In recent years, the role of design in behavioral health facilities has evolved beyond mere functionality. Architects and behavioral health providers are increasingly collaborating to meet the unique needs of their patient populations. Whether it’s enabling a patient confined to an inpatient setting to access outdoor space or incorporating a daycare at a substance use disorder (SUD) facility, the emphasis on patient autonomy, cultural competency, and the creation of therapeutic environments is transforming the landscape of behavioral health care.
Stephen Parker, a behavioral health planner at Stantec, a leading architectural and construction management firm based in Edmonton, Canada, highlights the importance of trauma-informed design principles. “A lot of trauma-informed design principles come into play,” Parker shares. “So giving patients autonomy, voice, and choice throughout the process is important, so that they have dignity going into the campus or facility.”
At the heart of this design philosophy is the idea that the built environment can deeply impact patient care, staff interactions, and overall recovery outcomes. Today’s modern behavioral health facilities prioritize designing spaces that enhance autonomy, cultural competence, and social connectivity while integrating essential elements such as community areas and outdoor spaces.
Autonomy: Empowering Patients through Design
One of the primary goals of architectural design in behavioral health care is to give patients more control over their environment. Many facilities are incorporating design elements that allow patients to make simple, yet powerful, choices throughout their daily lives.
“If a patient can see their role and have agency in their treatment plan, then they’re more likely to adhere to it and see it through,” Parker explains. “To give them ownership and agency in that process is to give them choices and not simply dictate to them in their treatment plan. They become an active participant.”
This could mean something as simple as providing patients with the ability to control their environment, like opening and closing their blinds without needing to ask a nurse. This seemingly minor feature can have a profound impact, allowing patients to regulate their sleep patterns and manage stress levels, which in turn, can positively affect their recovery process.
In addition to personal control over space, many facilities are opting for private or semi-private rooms, which further enhance a patient’s sense of ownership over their surroundings. These personalized spaces not only provide comfort but also contribute to a sense of dignity and respect.
Studies by environmental psychologists have shown that the design of spaces—especially those that incorporate social support, control, and nature—can help reduce stress and promote healing. A patient’s ability to choose where they spend their time, whether it’s in a social area or private space, is a critical factor in supporting mental well-being.
“We’ve tried to figure out ways to incorporate social interaction in the amenities spaces that we’re designing,” says Blima Ehrentreu, founder and CEO of The Designers Group. “Even in our recreation rooms, we’ve gotten creative in designing different furniture layouts and bringing in technology so that people could, let’s say, interact together but not necessarily be sitting right near each other.”
For Ehrentreu, the aim is to create spaces where patients can engage with others while still respecting their need for personal space, which is an important element of behavioral health design. Social spaces are often vital to the recovery process, providing individuals with a sense of belonging, acceptance, and support.
Designing for Cultural Competency and Community Connections
A crucial element in the design of behavioral health facilities is cultural competency. Architects are increasingly recognizing the importance of understanding the specific needs of diverse communities, particularly when it comes to treating substance use disorders and mental health issues within those communities.
Parker’s work with indigenous communities in North America highlights the importance of incorporating cultural touchpoints in facility design. “Truly looking at addressing specific cultural touch points through designing around care culture would be my big takeaway,” Parker says. “Because I have to understand my bias when I come into a project and understand the providers, patients, and stakeholders.”
For example, substance use disorder treatment centers designed for indigenous communities often emphasize the inclusion of spaces that allow for family involvement. This is crucial because, as Parker explains, the goal is to help address generational trauma, while still allowing patients to remain connected to their communities.
In these spaces, architectural elements include daycare areas for children, traditional crafting rooms, and ceremony spaces, which all help integrate the family and cultural practices into the healing process. Clinical spaces for outpatient counseling, group therapy, and intake are also included to provide a holistic and community-centered approach to recovery.
The Importance of Outdoor Space in Behavioral Health Design
Incorporating outdoor spaces in behavioral health facilities is another growing trend. Whether it’s psychiatric units, substance use disorder centers, or other treatment facilities, access to nature is increasingly seen as an essential component of patient care.
Parker recalls a project where he worked with a large academic medical center to design garden courtyards adjacent to psychiatric units. These courtyards were designed with “psych-safe features,” allowing patients to decide whether they wanted to access the outdoors. This design empowers patients to self-regulate by giving them the ability to make decisions about their environment and interactions with nature.
“It’s designed with psych-safe features,” Parker says. “So it limits the risk for individuals in crisis who are still under observation, but gives them the ability to self-regulate by choosing to go outside and socialize.”
The therapeutic benefits of nature are well-documented. Spending time outdoors can help lower stress levels, improve mood, and enhance overall well-being. For those unable to access outdoor spaces, many designers are using biophilic elements to bring the outdoors inside, such as incorporating natural light, plants, and nature-inspired materials into the building design.
Ehrentreu emphasizes the importance of integrating nature, stating, “There’s a lot of indoor-outdoor spaces. For people who can’t get out as much, we’re trying to mimic that and bring biophilia into the design. And we’ve definitely seen the benefit of vitamin D sunlight and just overall people are really enjoying the option to be able to go outside, and if they cannot go outside also bring the outdoors to people.”
Co-Located Services: One-Stop Treatment Centers
An emerging trend in behavioral health care is the development of co-located services, or “recovery campuses,” where various types of treatment are offered in one centralized location. This approach is particularly beneficial for individuals who require multiple forms of care, as it minimizes the logistical challenges of accessing services that are spread out across different facilities.
Blima Ehrentreu is involved in the design of a community center that integrates both physical and behavioral health offerings. “There’s a day habilitation program, as well as an urgent care component where there’s doctors’ offices, therapists, as well as a dentist,” Ehrentreu explains. “So it’s really giving the people in that community the ability to be able to come in and have all their needs taken care of.”
Similarly, Parker highlights the concept of recovery campuses that integrate behavioral health services, housing, preventive care, and more. These multi-use campuses often include several different providers from various sectors, with each space designed to cater to a specific need.
“Sometimes, we’re literally in the programming discussions because the organization that would run this doesn’t exist,” Parker notes, emphasizing the complexity of designing for a diverse set of services within a single facility.
Conclusion: Healing Spaces Built with Patients in Mind
The collaboration between architects and behavioral health providers is reshaping the way we think about mental health care environments. By prioritizing autonomy, cultural competency, outdoor spaces, and co-located services, designers are creating therapeutic settings that empower patients and promote recovery. As behavioral health facilities continue to evolve, it is clear that the built environment plays a significant role in fostering healing, dignity, and a sense of belonging—transforming the journey to recovery into one that is more collaborative and patient-centered.
