Behavioral health experts Erin Sharp-Newton and Bryan Pennington were selected to present at this year’s Healthcare Design Expo & Conference (HCD) on October 24, 2021, in Cleveland. In collaboration with Christine Belluardo-Tierney, MAS, BSW, Assistant VP of Behavioral Health Services, RWJBarnabas Health, Somerset, and Nicole Cocolin, president at DCC Design Group, they shared vision and innovation, coupled with research-based design principles, that shaped the new Eating Disorder Unit for Robert Wood Johnson University Hospital (RWJUH) Somerset. Presenting on what makes designing for behavioral health unique when addressing eating disorders, and how designing with biophilia can “tune” circadian rhythms to improve outcomes across the full spectrum of behavioral health.
Visioning care through design in the renovation of Robert Wood Johnson University Hospital Somerset resulted in leadership’s identification of the need to transform the first floor West Wing into a state-of- the-art inpatient unit for their nationally recognized eating disorders program.
This session focused on (1) outcomes from in-depth collaborative sessions with leadership, staff, and the design team, resulting in the mission and principles for their new eating disorder unit. (2) The unique challenges in designing for eating disorders as well as addressing the separation of commingled adolescents and adults into separate areas, while offering a well-planned, welcoming, comforting, and safe behavioral health environment that supports state-of-the art treatment. (3) How the design team generated a system of overlays to evaluate planning and design options that supported and reinforced the core principles and missions.
(4) Principles of biophilia, circadian controlled lighting, and connection to nature to design supportive to the therapeutic process for eating disorders and mental health.
(5) Patient safety, anti-ligature, and self-harm prevention methods and ways to design a warm, comforting healing environment while maintaining FGI requirements.
(6) Examples of how a well-planned eating disorder unit can maintain a balance of open/closed, public/private, patients/staff, with open inviting spaces that promote patient and staff safety.
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"Erin Sharp Newton has spent years designing buildings in cities around the globe, always with a focus on how her work can better the human condition. After a decade in Italy, she returned to the United States with a desire to tackle projects that go “beyond what looks cool.”
While working for NK Architects in Morristown, New Jersey, she found a design specialty that suited her: Behavioral Health. “Designing behavioral health facilities is a challenge that is unlike any other project type,” she says. “From the windows to the doors, the walls, the ceilings, the lighting, the fixtures; every aspect requires a totally different mode of thinking as compared to a typical design project.”
According to the National Alliance on Mental Illness, every year approximately 1 in 5 American adults experiences mental illness. At the same time, the past year saw only 41 percent of adults with a condition receive mental health services. Location and lack of availability are part of the problem, but the stigma of sealed-off, locked-away care—and the unwelcoming facilities that typically housed patients in the past—remains a pervasive factor as well.
“On a typical project,” Newton says, “you’d ask, ‘What looks nice?’ Maybe you’d envision picture windows, curtain walls, fancy finishes, French doors, seamless walls of glass, all kinds of other wonderful things. Every one of those, you cannot use in a behavioral health facility.” Instead, this means specialty door hardware, more durable flooring, modified handrails, and safer furniture, fixtures, and equipment. It also means getting granular and understanding the very specific requirements of clients and patients in this field...
“The fantastic thing here is that it was a ground-up,” Newton says. Many projects in this field are upgrades or renovations, she notes, which limits an architect’s ability to start from scratch. Here, the team could pursue their full agenda with the support of a committed and knowledgeable healthcare client."
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Historically patients with long term mental illness have been warehoused away from the local population. Driven by stigma, lack of understanding, and marginalized resources, citizens with mental health concerns were often isolated further in facilities separated from the community. Access to care is often limited, and the continuum of care has been disjointed. It can take 5 years for a patient to reach their place as a functioning member of society, managed and stabilized.
How does this fit into a system that focuses on short-term solutions, or otherwise long-term isolation?
Hackensack Meridian Health Carrier Clinic President Donald J. Parker addressed the European Healthcare Design Congress in London on the topic of “Designing a Healing Mental Health Campus to Create an Accessible Continuum of Compassionate Care” during the symposium entitled “Blurring the Boundaries – Designing Place-Based Health Systems.”
The conference was sponsored by the Royal Conference of Physicians. "From a farm-based, grassroots initiative,” he said, “Carrier, in conjunction with NK Architects’ behavioral health design team, has conceived and developed a unique healing campus.
Combining patient-designed care in unison with community-based initiatives and integrated leadership has resulted in the construction of a system of compassionate care that is helping to break through this stigma and is designing a continuum of accessible empathetic care into the community and beyond.
Compassion for humanity with alternative solutions and evidence-based best practices is the premise of the proposed solution to stigma and isolation.”
Supported by Erin Sharp-Newton, behavioral health design specialist at NK Architects in Morristown, N.J., and Ben Lee, CFO and principal at NK Architects and designer of Carrier Clinic’s ground-breaking campus expansion plan.
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SUN Behavioral Health’s motto is “solving unmet needs.”
The company’s President and Chief Executive Officer Steve Page sheds some light on what its team looks for when going into a new community:
“What we are ultimately looking for is to see signs of patients getting stuck,” he says. “Maybe they are stuck in the emergency room for a long time because psychiatric services are full, so they are looking for a place where the patient can begin treatment. We create services to relieve access challenges...
A safe, comfortable atmosphere for patients and staff must harmonize many elements all working in chorus: Open free space Close safe space Access to outdoor areas for recreation Access to natural light & good interior light; Materials that are pleasing and calming; Zones that allow for creativity, flexibility, activity; Security-focused materials, including windows and doors that are impact- and tamper-proof, and appropriately safe hardware, as well as pick-proof finishes, throughout the building.
Some of the ways the new building offers these are with: Creative open islands, softly flowing in the center of large day spaces, establishing a sense of gentle movement and flow. Living rooms, with armchairs that are set up around televisions, creating a home cinema experience. Two and four top café tables, and various configurations of spaces serving to create inclusiveness while gently expanding to provide appropriate boundaries. Deep nurse stations that open up to the patients, on floor plans strategized to maximize sight lines for the staff (without making patients feel “on watch”). Group rooms at the end of each wing are surrounded in natural light, which subtly emulates into the wings.
FACTS + NEEDS
"Kentucky ranks 49th (second worst) in the number of people suffering from depression and 49th (second lowest) in mental health well-being. Suicide in Kentucky kills more people every year than automobile accidents. “(From: Edward L. Smith Jr. Published May 3, 2015, Cincinnati.com/ USA Today)
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