Common Mistakes in Designing Psychiatric Hospitals – AIA

Common Mistakes in Designing Psychiatric Facilities - AIA

AIA ACADEMY OF ARCHITECTURE FOR HEALTH JOURNAL, September 2009

Suicide prevention and patient and staff safety issues in psychiatric units present a very unique set of issues.  Three newly constructed psychiatric hospitals, one on each coast and one in the center of the country last year had significant patient safety issues.  Other facilities spent substantial amounts of money remodeling existing units and not only didn’t resolve patient and staff  safety issues, but (in some cases) actually made them worse.

National  statistics show that the average 24 bed psychiatric unit will experience one successful inpatient suicide per year and patient-to staff injuries continue to be a major concern for most facilities.

Possibly the most important design feature of a psychiatric unit is maximizing visual observation  of patients from the nurse station.  If this is not addressed early in the schematic design phase, it will likely never be attainable.  The level of concern for
patient safety increases with the amount of time they spend alone in a space,
such as patient rooms and toilets.

The need for patient safety tends to drive the aesthetics of the units toward prison-like
environments.  This is counter-productive to treatment and the healing process of the patients and should be avoided.

The solutions are often the opposite of what is typically done on medical/surgical units.  Design professionals who do not address these issues carefully may be incurring major liability should a successful suicide or staff assault occur in an improperly designed unit that doesn’t meet a reasonable standard of care.

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