The state of design evidence in comorbid behavioral health

Research into the design aspects of comorbid behavioral health and medical conditions is ongoing. The following areas of study have lately seen increased activity:

Anti-ligature design. As discussed in the 2016 Design Guide for the Built Environment of Behavioral Health Facilities, published by the National Association of Psychiatric Health Systems, the prevailing paradigm to improve behavioral health environments has focused on mitigating risk of self-harm and harm to others. 

The physical environment can reduce the possibility of suicide by eliminating elements such as handles, door hinges, pipes, light fixtures and grab bars that might support hanging or other self-harm. 

Because no environment is ever completely safe, it is critical to find an appropriate balance of anti-ligature features in a medical and behavioral health comorbidity patient room. 

Healing, calming environment. Minimizing stress and anxiety may be especially important for patients with behavioral health comorbidities. In a recent study, “Psychiatric ward design can reduce aggressive behavior,” published in the Journal of Environmental Psychology in 2018, Roger Ulrich, et al., found that patient aggression was related to spatial and social density, and a lack of privacy and control. 

According to Ulrich’s findings, research evidence suggests that healing behavioral health care environments include private rooms, reduced noise, views of nature and nature art, patient control of the ambient environment and higher levels of daylight exposure.