Design for Health and Human Services Showcase.

This year Behavioral Healthcare invited design firms and provider organizations to submit their innovative building projects for our first Design for Health and Human Services Showcase. A panel of three highly regarded experts in this field reviewed them:

Michael Meehan, AIA, LEED AP, is an architect with BWBR Architects in St. Paul, Minnesota, where he serves as the professional development manager. His project experience includes a variety of corporate, higher education, and medical projects, including behavioral healthcare buildings (See behavioral.net/meehan 1108). In 2007, Meehan served as chair of the national AIA Young Architects Forum, and he received an AIA Young Architects Award in 2008.

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Aneetha McLellan, IIDA, NCIDQ, LEED AP, is director of interior architecture at HDR's Omaha, Nebraska, office where she has been an interior designer since 1996. she has been the project designer for numerous healthcare projects and has extensive experience in conceptual planning, space planning, interior architectural design and coordination, furniture coordination and packages, and user group meetings.

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David M. Sine, CSP, ARM, CPHRM, is President and founder of SafetyLogic Systems. He has been the state safety director of two Eastern states, the senior staff engineer for the Joint Commission, and a senior consultant for the American Hospital Association. He acts as a risk management advisor to the National Association of Psychiatric Health Systems and is a co-author of the Design Guide for the Built Environment of Behavioral Health Facilities: Edition 3.0.

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The jury praised designs that were not overly fancy but rather simple yet sophisticated. The jurors were impressed when designers created unique spaces with spot-on selection of colors and interior finishes, such as painting accent walls to give a room additional character. They did, however, express concern when shades of beige were used extensively.

"Adding color gives some depth and interest to a space that can be very scary and uninviting," said one juror, and another added, "Paint is one of the cheapest finishes available, and yet it can make a dramatic impact on the mood and character of a space."

Jurors cited the importance of having daylight permeate a building as well as providing multiple views of the outdoors, both of which can be accomplished creatively (such as by providing patients with window seats). Being "green" by using sustainable architecture strategies and pursuing Leadership in Energy and Environmental Design (LEED) certification (a green design industry building standard) received high marks, as did using evidence-based research to guide the design process. The jury also commended design teams that involved staff, administrators, and patients in the structure's planning.

Jurors, however, were concerned that some facilities used furniture and furnishings they considered inappropriate for behavioral healthcare environments (such as cabinet hardware and curtain rods that could serve as ligatures). "There are alternatives that don't look institutional and do look homelike," commented one juror.

The jury was particularly impressed by two projects and awarded them citations of merit.

Lindner Center of HOPE

The jury was impressed with this project's "marvelous" use of daylighting throughout the facility (including in patient room corridors) as well as abundant views of the surrounding landscape and gardens. (See page 22.) Jury members praised the design's use of a variety of finishes (which helps patients with wayfinding), including patterned floors.

"The interior palette makes great use of color, material, and light to create an open feeling and connection to the outdoors," explained one juror.

Another jury member noted that the building conveyed a sense of safety and security and that "I would feel good about leaving a friend here." In fact, the facility's use of "hardened suites" in patient care units to serve as storm shelters during tornadoes or other severe weather was cited as particularly innovative.

"Because some patients may be restricted to their patient care units and that is the one location within the facility that patients would spend the most amount of their time it seemed like the logical location for a shelter," Timothy M. Rommel, AIA, RAIC, ACHA, a principal at Cannon Design, Inc., told Behavioral Healthcare after the jury's review was completed. "In order to maximize the investment that was already being made we determined that with only a little extra in cost we could design the seclusion suites to withstand a tornado event. The walls and doors were already hardened (reinforced masonry units) and the rooms had no exterior windows. We added a reinforced concrete ceiling that completed the shelter. In the event of a tornado warning, all of the patients and their staff can move into the four seclusion suites, one on each unit, for protection until the threat passes."

Park Nicollet Melrose Institute

Jury members praised this facility's "stunning" design, noting that it resembled a hospitality environment and looked nothing like a stereotypical behavioral healthcare facility. (See page 26.)

"This is a project that in many levels does not look like a behavioral health facility," explained one juror, "It looks like a nice hospitality space with lots of nice and calming spaces to interact in."

The jury commended the designers' choice of a warm color palette carried from the building's exterior through the interior. Jurors appreciated the facility's application of daylighting, as well as carpeting in areas traditionally covered with other flooring types. And they praised the design team for giving patients a voice in shaping the building's design.

In addition, the jury was intrigued by the use of card-access locks in patient toilet rooms in the inpatient and residential patient areas.

"Access is controlled by the staff to ensure that patients cannot use the toilet rooms unobserved," Jessica Vogel, AIA, LEED AP, associate and project designer at Ellerbe Becket, told Behavioral Healthcare after the jury's review was completed. "Purging into the toilets or water loading from the sink are two common behaviors for patients with eating disorders."

Vogel further explained that "water loading" is when patients consume a massive amount of water to "instantly gain weight" when they know they are going to be weighed. The patients are weighed daily, if not multiple times a day, and all of the food they consume is measured and weighed. Water loading can produce inaccurate weight readings and lead to hyponatremia (an abnormally low level of sodium in the blood), which can be fatal--especially for dehydrated and malnourished patients.

To submit a project for a future showcase, e-mail Donna Paglia at [e-mail].

Design for Health and Human Services 2009 Showcase
Page Project

22  Lindner Center of HOPE (Citation of Merit)
26  Park Nicollet Melrose Institute (Citation of Merit)
28  Center for Life Management
29  Hancock Geriatric Treatment Center
30  Kings County Hospital Center
31  Memorial Cottage CTR

MENTAL HEALTHCARE FACILITY

Cannon Design GRAND ISLAND, NY

Lindner Center of HOPE MASON, OH

Situated on a 36-acre rolling meadow, the Center is tucked away in a wooded setting a half mile from the main thoroughfare. The landscape became the symbolic platform for understanding the challenges of, and opportunities for, mental healthcare treatment, and an essential factor driving building form and organizational plan.

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To achieve the client's goal of providing "the best evidence-based care in North America," the 64-bed Center offers an integrated program of inpatient care to adolescents, adults, and seniors. It also provides comprehensive outpatient services offering the latest advances in clinical neuroscience, and includes state-of-the-art diagnostic equipment as well as dedicated space for integrated research and educational programs.

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In support of the "active treatment" model of care, the facility is designed as a "treatment campus" utilizing the entire site to maximize patients' exposure to mental health treatment. The Bridge Building, which houses a "treatment mall" composed of diagnostic, dining, recreational, and educational functions, is both a literal and a metaphorical bridge, spanning a swale that crosses the campus and providing a highly salient access point through which all patients pass.

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Resembling a beautiful lodge, the Center is surrounded by paths and tranquil gardens, using a simple palette of stone, wood, and glass. On the exterior of each patient room, glass introduced between layers of stone and wood bends and turns, transitioning from transparent to translucent, balancing natural light and controlling views--a concept that encourages privacy for those rooms that face outdoor treatment spaces.

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Patient care units meet individual needs, offering private patient rooms that accommodate "rooming-in" family members. A unique "frontyard, backyard, courtyard" design allows the landscape to permeate the interior of each patient unit, affording every patient direct access to multiple landscapes--a connection to nature that creates a "grounding" effect for patients to monitor the passage of time as well as weather and seasonal changes.

A symbolic point of arrival and departure, the lobby is a two-story glass-enclosed space with views to the creek, bridge, and woods. Public outreach helps eliminate the stigma associated with mental illness. Major assembly and staff training areas are used by patients and staff during the day and the community after hours. The dining room, with cathedral ceiling, features a stone fireplace that represents the warmth and comfort of home, enjoyable from either the outdoor terrace or dining room.

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Jury Comment: Very nice project with some great details. Very sophisticated approach to the design solution and very welcoming. This is a project that truly means what they stated. Evidence-based design research was used in implementing the design and it is more than obvious.

Project category: New construction (completed August 2008)

Chief administrator: Paul Keck, MD, President & CEO, Lindner Center of HOPE, [phone]

Firm: Cannon Design, [phone]

Design team: John P. Hall, AIA, RAIC, OAA, Project Principal; Timothy M. Rommel, AIA, RAIC, ACHA, Planning Principal; James Kent Muirhead, AIA, Project Designer; David K. MacLeod, ASLA, MLI, Project Manager; Scott C. Whitehead, Project Architect (Cannon Design); Mark R. Graeser, Vice President, Construction Manager/General Contractor (Danis-Foxx Builders, LLC)

Photography: Tim Wilkes Photography

Total building area (sq. ft.): 91,800

Construction cost/sq. ft.: $305

Total construction cost (excluding land): $28,000,000