A mental health environment impacts users at a number of levels, including the architectural and interior design levels. The Pavilion, a 66-bed inpatient psychiatric hospital, combines the architectural efforts of Guernsey Tingle Architects and Landmark Design Group to mesh historical colonial architecture with the necessary attributes of a modern behavioral healthcare facility. The results give users their first introduction to The Pavilion and set the initial impression and expectations. Visual and physical access to nature is incorporated into the design, allowing people to experience our grounds even when they are in the building. The 33,500-square-foot facility features furniture, flooring, wall color, textures, trim, and artwork that create a non-institutional feel. These warm settings enhance the work that is essential in an acute inpatient psychiatric facility and is rooted in available evidence and best practices.
Patient engagement is a critical component of patient safety. Patients who feel connected to staff members are more likely to respond to or seek out those individuals in moments of distress, which can prevent or deescalate personal crises. For this reason, the layout of The Pavilion follows the hub-and-spoke concept, with each unit extending from a centralized nurses' station. Additionally, offices for counselors and social worker are located on each unit so that patients have access to their caregivers at all times. This reflects the patient-centered culture essential to a recovery-oriented system.
All inpatient rooms at The Pavilion are double occupancy but can easily be converted to single rooms should the need arise for one-on-one care. Each room features the following:
- An exterior window with integral blinds and laminated glass on the interior face
- A bathroom door with a pressure-sensitive alarm at the lintel, a continuous hinge, and an anti-ligature lever with a magnetic latch
- Non-breakable artwork that does not compromise patient safety
- Secure trim, headboard, and soothing colors that contribute to the homey atmosphere of the room
- Built-in desk and shelving unit to store patient clothing
- Woodgrain-patterned vinyl flooring and rubber baseboards to enhance the residential feel
Patient activity areas consist of living rooms/dayrooms, dining rooms, therapy rooms, group and family meeting spaces, a quiet room for retreating, and secure outdoor spaces. The design priority in these areas was the creation of an inviting, non-institutional environment free from features that may facilitate assaults or self-harm. These areas are supervised by staff and consequently present less of a safety/security threat than areas where a patient may be left unsupervised for a period of time.
Criteria for maintaining patient safety in these areas include:
- Lighting and other ceiling items are recessed and surface-mounted with vandal-resistant fixtures.
- Common areas have no sharp wall, furniture, or fixture edges on which patients could injure themselves.
- All wall items are flush mounted and securely fastened with security screws.
- Adequate secure storage rooms are available on each Pavilion unit to prevent carts and other equipment from being stored in the corridor or open alcoves off the corridor.
- Equipment used by patients while supervised—such as computer equipment—is located in rooms that can be locked when not in use.
An essential component of any inpatient mental health facility should be direct yet secure access by patients to the outdoors. Our outdoor spaces are designed with three key principles in mind:
- They must be located within the unit to be visible by staff from the nurses' station.
- They must be sufficiently enclosed to discourage patient elopement.
- They must be designed with hardscape and landscape features that do not support self-harm or assaultive behavior.
Dining at The Pavilion is not just about meals. It is an integral part of our treatment programs. Led by Director of Dietary Services Valerie Huckstep, our staff provides balanced nutrition at every meal and dietary coaching to help patients continue healthy eating habits after they leave us.
Each meal is carefully prepared to bolster both the physical and mental health of our patients. Foods that help stabilize mood are always on the menu, and comfort food helps our clients feel at home. Patients have multiple choices of entrées for every meal, and the menu changes every month. Valorie is also very conscious of the importance of social interaction at meals, and she strives to show her love and respect for the patients in all aspects of her job.
As patients prepare to leave our facility, Valorie works to help them maintain healthy eating habits. In addition to showing them how to plan meals and choose nutritional foods—and avoid unhealthy choices like processed food—she also helps them develop grocery shopping habits that will make it easier for them stick to their plan.
Geriatric Dietary Services Patients in our geriatric program often have special issues around meals. Some may be admitted after a period of not eating and will need to work with dietary services to find ways to remind them to eat. Physical problems can also create difficulties. For example, patients with Parkinson’s may have trouble holding utensils due to the tremors in their hands. Others may have difficulty with chewing or swallowing. Our knowledgeable dietary services staff is trained in caring for people with these issues and can help restore health and a measure of independence to geriatric patients.
About Valerie Huckstep
Valerie Huckstep, RD, is our Clinical Dietician at both The Pavilion and The Farley Center. She graduated from the University of Vermont with a B.S. in dietetics. She specializes in nutrition intervention for substance abuse recovery and improved mental health.