj an aesthetic evaluation process in the environments that are experiential ournal.co human brain by default, even when and immersive, which can go beyond m/article not prompted; that responses to mindless distractions to creating /its‐all‐ visual stimuli may be immediate and mindful, intentional, and healing about‐ emotional; and that aesthetics can be HERD Journal healing 2011 experiences. a source of pleasure, a fundamental perceptual reward that can help A trend for difficulties to occur as mitigate the stress of a healthcare children passed from one space to https://w environment. The authors also another was found. Transitional zones ww.herdj provide examples of studies that without territorial definition, such as ournal.co address the role of specific visual hallways and entries, were sites of a Children's m/article elements and visual principles in significant number of negative Environments, /neuroes aesthetic evaluations and emotional Vol. 12, No. 3 1995 behaviors. thetics‐ responses. Finally, they discuss the and‐ implications of these findings for the healthcar design of art and architecture in By examining the relationship HERD Journal e‐design 2009 healthcare. between EBD principles, adolescent developmental needs, and environmental needs of those The provision of healthcare must be https://w suffering from mental illness, a in a friendly, safe environment that ww.herdj foundation for understanding a respects individual autonomy and ournal.co unique population was accomplished. fosters independence (Rigby, Payne, m/article Incorporating opportunities for & Froggatt, 2010; Tesh, McNutt, /environ connection to nature, choice and Courts, & Barba, 2002). Gross, ment‐ control, privacy, social support, and Sasson, Zarhy, and Zohar (1998) draw inpatient‐ positive distraction as determined by upon Corey and colleagues, who healthcar previous EBD studies allowed for a e‐ argued that the simple redesign and more holistic healing environment Healthcare delivery‐ renovation of a uni‐the furnishings tailored to specific needs in an effort Design and‐its‐ and floor coverings and thoughtful Magazine 2012 to maximize healing. influence‐ use of color‐had a positive effect not only on staff, but also on service outcome‐ VA Palo Alto, exterior courtyards, Department of care 2012 users. HERD Journal 2010 The environments we create for our spatial relationships, materials, etc. Veterans Affairs https://w patients and our families cannot cure, ww.herdj John Wiley & ournal.co 2008 but they can heal. HERD Journal 1999 Sons http://w 6% of all deaths resulted from 2004 suicide. WHO ww.who. https://w The combination of bright colors, engaging themes, and nature content is consistently highly rated by pediatric patients. However, pediatric
Guidelines
ww.herdj ournal.co m/article /pediatri c‐art‐
Program
Site
Bibliography
Subject
Title
Author
Date
ANN. BIB.
Atlas Child and Adolescent Mental Health
Data
Visual Elements
Child and adolescent mental health Neuroesthetics and Healthcare Design
Children
Measurement of Quality of Life in Children
Adolescent Behavioral Health
Caring for children and adolescents with mental disorders
Adolescent Behavioral Health
Adolescent Mental Health
Data
Mission
Upali Nanda, PhD, Debajyoti Pati, PhD, and Katie McCurry, PhD 1‐Feb Margaret O'Connor, DN; Anthony Jun O'Brien, PhD; Melissa Bloomer, MN(Hons); Julia Morphett, MN(Ed); Louise Peters, PhD; Helen Hall, Kessler et al MMid; (2005) Arlene Levav I, Parry, MEd; 5‐Dec Jacobsson L, Tslantis J, et Richard al Kobus 30‐Sep
Lifetime prevalence and age of onset distributiona of DSM‐IV The Environment of Inpatient disorders in the National Healthcare Delivery and Its Comorbidity Study Replication Data Positive Healing Influence on the Outcome of Psychiatric services and training Care Space for children and adolescents in Positive Healing Europe: Results of a country survey Data Space Design and an excess of Drama Fewer than One in Eight Adolescent Substance Abuse Treatment Admissions are Referred to Treatment by Schools Feb Adolescents Prescription for Wellness: Upali Nanda, Children's Mental Health Best PhD, Assoc Treatment Practices AIA, Cheryl Apr
Vision
Goals
Year Written
Results
Publication
The gap in meeting child mental In this paper the authors share health training needs worldwide is evidence that visual stimuli undergo staggering with between 1/2 and an aesthetic evaluation process in the 2/3rds of all needs going unmet in human brain by default, even when most countries of the world, with not prompted; that responses to signicantly higher proportions of visual stimuli may be immediate and unmet need in low and middle emotional; and that aesthetics can be income countries. a source of pleasure, a fundamental WHO 2005 perceptual reward that can help mitigate the stress of a healthcare Worldwide 10-20% of children and environment. The authors also adolescents experience mental provide examples of studies that disorders. Half of all mental address the role of specific visual illnesses begin by the age of 14 elements and visual principles in and three-quarters by mid-20s. aesthetic evaluations and emotional Neuropsychiatric conditions are responses. Finally, they discuss the the leading cause of disability in implications of these findings for the young people in all regions. WHO design of art and architecture in Look at need for instrument to HERD Journal 2009 healthcare. measure quality of life for children and review possible methods for doing so. WHO/IACAPAP 1993 The provision of healthcare must be
Link
http://ap ps.who.i nt/iris/bi tstream/ 10665/4 3307/1/9 2415630 44_eng.p df http://w ww.who. https://w int/ment ww.herdj al_health ournal.co /women m/article _children /neuroes /child_ad thetics‐ olescent/ and‐ en/ healthcar ww.who. e‐design int/ment al_health /media/e http://w https://w
in a friendly, safe environment that World: DALYs in 2000 attributable to respects individual autonomy and 2003 fosters independence (Rigby, Payne, selected causes, by age and sex WHO 20% of adolescents in any given year & Froggatt, 2010; Tesh, McNutt, experience a mental health problem… Courts, & Barba, 2002). Gross, happy and confident adolescents are Sasson, Zarhy, and Zohar (1998) draw most likely to grow into happy and WHO 2012 upon Corey and colleagues, who
ww.who. ww.herdj int/ment ournal.co al_health m/article http://w /environ hqlibdoc. ment‐ who.int/ inpatient‐ publicati healthcar
argued that the simple redesign and renovation of a uni‐the furnishings and floor coverings and thoughtful Arch Gen use of color‐had a positive effect not 2005 Age of onset‐14 Psychiatry only on staff, but also on service 2012 users. HERD Journal The environments we create for our Eur Child Adolescent facilities are of lower Adolesc patients and our families cannot cure, 2004 quality than adults (psychiatric) Psychiatry 2008 but they can heal. HERD Journal
e‐ delivery‐ and‐its‐ 62(6):59 influence‐ 3‐602 outcome‐ care https://w 13:395‐ ww.herdj 401 ournal.co
Center for Behavioral Substance Abuse Treatment https://w Admissions Aged 12 to 17, by Referral Health Statistics ww.herdj and Quality 2012 The combination of bright colors, Source*: 2009 ournal.co m/article engaging themes, and nature content New Roles for Families in Systems of Community /pediatri is consistently highly rated by 2010 pediatric patients. However, pediatric Care Action Network c‐art‐
Guidelines
Program
Site
Bibliography
Subject Adolescents
ANN. BIB.
Treatment
Treatment Admissions are Referred to Treatment by Title Schools Prescription for Wellness: Children's Mental Health Best Practices
Author
Date Feb
Apr
Bruns, Eric, Walker, Janet, Zabel, Michelle, Matarese, Marlene, Estep, Kimberly, Upali Nanda, Harburger, Deborah, Intervening in the Lives of Youth PhD, Mosby, with Complex Behavioral Health Debajyoti Madge, Challenges and their Families: Pati, PhD, and Katie Pires, Sheila Dec The Wraparound Process Treatment Neuroesthetics and Healthcare McCurry, PhD 1‐Feb Visual Elements Design Margaret Mental Health Services then and O'Connor, Mechanic, Nov/De DN; Anthony Treatment now David c O'Brien, Physical activity, exercise, PhD; Melissa depression and anxiety Strohle, Bloomer, Physical Activity disorders Andreas Apr MN(Hons); Julia Morphett, MN(Ed); Burns, Promising Practices in Barbara, Wraparound for Children with Louise Goldman, Serious Emotional Disturbance Peters, PhD; Helen Hall, The Environment of Inpatient Sybil and their Families Treatment MMid; Healthcare Delivery and Its Shepley, Arlene Positive Healing Influence on the Outcome of Mardelle, 5‐Dec Care Space Pasha, EBD and Design Research and Behavioral Parry, MEd; Samira Jul Adolescents Health Facilities Positive Healing Richard Ulrich, Space Design and an excess of Drama Kobus 30‐Sep Roger, Bogren, Lennart, Aggression in Towards a design theory for Lundin, Psychiatric reducing aggression in Stefan Nov Facilities psychiatric facilities
Mission
Vision
Upali Nanda, PhD, Assoc Gruttadaro, AIA, Cheryl J.D., Burns,
Goals
Behavioral Substance Abuse Treatment Year Admissions Aged 12 to 17, by Referral Health Statistics Written Publication Link and Quality 2012 Results Source*: 2009 In this paper the authors share New Roles for Families in Systems of Community 2010 evidence that visual stimuli undergo Care Action Network an aesthetic evaluation process in the human brain by default, even when not prompted; that responses to visual stimuli may be immediate and emotional; and that aesthetics can be a source of pleasure, a fundamental perceptual reward that can help mitigate the stress of a healthcare https://w environment. The authors also ww.herdj provide examples of studies that ournal.co address the role of specific visual m/article elements and visual principles in /neuroes aesthetic evaluations and emotional Am J thetics‐ responses. Finally, they discuss the Explanation of the Wraparound Community and‐ 2010 implications of these findings for the Model of Care Psychol. healthcar design of art and architecture in HERD Journal 2009 healthcare. Project HOPE: e‐design The people to people health History of Behavioral health https://w foundation 2007 The provision of healthcare must be treatment in a friendly, safe environment that ww.herdj respects individual autonomy and ournal.co m/article 2008 fosters independence (Rigby, Payne, Benefits of physical activity: anxiety & Froggatt, 2010; Tesh, McNutt, /environ Center for Courts, & Barba, 2002). Gross, ment‐ Effective Sasson, Zarhy, and Zohar (1998) draw Collaboration inpatient‐ upon Corey and colleagues, who and Practice, healthcar e‐ argued that the simple redesign and American renovation of a uni‐the furnishings Institutes for delivery‐ and‐its‐ Research 1998 and floor coverings and thoughtful Breakdown of wraparound process influence‐ use of color‐had a positive effect not only on staff, but also on service outcome‐ 2012 users. HERD Journal care Literature review of ebd for Center for 2013 The environments we create for our adolescent behavioral health facilities Health Design https://w patients and our families cannot cure, ww.herdj 2008 but they can heal. Providing single bedrooms may be HERD Journal ournal.co Arch 12: the most important design intervention for reducing stress and Archtiecture/Re search/Care/He https://w thereby aggression in inpatient ww.herdj alth 2012 psychiatric wards. ournal.co The combination of bright colors, m/article engaging themes, and nature content /pediatri is consistently highly rated by c‐art‐ pediatric patients. However, pediatric
Guidelines
Program
Site
Bibliography
Lundin, Author Stefan
Psychiatric Subject Facilities
reducing aggression in Title psychiatric facilities
EBP and Adolescents
Gruttadaro, J.D., Burns, Barbara, Choosing the right treatment: Duckworth, Kenneth, What families need to know about evidence‐based practices Crudo, Dana May
ANN. BIB.
Date Nov
Definition of recovery updated The Village System Adolescent Mental Health: Service settings and reasons for Services receiving care Upali Nanda, Feb Mental Health Child and adolescent mental PhD, Facilities health policies and plans Debajyoti Pati, PhD, and Katie Neuroesthetics and Healthcare McCurry, PhD 1‐Feb Visual Elements Design Margaret O'Connor, DN; Anthony O'Brien, PhD; Melissa Bloomer, MN(Hons); Julia Morphett, MN(Ed); Severe Mental Director's Blog: Understanding Louise Insel, Illness Severe Mental Illness Thomas Jan Peters, PhD; Helen Hall, The Environment of Inpatient Beronio, MMid; Healthcare Delivery and Its Kirsten, Po, Arlene Influence on the Outcome of Positive Healing Affordable Care Act will expand Rosa, mental health and substance use Parry, MEd; 5‐Dec Care Space Skopec, disorder benefits and parity Laura, Glied, Positive Healing protections for 62 million Richard Sherry Americans Finances Space Design and an excess of Drama Kobus 30‐Sep
Year thereby aggression in inpatient Written psychiatric wards. 2012 Results
In this paper the authors share evidence that visual stimuli undergo an aesthetic evaluation process in the human brain by default, even when Evidence‐Based Psychosocial not prompted; that responses to Interventions & visual stimuli may be immediate and Psychopharamacology NAMI emotional; and that aesthetics can be a source of pleasure, a fundamental perceptual reward that can help mitigate the stress of a healthcare environment. The authors also provide examples of studies that Reasons for receiving services NSDUH address the role of specific visual Typical ranges for presentation of elements and visual principles in selected disorders WHO aesthetic evaluations and emotional responses. Finally, they discuss the implications of these findings for the design of art and architecture in The most common form of violence HERD Journal healthcare. associated with mental illness is not against others, but rather, against oneself. In 2007, the most recent year The provision of healthcare must be for which we have statistics, there in a friendly, safe environment that were almost 35,000 suicides, nearly respects individual autonomy and twice the rate of homicides. Suicide is fosters independence (Rigby, Payne, the 10th leading cause of death in the & Froggatt, 2010; Tesh, McNutt, United States.iii Although it is not Courts, & Barba, 2002). Gross, possible to know what prompted Sasson, Zarhy, and Zohar (1998) draw every suicide, it is safe to say that upon Corey and colleagues, who unrecognized, untreated mental argued that the simple redesign and illness is a leading culprit. NIMH renovation of a uni‐the furnishings and floor coverings and thoughtful use of color‐had a positive effect not only on staff, but also on service users. HERD Journal The environments we create for our Mental Health and Substance Abuse ASPE Research patients and our families cannot cure, Service Statistics Brief but they can heal. HERD Journal
https://w ww.herdj ournal.co m/article /environ ment‐ inpatient‐ healthcar e‐ delivery‐ and‐its‐ influence‐ outcome‐ care https://w ww.herdj ournal.co
Coverage of Selected Benefits in the Small Group Market and State and ASPE Research 2011 The combination of bright colors, Federal Employee Plans Brief engaging themes, and nature content is consistently highly rated by pediatric patients. However, pediatric
https://w ww.herdj ournal.co m/article /pediatri c‐art‐
2007
Recovery
Finances
Mission
ESSENTIAL HEALTH BENEFITS: Glied, COMPARING BENEFITS IN SMALL Sherry, GROUP PRODUCTS AND STATE Kronick, Dec AND FEDERAL EMPLOYEE PLANS Richard Substance Abuse Treatment Upali Nanda, Facilities, by Whether Facility PhD, Assoc Offers Some Type of Payment AIA, Cheryl
Vision
Goals
search/Care/He Publication Link alth
2009 2005
2009
2011
2012
2013 2008
Guidelines
https://w ww.herdj ournal.co m/article /neuroes thetics‐ and‐ healthcar e‐design
Program
Site
Bibliography
protections for 62 million Americans Title
Finances Subject
Laura, Glied, Sherry Author Date
ESSENTIAL HEALTH BENEFITS: Glied, COMPARING BENEFITS IN SMALL Sherry, GROUP PRODUCTS AND STATE Kronick, AND FEDERAL EMPLOYEE PLANS Richard Substance Abuse Treatment Facilities, by Whether Facility Offers Some Type of Payment Assistance: 2008
ANN. BIB. Finances
Finances
Finances
Recovery Recovery
Visual Elements Wraparound Case Studies
Daylight
Group seating
Dec
The Affordable Care Act: How it helps individuals and families living with mental illness Jan Transforming mental health care in America: The Federal Action Upali Nanda, PhD, Agenda: First Steps Feb SAMHSA'S Working Definition of Debajyoti Pati, PhD, Recovery and Katie Neuroesthetics and Healthcare McCurry, PhD 1‐Feb Design Wraparound basics Margaret architecture + O'Connor, DN; Anthony Selling the private asylum: therapeutic landscapes and the O'Brien, (re)valorization of confinement PhD; Melissa Moon, G., Bloomer, in the era of community care Joseph, A. MN(Hons); Environmental design for Julia individuals with schizophrenia: Morphett, Gabb, B., an assessment tool Lodl, K. MN(Ed);
Louise Mental health facilities design Peters, PhD; Place attachment guide: foreward Karlin Dec Helen Hall, The Environment of Inpatient Architectural guidelines for state MMid; Healthcare Delivery and Its Private space Gulak, M Arlene Influence on the Outcome of Positive Healing psychiatric hospitals Parry, MEd; 5‐Dec Care Space Duffy, Tama, Huelat, Positive Healing Richard Lighting Psychiatric care units Barbara Space Design and an excess of Drama Kobus 30‐Sep
Shared rooms
Mission
Understanding and evaluating therapeutic environments for children
Vision
Wolfe Upali Nanda, PhD, Assoc AIA, Cheryl
Goals
Mental Health and Substance Abuse ASPE Research Year 2013 Service Statistics Brief Written Results Publication Link
2011
2008
2011
2009 2009
2009 2013
In this paper the authors share Coverage of Selected Benefits in the evidence that visual stimuli undergo Small Group Market and State and ASPE Research an aesthetic evaluation process in the Federal Employee Plans Brief human brain by default, even when not prompted; that responses to visual stimuli may be immediate and emotional; and that aesthetics can be Pie Chart! SAMHSA News a source of pleasure, a fundamental perceptual reward that can help mitigate the stress of a healthcare environment. The authors also NAMI provide examples of studies that address the role of specific visual elements and visual principles in Agenda SAMHSA aesthetic evaluations and emotional responses. Finally, they discuss the Definition and Principles SAMHSA implications of these findings for the National design of art and architecture in Wraparound healthcare. HERD Journal Definition and principles Institute Home Neighborhood Downtown architecture +
The provision of healthcare must be in a friendly, safe environment that respects individual autonomy and 2006 fosters independence (Rigby, Payne, Daylight is good & Froggatt, 2010; Tesh, McNutt, Courts, & Barba, 2002). Gross, Sasson, Zarhy, and Zohar (1998) draw 1992 upon Corey and colleagues, who Clustered seating
2010 1991 2012
1989 2008
https://w ww.herdj ournal.co m/article /neuroes thetics‐ and‐ healthcar e‐design
https://w ww.herdj ournal.co m/article /environ ment‐ inpatient‐ healthcar e‐ argued that the simple redesign and Department of delivery‐ renovation of a uni‐the furnishings Place attachment Veterans Affairs and‐its‐ and floor coverings and thoughtful influence‐ use of color‐had a positive effect not Center for Adolescents desire private space Health Design outcome‐ only on staff, but also on service users. HERD Journal care The environments we create for our Journal of https://w Lighting is good but can cause Healthcare patients and our families cannot cure, ww.herdj distorted images Interior Design ournal.co but they can heal. HERD Journal
Transactional Institute British Geography Journal of Applied Rehabilitation Counseling
A 2‐bed room [unit] forces a social Designing for intimacy that may be intimidating and therapeutic 1975 detrimental to interaction. environments The combination of bright colors, engaging themes, and nature content is consistently highly rated by pediatric patients. However, pediatric
Guidelines
https://w ww.herdj ournal.co m/article /pediatri c‐art‐
Program
Site
Bibliography