Behavioral health facilities are seeing more patients presenting with comorbid conditions, yet built environments traditionally haven’t been designed to service both behavioral and medical conditions simultaneously. Speakers at HCD Virtual shared how this situation is driving the need for a new, more inclusive room type during the session “Designing for Medical/Behavioral Health Comorbidity: The Inclusive Inpatient Room.”

“The built environment can and will make a difference in quality of care by providing more therapeutic rooms,” said Shary Adams, medical planner at HGA, who co-presented with Kayvan Madani-Nejad, a senior healthcare architect at the U.S. Department of Veterans Affairs, Facilities Standards Service, Terri Zborowsky, design researcher at HGA, and Kara Freihoefer, director of research at HGA.

Specifically, the speakers said they set out to create the next generation of universal/inclusive patient room design “to care for anyone in any room at any time,” Adams said. “Our research process was also inclusive We included a variety of practitioners—medical planners, interior designers, architects, facilities managers, clinical staff—to help us understand this patient type through their lens.”

The team started with the thought to design for the behavioral health safety needs as well as address the ability to care for a medical or post-surgical patient but needed with a patient room and unit that addresses the needs of all patients in an acute care setting.

“Looking at it through an equity lens, we asked, ‘Can this encourage less stigmatization, less thinking in silos? Can we create an environment that can flex for safety and security?’” Adams said. “The answer, we think, is ‘Yes’.”

The proposed inclusive patient room design features:

  • Improved safety, such as integrated medical supplies (gases, outlets, etc.) seamlessly built into the architecture, which facilitates a more therapeutic, less-institutional environment for all.
  • Access to fresh air/outdoor spaces in the patient room and throughout the unit.
  • Medical clearances maintained around the patient bed and clear and consistent lines of sight of the entire patient room and the unit as a whole.
  • An integrated toilet/sink/shower/handrail as opposed to applied on the wall.
  • Sliding doors in lieu of swinging to reduce ligature/anchor points.

Zborowsky said the firm utilized research methods to gain insight into the social, psychological, and spiritual needs of the behavioral health patient, for this patient type. “It requires more detail, more knowledge, more time, and understanding,” she said.

Looking to the future for inclusive design, Adams said she sees a need for integrated inpatient medical and psychiatric care that will improve outcomes, address current patient populations, and support new guidelines. “Designing for the most vulnerable often meets the needs of many and provides flexibility for that unit now and into the future,” she said.

Zborowsky added that it’s also time to address staff environments in behavioral health settings. “Staff members working in this area are at risk for workplace violence,” she said. “Inclusive design addresses staff needs as well,” she said.

Missed HCD Virtual? Don’t worry. Registration is still open, and all sessions will be available on demand through the end of the year. Visit for more information.

Tracey Walker is managing editor of Healthcare Design. She can be reached at