10 Years of Research, Practice and Progress in Behavioral Health Patient Room Design
The Evolution of One Haven
Ten years ago, our team set out to reimagine the behavioral health patient room, not as a place of confinement, but as a place of healing. That vision sparked the creation of One Haven. Our goal was to create an uplifting, restorative environment that empowers patients to take active ownership of their behavioral health wellness journey, while establishing a dignified and secure environment for all users. One Haven was rooted in core design principles based on research and evidence: artwork, control over environment, dignified security, acoustics, connection to nature, positive distractions, lighting and social connection.
First envisioned for a design competition sponsored by the Institute for Patient-Centered Design, One Haven received national recognition in 2015 and was later built as a full-scale mockup at a Veterans Administration facility in New Jersey, with patients and staff helping to refine what would become a new model for behavioral health design.
Early Adoption of the Design Concept
Shortly after winning the competition, we realized our design was something special. We began by sharing internally throughout HDR, but then noticed others in the industry were using the design as inspiration for their work as well. Although implementation of the complete One Haven design didn’t occur right away, elements of the design started to appear in our projects.
Early on, we had the opportunity to bring the model as a prototype design to a 200-bed behavioral health hospital in the Middle East. Because the client was looking to us to deliver the latest innovations and ideas from the U.S., we were able to incorporate the model in its entirety with very few obstacles. However, that was not the same story in the U.S. due to project budget constraints, overall room dimensions, client interest, concerns about durability and limited products and technology. With elements such as digital interactive artwork displays suitable for behavioral health settings, the ligature-resistant sliding ensuite bathroom door, furniture that did not exist yet and operable windows in patient rooms, our forward-thinking solution was a step ahead of its time.
Most early adopters embraced some or many of the core design principles from One Haven. For example, in Coquitlam, British Columbia, Healing Spirit House patient rooms are smaller with a mid-board toilet room configuration, but many of the same design principles such as control over environment, dignified security, connection to nature, comfortable lighting and positive distractions were introduced through operable windows, control over window blinds and dimmable lighting, and a whiteboard within the room for creativity and self-expression.
The bedroom at Garry Hurvitz Brain Sciences Center in Toronto, Ontario, was designed around 2019 — four years after One Haven’s inception. This bedroom includes operable window blinds and a contiguous desk/bench surface as originally proposed in the design.
A movement in pediatric patient room design occurred around the midpoint of One Haven’s decade when a day bed — or full second bed in some cases — was provided within the room for a family member to stay overnight if determined to be clinically and operationally appropriate. One Haven had hinted at this idea with a bench that extended the full length of the window wall. Not wide enough to comfortably sleep on, this bench was designed to support someone in a seated or lounging position comfortably. The movement for a second bed made its way into some of our recent pediatric behavioral health designs, while still maintaining the core principles of One Haven.
Children’s Minnesota includes lighting control and operable blinds to support patient autonomy, a secure display screen above the desk, and artwork that is unique to each patient room to help reinforce individuality and identity, which is often a struggle among many adolescent behavioral health patients.
10 Years Later
We’ve designed patient rooms akin to One Haven, with the core principles and the look and feel of the original design. Much of this is possible because of the advancements in the last 10 years: digital interactive displays, additional ligature-resistant ensuite door solutions that balance dignity and privacy, and furniture that is intentionally designed for use in behavioral health patient rooms. Advancements in dignifying lighting have also played a critical role in realizing this new model.
Careful attention must be given to the details in the room, such as ceiling-mounted elements and mechanical systems, and the durability of all materials and components. The core principles remain, and we’re still seeing a continued movement toward more normalized patient rooms with clear lines of sight for care providers in all solutions.
With the understanding that patients typically spend little time in their bedrooms throughout the day, contrary to medical rooms, our goal is to make these personal spaces as customizable and dignifying as possible to encourage patients to take ownership of their space in a protected and therapeutic way, which can lead to patients being more open to treatment.
Where Do We Go from Here?
Advancements in technology continue to change the way we think about behavioral health treatment. We’re not there yet, but technology is continuing to improve security while giving patients more autonomy. That technology is slowly making its way into the bedroom, from digital interactive touch screens to artificial intelligence (AI) and contactless biometric monitoring to improve vital signs monitoring, while supporting the same core design principles based on research and evidence: artwork, control over environment, acoustics, connection to nature, positive distractions, quality lighting and social connection.
