ARCHITECTURE FOR MENTAL HEALTH
As an advocate for the best design possible for Behavioral Health Architecture, and as a designer who is passionate about seeing the built environment of mental health improve and rise to a better level of design,so that the buildings and environments can truly be more healing, efficient, safe and less institutional, I am challenged to forge through the many layers of (perceived) obstacles to good design, while simultaneously required to understand those (again, "perceived") obstacles to come up with solutions that maintain safety and security, and still succeed in gently pushing the envelope for better design outcomes.

Sometimes in my work, I am asked for references, to help people find their way through the requirements and evidence based “best practices” for mental/ behavioral health projects. This article is meant to provide a quick overview of preliminary required/ suggested resources.  These resources outline basic information, and do not begin to be exhaustive, by any means.

2018
To be most current in 2018, as a result of the industry moving towards more outpatient-based care, the Facility Guidelines Institute released a stand-alone Guidelines for Design and Construction of Outpatient Facilities reference in January 2018.  Relevant changes regarding behavioral health are found regarding outpatient psychiatric facilities:

Space requirements were added for consultation rooms, group rooms and observation rooms. Requirements for optional exam, seclusion and quiet rooms were also added. In addition, where the need is indicated by the behavioral and mental health risk assessment, “space for a clear path of escape for staff” and a “staff assist device to communicate with [others]” are required, although the “staff assist device” is required for all consultation and group rooms.

DESIGN GUIDE FOR THE BUILT ENVIRONMENT OF
BEHAVIORAL HEALTH FACILITIES
The baseline, or fundamental, requirements for designing behavioral health facilities appear in the FGI Guidelines for Design and Construction documents. In addition to these requirements, one of the major resources that can be found on the FGI website is the Design Guide for the Built Environment of Behavioral Health Facilities.  This year, 2018, a major update was incorporated as a new edition (7.3) in January.  This resource is published by its authors Jim Hunt and Dave Sine.  The current edition of this document can be found at their Behavioral Health Facility Consulting website: http://www.bhfcllc.com. The design guide deals with designing for the built environment for general adult inpatient units, and adds to current regulatory requirements what the authors propose as best practices.  In this guide are products, specifically reviewed by the authors. 

To download a free copy that includes a revised Patient Safety Risk Assessment Tool to align with The Joint Commission’s November 2017 Recommendations through their site go here: http://www.bhfcllc.com/downloa...

For the safety risk assessment tool, go here: http://www.bhfcllc.com/patient...

JOINT COMMISSION
To read the Joint Commission’s Online issue that addresses the surveying, scoring of ligature, suicide, self-harm in inpatient psychiatric setting , as well as other related topics, including a Sentinel Event Alert that focuses on leadership’s role in establishing safety culture, go here: https://www.jointcommission.or...

SUMMARY + ADDITIONAL REFERENCES
These documents are the touchstone for research and should be used as the departure point for understanding guidelines or requirements. 

For more reading of evidence based research, and works in progress dealing with design for behavioral health the Center for Health Design launched a topic toolbox: Behavioral & Mental Health Toolbox. Each toolbox contains a library of newly-created and Center staff-curated content - research findings, expert insights, strategies, tools, and other useful resources. To connect to these resources go here: https://www.healthdesign.org

For resources related to Urban Design, The Centre for Urban Design and Mental Health (UDMH) curates and creates research and dialogue among policymakers and urban practitioners to inspire, motivate and empower the integration of mental health into projects for a healthier, happier urban future. The website can be reached here: https://www.urbandesignmentalhealth.com

•Approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%experiences mental illness in a given year. (Any Mental Illness (AMI) Among Adults. (n.d.). Retrieved October 23, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/any-mental-illness-ami-among-adults.shtml)

•Approximately 9.8 million adults experience a serious mental illness in a given year that substantially interferes with or limits one or more major life activities. (Serious Mental Illness (SMI) Among Adults. (n.d.). Retrieved October 23, 2015, from http://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml)

•Among the 20.2 million adults in the U.S. who experienced a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness. (Substance Abuse and Mental Health Services Administration, Results from the 2014 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-50, HHS Publication No. (SMA) 15-4927. Rockville, MD: Substance Abuse and Mental Health Services Administration. (2015). Retrieved October 27, 2015 from http://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf)

For more NAMI facts, go here:
https://www.nami.org/learn-mor...

REFERENCES & RESOURCES:

The National Alliance on Mental Illness (NAMI):  
https://www.nami.org

The National Institute of Mental Health (NIMH): https://www.nimh.nih.gov/index...

The Federal Guidelines Institute (FGI):
https://www.fgiguidelines.org/