Holistic Designs for Mental Health and Well-being

Our collaborative and inclusive design process brings together outside-thebox thinkers who lead with ideas. In embracing many perspectives, we foster healthy discussions that tackle some of the greatest challenges facing the built environment today. Together, we seek to partner with communities and our clients to build great places that are inspiring and meaningful.

Our commitment extends to our work in behavioral health, where we recognize the importance of addressing mental health needs at a community level, and serving patients with effective clinical models along a broad continuum of care. By challenging ourselves and our clients to identify and fill the gaps in our mental health system, we can contribute to the overall health of our communities.

LEADERSHIP AND EXPERIENCE IN BEHAVIORAL HEALTH

Our team is deeply involved in the ongoing expansion and recalibration of mental health services in Washington and Oregon. In the past two years alone, we have completed a comprehensive master plan and pre-design for the replacement facility for Western State Hospital; worked with the University of Washington to program and design the Behavioral Health Teaching Facility, currently in construction, where new generations

of clinicians will be trained; designed and implemented multiple renovations at the Oregon State Hospital facilities in Salem and Junction City; and developed and designed an inpatient mental health hospital for a private operator.

We are currently starting to design a Crisis Stabilization Center for Skagit County, Washington, guiding the UW Behavioral Health Teaching Facility through the final months of construction, and continuing to seek ways the SRG team can create connections, foster conversations, and collaborate with others to solve the most pressing issues facing our mental health system.

PRIORITIZING MENTAL HEALTH NEEDS IN

EVERY PROJECT WE CREATE

SRG’s mission is to Invent a Better Future. We seek the intersections between our primary markets of Wellness, Performance, and Discovery. We design spaces holistically, benefitting our emotional wellness, our physical health, and the way we connect to one another. While this may manifest differently in each facility type – from a baseball stadium or a highperformance athlete training space; a student success center or an inpatient psychiatric facility; a student health clinic or a center for cancer research –we bring our full expertise to bear on every project, prioritizing the mind-body health of each and every person who works, plays, or heals within that space.

We are also engaged in a firmwide research study with Portland State University, investigating the impact of the built environment on the success of neurodiverse individuals, and we hope to apply our research findings to all subsequent projects.

A TEAM COMMITTED TO YOUR SUCCESS

Our core team brings unique experience and knowledge that is key to the success of our behavioral health projects. Team Leader and Design Principal, Carl Hampson, brings extensive behavioral health experience in a wide range of settings, including work for both private and public providers. Lori Epler, the team’s Behavioral Health Specialist for Planning and Design, holds a unique ability to bring stakeholders together to make decisions that lead to the best possible outcomes. Her recent projects include facilities for the Oregon State Hospital, the UW Behavioral Health Teaching Facility, Swedish Health Services, and a private inpatient operator in Pierce County. Aimée Duquette, our Project Manager, is just wrapping up her role on the UW Behavioral Health Teaching Facility project. She is an experienced leader and collaborator with strong budget and time management skills. Jon Melschau, our Senior Project Architect, has spent his career working on a variety of healthcare projects, including several behavioral health projects.

Jon understands the technical, regulatory and code challenges required for a successful project.

UNDERSTANDING THE REQUIREMENTS FOR A SUCCESSFUL MENTAL HEALTH PROJECT

Each one of our clients works within a finite budget for design and construction. Our approach is to work closely with client teams to fully understand their individual priorities and look for ways to provide the most value for the money allocated to the project. This includes analysis and streamlining clinical operations, where applicable, as well as understanding the life-cycle costs of operating and maintaining the facility, allowing the facility to serve clients’ needs well into the future.

Through our team’s extensive experience on mental health projects, we have formed strong relationships with the Washington Department of Health and Oregon Health Authority, and we have developed a clear understanding of the regulatory and safety requirements for highrisk behavioral health environments in our region. Our goal is to create environments that are safe, therapeutic, and conducive to the high quality of mental healthcare that our clients provide.

At SRG Partnership, we are committed to creating a lasting, positive impact on the lives of those around us.

Mental Health Practice Leaders

Design Principal + Behavioral Health Thought Leader

ABOUT CARL

With 30 years of experience, Carl is a gifted designer who specializes in healthcare design, with specific expertise in behavioral health projects. Carl’s innovative work has earned numerous accolades, including two National AIA Design awards and multiple regional AIA and industry honors. He brings a collaborative approach to design leadership with a creative process that merges context, sustainability and performance with client goals and objectives.

Carl Hampson aia, leed ap

UNIVERSITY OF WASHINGTON BEHAVIORAL HEALTH TEACHING FACILITY

PIMA COUNTY BEHAVIORAL HEALTH + CRISIS RESPONSE CENTER*

ARIZONA STATE FORENSIC HOSPITAL*

ABOUT LORI

Lori brings more than 20 years of experience successfully collaborating on health and wellness projects for a broad spectrum of healthcare clients. Her deep understanding of healthcare operations, applicable codes, and best practices informs each project she approaches.

Lori is a systems thinker who moves fluidly between big picture and small details to identify and resolve problems as they arise.

Lori Epler

aia, edac, leed ap

Principal + Senior Healthcare Planner

OREGON STATE JUNCTION CITY PSYCHIATRIC HOSPITAL

UNIVERSITY OF WASHINGTON BEHAVIORAL HEALTH TEACHING FACILITY

HEALTHCARE BEHAVIORAL HEALTH HOSPITAL

SRG’s Experience

SRG was founded 50 years ago on a simple idea: partnership as both our name and an attitude that shapes everything we do. Partnerships define how we engage our clients, how we work with each other, and how we build our teams. Our Northwest roots contribute to this outlook through a deep appreciation for the natural beauty that surrounds us and a pioneering spirit that drives us forward.

HEALTHCARE DESIGN EXPERIENCE

Designing healthcare facilities and wellness-focused spaces is a cornerstone market of SRG Partnership. SRG’s healthcare portfolio ranges from medical clinics to full replacement hospitals as well as from studies, facilities plans, and pre-designs to full institution master plans.

EXPERIENCE WITH BEHAVIORAL HEALTH FACILITY STANDARDS, SPECIFICATIONS, AND REQUIREMENTS

Our healthcare team’s experience includes a range of behavioral health projects at all scales including the two main behavioral health state hospitals in Oregon—the Salem and Junction City Psychiatric Hospitals, the Western State Hospital Behavioral Health Master Plan and pre-design, the University of Washington Behavioral Health Teaching Facility, and the Signature Healthcare Behavioral Health Clinic. These projects, in addition to each of our team members’ previous experience, have given us insight into a design that supports a new therapeutic model, emphasizing individual care that accelerates recovery and the healing process.

The SRG team has planned for and/or designed more than 600 licensed behavioral health beds in Washington alone. Through these projects, we have established a deep understanding of various Department of Health approval processes, the FGI guidelines, the New York State Office of Mental Health Patient Safety Standards Materials and System Guidelines, and other guidelines related to behavioral health projects.

Rooted in Pacific Northwest values of environmental sustainability and social responsibility, we use the collective brainpower, diverse capabilities, and inherent curiosity of our team to overcome complex design challenges, question conventional thinking, recognize opportunities, and guide our clients toward thoughtful design that stands the test of time.

CRITICAL ACCESS HOSPITAL PROTOTYPE

OREGON STATE JUNCTION CITY PSYCHIATRIC HOSPITAL

SHRINERS HOSPITAL FOR CHILDREN - LOS ANGELES

OREGON STATE SALEM PSYCHIATRIC HOSPITAL

UNIVERSITY OF WASHINGTON BEHAVIORAL HEALTH TEACHING FACILITY

SHRINERS HOSPITAL FOR CHILDREN - LOS ANGELES

WESTERN STATE HOSPITAL MASTER PLAN & PRE-DESIGN

“We tend to focus, just like in physical health, on sick care rather than preventative medicine. The worst-case scenario in mental health that’s getting a lot of attention right now is treating people downstream, after a crisis. But there is an equal amount, if not more, that we need upstream in the mental health system.”

– Carl Hampson, Principal and Architect, SRG Partnership

Reimagining Behavioral Emergency Environments

In 2022, Mental Health America ranked Washington State #32 in the nation in terms of prevalence of mental illness and rates of access to care for adults. In recent years, the state has committed to investing significantly in inpatient mental health beds, but many gaps remain in the community safety net. Often developed at the county level, Crisis Stabilization Units (CSUs) can begin to fill some of those gaps by providing urgent care for mental illness and/or substance abuse disorders. Unlike standard urgent cares or emergency departments, these facilities are designed specifically for mental illness, and programs are designed to help staff quickly stabilize patients, connect them to resources, and then get them back into the community.

in a national

The session began with former patients and current patient advocates describing their personal experiences in a similar environment, allowing each participant to build empathy and a deeper understanding of specific challenges faced with this facility type. Through process mapping exercises, they prioritized the issue of the “one size fits all” nature of many units, developing a unit that ensures the right level of care for each patient and empowering them to maintain individual autonomy and a sense of control.

Once they identified this primary goal, the team rapidly identified, prototyped, and tested ways to address that challenge. Focusing on the emPATH unit concept and using Human Centered Design principles, Lori’s team developed diagrammatic concepts that allowed the facility to flexibly subdivide by diagnosis, age, locked vs. unlocked units, and other factors. The group also identified firmwide peer advocates as a key and often missing part of the care team, and found multiple ways to incorporate advocates into the facility’s workflow.

The below final product depicts an emPATH unit located adjacent to an existing emergency department. Walk-in patients are assigned peers or navigators upon check-in, while other patients arrive through a centralized, secure sallyport. After the triage process, patients may be escorted into the treatment area. These large spaces can be subdivided into multiple separate units that have been flexibly designed. Each sub-unit would accommodate different age groups and acuity/ security levels, allowing each unit’s

census to ebb and flow as needed based on the patient population.

The workshop’s goal was to further the discussion of ways to improve the Crisis Stabilization Model to incorporate empathy and the patient experience. SRG Partnership is using what Lori learned to discuss, imagine, and design what this type of unit could be. SRG has committed to continuing the conversation through an upcoming series of design discussions and work sessions firmwide.

In December 2022, SRG’s Lori Epler participated

workshop that brought behavioral emergency clinicians, former patients, and designers together to reimagine behavioral emergency environments.

“We are in the middle of a mental health crisis in this country. More than 1 in 5 US adults and youth will have a seriously debilitating mental illness in their lives. At the same time, more than a third of Americans live in a mental health professional shortage area – defined by looking at the population to provider ratio, percent of population below poverty level, and travel time to care. Many, many people living with serious mental illness are unable to access care in this country.”

- Lori Epler, Principal and Senior Medical Planner, SRG Partnership

Behavioral Health Teaching Facility

UNIVERSITY OF WASHINGTON / SEATTLE, WA

The University of Washington has established a bold vision for a new Behavioral Health Teaching Facility that will become the foundation for positive transformation of the entire Behavioral Health system in the state of Washington. Located adjacent to an existing acute care hospital on the UW Medical Center Northwest Campus, the new six-story building will be a fully integrated welcoming, and healing environment for individuals struggling with both physical and behavioral health conditions. The facility will support a full continuum of clinical services ranging from effective medication management and psychotherapies to state-of-the-art neuromodulation treatments, as well as medical and surgical care for individuals with behavioral health disorders.

A HOLISTIC APPROACH TO PATIENT CARE

Our progressive design-build team is working together to deliver an efficient, safe, and quality setting that promotes well-being, healing, and learning around a new patient-centered model. In this state-of-theart Integrated Care program, medical, mental health, and social service professionals will collaborate closely to provide a holistic approach to patient care that reinforces the connection between mind and body.

ENVIRONMENT AS TREATMENT

Recognizing that the new building is an expansion of the existing hospital, attention to scale, articulation, openness, and warmth will reinforce the vision for a new standard of behavioral health care. The design will maximize access to daylight and views while assuring patient privacy, dignity, and safety. A minimal neutral palette will be used with wood tones and accents throughout to create a serene and comforting environment and a sense of place that eases stress and is inviting to patients, family, and visitors.

KEY FEATURES

› Crisis center

› Communitybased design

› Significant cost savings

› Sustainable design

Pima County Behavioral Health + Crisis Response Center

UNIVERSITY OF ARIZONA & BANNER HEALTH / TUCSON, AZ

Integrated into an academic medical center, this pioneering behavioral health facility works in unison with an acute care hospital to offer an integrated approach and full continuum of care for patients and the local community.

INNOVATIVE COMPREHENSIVE CARE

Care includes acute and sub-acute inpatient services, outpatient clinics, crisis assessment and stabilization, physical healthcare, and law enforcement support, delivering a holistic approach to behavioral health treatment.

MEDICAL EDUCATION

Providing an integrated healthcare environment to train new physicians and support community engagement and education.

HEALING, SAFE, AND NON-INSTITUTIONAL ENVIRONMENT

“Normalized” patient environments balance safety and security requirements with the clinical goal of creating a place that promotes healing and rehabilitation.

EFFECTIVE COST MANAGEMENT

Lean design approaches, construction management collaboration, and the creative use of standard materials and systems resulted in a per-square-foot cost of only $187.

56% of individuals diverted by services at the CRC under Emergency Application for Submission to community services or voluntary care, resulting in significant cost savings for Pima County.

80% of adults receiving care at the CRC are able to return to the community, rather than needing more intensive and costly services.

$43 - $75 million estimated savings by the CRC to Pima County in criminal-justice costs alone.

CARL HAMPSON’S PRIOR EXPERIENCE

Western State Hospital Master Plan & Predesign

DEPARTMENT OF SOCIAL AND HEALTH SERVICES / LAKEWOOD, WA

This 10-year Master Facilities Plan for the Western State Hospital Campus in Lakewood, Washington, will operate separate adult and adolescent psychiatric hospital programs on a 288-acre campus.

INNOVATION IN BEHAVIORAL HEALTH

The number one goal of the Master Plan was to establish a new recovery model of care for the forensic patient population with the construction of a new hospital and the conversion of older, corrections-based designed buildings into support facilities. Civil

commitment patient programs will be relocated into smaller, communitybased housing and treatment facilities as part of the Governor’s directive for the State’s Behavioral Health Initiative.

LOCAL ESSENTIAL PUBLIC FACILITIES APPROVAL PROCESS

The Predesign Study for the new, 350-bed Forensic Center of Excellence followed all local standards, specifications, and requirements and was successful in obtaining project funding from the State Office of Financial Management.

Behavioral Health Hospital

SIGNATURE HEALTH / TACOMA, WA

This new facility will provide 105 inpatient beds, support services, outpatient care, and dependency rehabilitation in a community-based setting.

ENVIRONMENT AS TREATMENT

The hospital serves as a safe, patientcentered environment and emphasizes view connections to the surrounding wooded areas and courtyards. Nestled into the sloping site, the building blends in with the residential neighborhood, terraced parking minimizes impacts to the adjacent wetlands, and native plantings will restore the site to a naturalistic setting.

MAXIMIZING FLEXIBILITY AND EFFICIENCY FOR THE COST

Patient wings and accessible courtyards are arranged so they can be partitioned into adolescent, adult, or geriatric populations as needs fluctuate. Outpatient activities and support services remain accessible but discrete from inpatient services and populations. Amenities including the gymnasium, dining, and conferencing space flex between inpatient, outpatient, and community use to maximize their reach and program efficiency.

Oregon State Hospital Renovations and Additions

STATE OF OREGON / SALEM & JUNCTION CITY, OR

This transformative project for the State of Oregon included 620 inpatient beds, with treatment and therapy program space organized in a Recovery Model of Care.

INNOVATION IN BEHAVIORAL HEALTH

SRG collaborated with Frank Pitts and architecture+ to transform the Model of Care for the State of Oregon from a correctional model to a modern treatment model for the project.

REDUCING COST AND SCHEDULE

The initial building design included concrete tilt-up wall panels as the main exterior cladding system and structural support. A local pre-cast concrete contractor proposed the use of pre-cast panels instead to take advantage of their nearby production facility which saved construction time and increased the quality of the panel appearance due to quality controls available internally.

EFFECTIVE DESIGN TOOLS

Working with the contractor early to test materials and systems in room prototype mock-ups resulted in effective decision-making with the users and efficiencies during construction.

LONG-TERM RELATIONSHIP

SRG has continued to support Oregon State Hospital as their census and clinical needs change, inserting additional seclusion spaces, developing a specialized single-patient unit, and completing various other renovation projects across both campuses.

Arizona State Forensic Hospital

STATE OF ARIZONA / PHOENIX, AZ

CARL HAMPSON’S PRIOR EXPERIENCE

The forensic campus is organized around a “courtyard in the desert” with a healing community concept that effectively belies the hospital’s high level of security. The tranquil cloister promotes patient advocacy, calmness, and recovery.

COLLABORATIVE DELIVERY AND COST MANAGEMENT

During the programming phase, the original 200-bed plan was deemed not possible for the established budget. Through a collaboration of the architect and CM, a revised plan of 80 beds was created with an alternate for 20 additional beds. When the GMP was developed, the team was able to streamline costs to deliver 40 additional beds within the allotted budget, bringing the facility up to 120 beds and allowing

the state to meet the current population needs for the Forensic Hospital.

ENVIRONMENT AS TREATMENT

The concept of “town community” is manifest in the design of the central courtyard and its covered exterior walkways. A therapy mall, the center of patient life hosts a variety of activities including arts and crafts, ceramics, music, a clothing store, and a gymnasium, all focused on patient stabilization and normalization.

SAFETY AND SECURITY STANDARDIZED

Patient units with on-stage/off-stage internal organizations support staff safety while promoting effective and consistent treatment for all patients.

A COLLABORATION WITH SRG + HOK

Capital

Programs Director

Department of Social and Health Services

e: robert.hubenthal@dshs.wa.gov

t: 360-480-6935

PROJECT

Western State Hospital

Master Plan and Study

Steve Tatge

Executive Director, Project Delivery Group

University of Washington

e: statge@uw.edu

t: 206-459-5439

PROJECT

University of Washington Behavioral Health Teaching Facility

Jerry Frampton

Director of Facilities Operations

Oregon State Hospital

e: jerry.d.frampton@dhsoha.state.or.us

t: 503-945-2925

PROJECT

Oregon State Hospital Psychiatric Hospital Renovations

Jürgen Unützer, M.D.

Chair of the UW Psychiatry and Behavioral Sciences, director of the UW Medicine Advancing Integrated Mental Health Solutions (AIMS) Center, and a UW professor of Psychiatry and Behavioral Sciences

University of Washington Medical Center

e: unutzer@uw.edu

t: 206-543-3752

PROJECT

University of Washington Behavioral Health Teaching Facility

Our success in maintaining long-term relationships comes from our ability to understand and meet our clients’ needs, often outperforming their expectations. We invite you to speak to our references below to get an understanding of the value we can provide for your organization.

Bob Hubenthal

UNIVERSITY OF WASHINGTON BEHAVIORAL HEALTH TEACHING HOSPITAL

UNIVERSITY OF WASHINGTON BEHAVIORAL HEALTH

OREGON STATE SALEM PSYCHIATRIC HOSPITAL

Research + Process

The Future of Mental and Physical Well-being

Our practice leverages our thought leadership, expertise, and imagination to continually explore and influence the future of mental and physical wellness. We engage partners beyond our organization to participate in design forums where we can leverage their unique perspectives and experience. Our recent “WellCity” design exploration brought together diverse minds to explore the gaps in our mental health system and resulted in innovative concepts driven by design-thinking and collaboration.

WELLCITY

THIS CONCEPT EXPLORES THE RELATIONSHIP BETWEEN PUBLIC SPACE AND WELLNESS SYNERGIES

RETAIL THERAPY

THIS CONCEPT EXPLORES THE REPURPOSING OF DEFUNCT SPECIALTY STORES INTO MENTAL HEALTH WELLNESS ENVIRONMENTS

DEPLOYABLE RE-BOX

THIS CONCEPT EXPLORES THE MOBILE MENTAL HEALTH PREVENTION AND TREATMENT PLATFORMS

THIS CONCEPT EXPLORES THE TRANSFORMATION OF BIG BOX STORES INTO HOLISTIC HEALTH AND WELLNESS ENVIRONMENTS

Bridging the Gaps in our Mental Health System

Bridging the Gaps in our Mental Health System

+ What is missing in our current mental health system?

+ How will the recently approved King County Crisis Centers Levy fit into the equation?

+ What else is needed to successfully support our region’s mental health?

Participants collaborated across disciplines to complete a visual exercise that inspired discussion about challenges in our current system and strategies to make systematic improvements to connect and bridge those gaps.

+ Enhance preventative care in schools and communities

+ Activate diversion programs and develop alternatives to jail

+ Create federal licensure and facility standards

+ Expand supportive services to be available immediately after the first diagnosis

+ Develop systems to tackle houselessness

Panelists Include:

+ Margie Balfour, MD, Ph.D.; Psychiatrist and Chief of Quality & Clinical Innovation, Connections Health Solutions

+ Rebecca Chamaa, Speaker for NAMI of California In our Own Voice program, lived experience with chronic schizophrenia

+ Carl Hampson, Principal, and Architect, SRG Partnership

+ Charity Holmes, Assistant Administrator of Behavioral Health Services, UWMC

+ Anna Nepomuceno, Director of Public Policy and Advocacy, NAMI of Washington

SRG hosted a public forum led by a panel of experts to connect advocates, professionals, designers, and builders to answer some of Washington State’s most pressing questions about accessing care.

FROM LEFT TO RIGHT: LORI EPLER, ANNA NEPOMUCENO, CHARITY HOLMES, MARGIE BALFOUR, CARL HAMPSON, REBECCA CHAMAA

“A crisis system is not just a single crisis program. Training police to respond with crisis response teams is one piece, but you need a whole system with someone to call, the appropriate clinicians to respond, and a place to go to receive treatment. That continuum isn’t available across a lot of this country.”

– Margie Balfour, MS, Ph.D.; Psychiatrist and Chief of Quality & Clinical Innovation, Connections Health Solutions

“Trauma informed care has to be at the heart of everything that we do, and it’s the change in culture that our healthcare system needs.”

– Charity Holmes, Assistant Administrator of Behavioral Health Services, UWMC