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Perspectives on Behavioral Health: Navigating the Design Challenges, Trends and Solutions

Welcome to a new Q & A series designed to uncover what behavioral health really means within secure justice facilities, including the current and future trends in design, the crossover with the healthcare, the shared focus we have with our clients and partners, and the best way forward.

The greatest challenges to behavioral health for secure environments continue to be access to care and continuity of care. With the closing of mental hospitals as part of a “de-institutionalization,” program in the U.S., our corrections and detention facilities have often taken their place. This means those most at risk for behavioral health issues are often detained and confined. This in turn impacts operations and facility design for corrections and detention facilities.

We’re dedicated to championing healthy communities by helping our clients and partners plan, program and design their facilities to achieve their goals. This means we must first explore and understand what is happening in our communities, including the issues and challenges, effective and therapeutic design,  and the evolving solutions.

In our first Q & A of the series, Greg Cook shares his informed perspective, based on his years of experience designing a broad range of facilities, with a specialty in justice.   
 

Q: How long have you been in the justice field and when did you become focused on behavioral health design within secure facilities? What do you find most interesting about behavioral health projects?

GC: I have been working with projects related to criminal justice for 10 years. The first part of my career was spent designing single family homes. After moving to a larger practice in 2007, I spent time designing higher education and commercial projects before being introduced to justice design. It just happened that my first justice project included an array of mental health treatment spaces, including a step-down crisis unit, which initiated my interest in restorative design concepts and how they might be implemented in secure environments. My continued interest in behavioral health projects is supported by the unique challenges (and often contradictions) that they present, such as providing openness while limiting movement, or providing privacy while allowing visibility. Success is in the balance. I’m also always surprised and invigorated that many of the same principles that I learned on previous project types can apply in the justice sector, if perhaps through a different lens.

Q: How do you define behavioral health in the justice market?

GC: The criminal justice system has a broad reach and touches individuals and families far beyond the walls of a facility that might be designed. Because of that, and the diversity of the range of populations that are incarcerated, behavior health in corrections is generally vast and hard to define in narrow terms. As in our communities in general, mental health and substance abuse issues often coexist, but the rate of occurrence in our criminal justice system is truly staggering. In that regard, I believe that our criminal justice facilities are an essential component of our social infrastructure, which often captures members of our society that are most in need of treatment while being the least likely to receive it.

Q: What design trends do you see developing in the design response for behavioral health within secure environments?

GC: The most important development I have seen across the country is a fundamental shift in the view of what the purpose of the criminal justice system is by the public and by our elected officials. We are rightly demanding more of our criminal justice system, and our facilities are often failing to catch up. Any facility that we might plan or design must be thought of as part of a treatment pathway, one that extends out into the community in two directions — one as treatment, one as prevention. As these community connections, and continuity of care, are becoming more important, the idea of a more permeable, transparent correctional facility begins to take shape. Family reunification, connections to community health care providers, housing and job placement are now recognized as essential to reintegration with the community.

Q:  How can we, as designers, support the mission and the focus of a facility designed around behavioral health or mental health?

GC: As designers working in correctional settings, we understand that administrators and staff are continually being asked to do more with less. We have to be ready to facilitate the important discussions with staff that allow their expertise to be the catalyst that allows a successful design to emerge. Because of the rapidly changing demographics of the incarcerated population and the expectation that treatment modalities will progress with them, designers have the ability to conceptualize spaces that meet current needs and can evolve to meet future ones. Designers also have a unique understanding of the human condition, allowing us to develop concepts that use space, natural light, landscape and movement to strengthen our connection to the outside world and our place in it.