Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.
Issue link: https://mcdmag.epubxp.com/i/509247
outpatient facilities are adopting more homelike features that create a positive experience and restore a sense of dignity. Designing for dignity gives clients a sense of choice and control in their environment, while keeping them safe and comfortable. Two behavioral health facilities illus- trate how healthcare organizations are planning and designing for client dignity and choice along the continuum of care. Homelike features at Hope House Hope House, operated by Contra Costa County Behavioral Health Services in northern California, is a 6,850-square-foot, 16-bed crisis residential facility providing voluntary, step-down transitional care for clients leaving the hospital but still needing mental health assistance in a less restrictive setting. The supervised residential facility provides continuous assessment, individual and group treatment, peer counseling, medication evaluation and life-skills train- ing for residents staying up to 30 days. The facility projects homelike features that accommodate clients and their families in a soothing setting that lowers stress, promotes safety and improves outcomes. Typical residential features are replicated to provide a sense of comfort synonymous with home. These include: › Hardwood fl oors › Lounge furniture › Pocket seating areas › Carpeted bedrooms with operable windows › Community kitchen with breakfast bar › Expansive views to the outdoors and patio access Other amenities such as a quiet room, group room, library and numerous indoor- outdoor areas for individual respite and group therapy add to the healing environ- ment. The building is nestled within the contours of a hillside. The stucco-and- wood exterior suggests a lodge rather than an institution, which is appropriate for its wooded setting near a residential area. Ultimately, Hope House is designed to shed the stigma of mental illness and re- store a sense of personal dignity and choice. Right-sized care at Cordilleras Cordilleras Mental Health Center for San Mateo County Department of Public Works and County Health System in California is taking a similar approach with its recent feasibility study to replace a 117-bed facility, originally built in 1952 as a tuberculosis hospital. Located on a hilly, wooded, semi-se- cluded 19-acre site, the center houses two separate treatment programs for adults with chronic mental illness: a locked 68- bed mental health rehabilitation center and a licensed 49-bed adult residential facility. The feasibility study transitions the pro- gram into a series of smaller buildings that emphasize homelike settings, while captur- ing federal Medi-Cal reimbursements for facilities with 16 beds or fewer. More than just a design trend, healthcare research tracks a correlation between larger pro- gram size and longer lengths of stay. As the number of program beds increase, the residents' length of stay increases. Smaller program sizes, however, often translate into shorter client stays. As such, the study recommends build- ing a total of six facilities, comprising fi ve single-story 10,500-square-foot, 16-bed MHRC facilities and one three-story, 30,000-square-foot, 55-bed ARF. The fi ve independent MHRCs provide variation in the type of care appropriate to the population in each household. Each single-story house is further divided into smaller pods or neighborhoods of four bedrooms each, in which the clients have the freedom to move from communal space to more private space. Clients have an op- portunity to "graduate" from the MHRCs to the ARF, which is planned above a campus center housing communal and administra- tive program areas. Key to the study's success, which proposes the project be built over mul- tiple phases for completion in early 2020, is giving clients a sense of choice in their environment while maintaining security for them and staf . For instance, a careful bal- ance between on-stage and of -stage areas for staf , and controlled access to the out- doors on the bucolic campus, was proposed. Hope House and Cordilleras Center rep- resent new directions in behavioral health facility planning. By emphasizing dignity and a sense of choice, clients can progress more successfully along the continuum of care. Tying in with the national trends fo- cused on outpatient care, behavioral health facilities will continue to break down the institutional walls in favor of smaller, more homelike environments that recognize each client's individual needs. Vince Avallone, AIA, ACHA, CASP, NCARB, LEED AP BD+C, is a healthcare architect and medical planner at HGA Architects and Engineers. Kevin Day, AIA, LEED AP BD+C, is a healthcare architect at HGA Architects and Engineers. Rebecca Kleinbaum Sanders, AIA, NCARB, is a healthcare architect and medical planner at HGA Architects and Engineers. 50% In their lifetimes, about half of Americans will have a serious mental health condition. 64.4 million Number of visits (to physician offi ces, hospital outpatient and EDs) with mental disorders as primary diagnosis. MCDM AG.COM | M AY/ J U N E 2015 | Medical Construction & Design 29