Behavioral health (BH) issues have been growing problems in our society for years but became acute during the Covid-19 pandemic, which caused an estimated 25 percent spike in depression and related issues.

And although government funding for BH facilities isn’t close to what many experts have called for, it has risen in recent years. The 2022 U.S. federal budget, in particular, earmarked $2.14 billion for the National Institute for Mental Health (NIMH) and $857 million to help state and local governments address funding gaps.

Some of these gaps include BH treatment services and facilities. But designing and building such a facility requires special considerations.

Indeed, recent studies show elements such as natural daylight, suicide-resistant building materials, and good sightlines can dramatically improve health outcomes in all patients – but especially those suffering from BH issues.

Modern behavioral health design: The foundations

BH design has come a long way since its early days, with the so-called “lunatic asylums” of past generations giving way to more open, modern facilities with clear sightlines, bright colors, ligature-resistant furniture, and plenty of windows and natural light.

Indeed, several best practices have developed through evidence-based design (EBD) that should inform BH facility design. BH facility design should aspire to create:

A therapeutically enriching environment

• Patient autonomy, respect, and privacy
• Visual access to nature to promote healing
• Tranquility and a home-like atmosphere

A safe and secure environment

• Minimize potential physical hazards
• Enhance staff visibility and engagement with patients
• Use of abuse-resistant materials, furnishings, and fixtures
• Open floor plans and good sightlines

An additional key design consideration around the importance of natural light in behavioral health design is the inclusion of natural light wherever possible. “Inpatient and residential facilities, where feasible, (should be) single story or village-like, with multiple exterior courtyards bringing in more natural light and views of nature,” according to the U.S. Department of Veterans Affairs Design Guide for Mental Health Facilities.

The guide also says that natural light in staff and patient areas can significantly reduce stress, that all indoor patient areas should have access to natural light, and that designers should “provide daylight in all feasible areas in appropriate quantities.”

While artificial light is important when natural lighting is impossible to avoid any dark spots in the facility, the former should be used with care. While natural light has positive benefits for patients, studies have shown that bright artificial lights can deter healing of all types. Patients need sleep to bolster recovery, and bright lights seeping in from corridors, nursing stations, and other adjacent rooms can significantly impact a patient’s rest.

The importance of natural light in behavioral health facilities

A brief glimpse at the data clearly shows the importance of natural light in BH facilities for patients and staff.

Studies have shown how daylight impacts health outcomes by reducing depression among patients, decreasing the length of stay in hospitals, improving sleep, lessening agitation among dementia patients, and easing pain. “Access to outdoor spaces also has become an important aspect of therapy,” according to Health Facilities Management. “In situations where this is not practical, a view to the outdoors and access to natural light are important in the healing process.”

Indeed, one facility showed that patients in inpatient rooms without natural light have longer hospital stays than those in rooms with natural light.

And a Shepley-Bulfinch/Cornell survey also found that good daylighting and noise control are the highest rated environmental features by behavioral health facility staff.

The same report concluded that while staffers are, of course, concerned for their personal safety, they often place their desire for amenities (such as respite space) below the priority they place on patient needs.

Other behavioral health considerations

Of course, it’s not just the importance of natural light in behavioral health design that comes into play. Other important factors must also be weighed, including:

• The safety of building materials: This includes using ligature-resistant furniture, windows and doors; along with impact-resistant glazing (preferably AAMA 501.8-certified glazing for resistance to human impacts of up to 2,000 ft-lbs
• Patient privacy: Patients need to have a sense of privacy while allowing for discreet monitoring by staff. Privacy solutions should be adjustable, permitting both open views and privacy
• Daylight and solar heat gain: Glazing should be adjustable to minimize glare and raise or lower solar heat gain depending on the season
• Sound attenuation: Loud noise is antithetical to a therapeutic environment. The ability to minimize noise for patients is vitally important for both calming and healing

Learn more about behavioral health design in our AIA/CES course

You can learn about these and other important considerations for BH design in Unicel Architectural’s AIA-approved continuing education course on BH design, which can be delivered either in-person or via webinar.

In the course you’ll discuss new design options and best practices for behavioral health applications, along with seeing real-world examples through recent case studies from several leading healthcare facilities, all while earning continuing education credits. You can contact us for more information or to book a presentation.