Awards + Events

The 2024 Healthcare Design Expo & Conference will be held Oct. 5-8, at the Indiana Convention Center in Indianapolis. The annual event will offer a variety of keynote and breakout sessions on a range of topics.

Healthcare Design is previewing some of the upcoming educational sessions in a series of Q+As with speakers, sharing what they plan to discuss and key takeaways they plan to offer attendees.

Session: Crisis Care Continuum: Evolving Behavioral Emergency & Crisis Care Models

Speakers: Scott Zeller, vice president of acute psychiatry at Vituity; Stephen Parker, architect & behavioral health planner at Stantec; and Jon Sell, principal & behavioral health SME at Stantec.

In a post-pandemic world, the growing awareness of mental health has led to an increase in the design of crisis stabilization centers and behavioral emergency units. These facilities help divert mental health patients from law enforcement and overcrowded emergency departments. This session explores how partnerships, expertise, and resources can address the demand for psychiatric EDs, EmPATH models, and crisis care units. Presenters will discuss recent projects, including CHS Kirkland Crisis Receiving Center and a modular crisis concept, emphasizing patient-centered design, staff safety, and community impact.

Healthcare Design: How have attitudes on mental health and well-being changed in the past decade?

Stephen Parker (Image credit: Stantec)

Stephen Parker: Since the pandemic, seemingly everyone has some shared, lived experience with how their personal spaces impacted their mental well-being when their homes became impromptu workplaces, playgrounds, and default social spaces.

This forced social experiment acknowledged that demand for mental health services was chronically ignored and underinvested in decades prior—to the detriment of subsequent generation’s mental well-being.

I think public figures including Olympic athletes Simone Biles and Michael Phelps sharing their experiences and openly talking about their struggles with mental illness has helped bring more awareness to the topic and hopefully has inspired other to seek treatment, as well.

Coupled with the rapidly expanding demand and limited existing capacity of mental health beds, providers, and services, this has led to a sea-change in attitudes, funding, and focus in behavioral health care. My hope is that this society-wide lifting of stigma and recognition of behavioral health as an inseparable component of overall health is sustained beyond a once-in-a-generation investment.

How is this driving new approaches and demand for mental health care environments?

Jon Sell (Image credit: Stantec)

Jon Sell: Harmonizing the evidentiary with the empathetic can help defy stigma by design. We’ve seen states, municipal health systems, and the federal government pour in funding and it’s taking shape in suburban, rural, and urban communities to provide greater access to crisis care.

Specifically, many renovation efforts and new construction projects are in progress, ranging from limited interior upgrades to implementing new system-wide planning concepts to address the “no-wrong-door” approach.

Emergency departments (EDs) and law enforcement settings are ill-equipped to handle this crisis. Supporting the three legs of the crisis system, from 988 crisis lifeline call centers to mobile crisis teams, facility-based crisis services provide the safe and stabilizing environment of care in those crucial first hours of individuals in crisis.

Although crisis centers are vital for episodic mental health issues, we need to also be concerned with what happens to the individual once they leave a facility, ensuring they have access to resources in the community.

What are some of the new and emerging crisis care models that have materialized in recent years?  

Dr. Scott Zeller (Image credit: Vituity)

Dr. Scott Zeller: There are two emerging crisis care models that have rapidly progressed from virtually “unheard-of” to “in-demand” across all parts of North America: the Emergency Psychiatry Assessment, Treatment and Healing (EmPATH) model unit and the peer respite facility.

EmPATH units are designed to address the persistent problem of behavioral health patients being stuck untreated and “boarding” for hours in EDs, waiting for transfer to an inpatient psychiatric facility. These units feature a comfortable and open atmosphere with engaged staff where needs are met without coercion.

By swiftly moving such patients out of the ED into the hospital’s nearby EmPATH units, patients are seen promptly by a psychiatrist, and treatment is initiated with a goal of recovery and avoiding inpatient admission if possible.

On the other end of the spectrum, a peer respite approach features a relaxed and inviting facility in the community that’s completely operated by peer support specialists (individuals with lived experience with mental illness who have been trained and certified). The set-up offers a nonjudgmental place to go for those with urgent issues or a need to decompress or for supportive interventions.

Both EmPATH units and peer respite programs are important parts of the crisis system and complement other levels of crisis care.

What design features are important to consider in creating care environments that contribute to improving patient outcomes and safety in psychiatric crisis stabilization centers?

Sell: The hallmark of crisis stabilization remains the open and inviting living room concept; limiting coercion, confinement, and re-traumatization of individuals in crisis, and complimented by the peer-support approach.

Additionally, access to sensory-enabled architecture beyond the singular calm room offers greater opportunity for self-regulation and neurodivergent considerations. Lower social density helps mitigate adverse incidents between patients and providers, leveraging long-standing evidence-based design principles.

Biophilic strategies and access to nature (both virtual and physical) are also being incorporated more and more into crisis care settings  whenever possible and help provide greater stress relief opportunities. Trauma-informed design principles are ever evolving through furniture layouts, diverse social spaces, and amenities such as sensory-enabled architectural features that are haptic, engaging & foster belonging. Design strategies that incorporate safer and less institutional psych-safe full-spectrum lighting controls, safe yet non-institutional fixtures, have given much greater design freedom to architects of all knowledge levels as well.

What’s a takeaway you hope attendees learn from your session?

Parker: Design decisions can and should drive dignity, and environments of care can be an important component of crisis stabilization.

For news updates and information on the 2024 HCD Conference + Expo, click here.