Behavioral Healthcare Design: Ten Things You ‘Know’ That ‘Just Ain’t So’

By: JAMES M. HUNT, AIA, NCARB

This article was originally published in the AIA Academy of Architecture for Health | Academy Journal 2015.

Preliminary meetings involving architects, psychiatric hospital management, and unit staff members often result in decisions that crystallize into critical details of facility design very early in the planning process. These can be very difficult, if not impossible, to change later on.

During these sessions, it is not unusual for psychiatric hospital staff to state any number of time-honored platitudes that, through sheer repetition, have come to be “known” as unchallengeable facts of psychiatric facility design. Typically, staff comes to “know” such things because they have heard them during their education and throughout their professional lives in the facilities in which they have worked. But using such “common knowledge” while designing new psychiatric facilities can be very problematic and very costly.

Former baseball great Satchel Paige explained the problem best when he said, “It’s not what you don’t know that will hurt you; it’s what you ‘know’ that just ain’t so.”

And so it is, I find, with the design of psychiatric hospitals. The intelligent and highly educated people who are brought together in preliminary design meetings frequently fail to consider whether what they have come to “know” about psychiatric facility design is now (or ever was) valid. Let’s look at the data available from some credible sources to see if some of these “known” statements are actually correct.

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