Perspectives on Behavioral Health: The Overlay of Classification and Design

Welcome to our 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 healthcare, the shared focus we have with our clients and partners, and the best way forward.

This is the fifth installment in our Q & A series which has previously featured Brian Giebink, Paul Nagashima, and Dave Redemske. Here we’re featuring our David Bostwick — one of the country’s leading justice consultants. David is a 28-year veteran in justice architecture focused extensively on justice facility planning and design. He is talented in working through the public planning process with his clients to develop solutions that are operationally efficient, sustainable and focused on their long-term needs.

Q: How long have you been a planner for both health and correctional facilities and when did you become focused on behavioral health design?

DB: I have been in the justice planning and design field for 28 years. Early on in my career, I learned that many people who come in contact with the justice system have some degree of behavior health issue. Designing for behavioral health, means designing for people with mental health and/or substance abuse issues in mind. Research has shown that the majority of these individuals have suffered trauma in their lives. Often times, the underlying cause of substance abuse (self-medicating) stems from physical, emotional and/or sexual trauma in a person’s past.

Q: Can you speak to the complexities behind designing a justice system with behavioral health in mind?

DB: Every justice system should be designed with behavioral health in mind because, over the long run, it saves money, reduces recidivism and creates healthier and safer communities. The countries and communities that have adopted smart justice strategies with the inclusion of behavior health, tend to see lower jail incarceration rates and require fewer jail beds.

But how can these strategies be defined and, more importantly, implemented? To that question, I recommend to our clients (as part of our justice systems assessments) that they form a Criminal Justice Coordinating Council (CJCC) made up of system stakeholders, law enforcement, community-based organizations, in addition to local medical and mental health providers. Such a group can holistically evaluate the justice system, make recommendations to improve it, and can measure and monitor improvements. The key is to have those people who are in charge of the system break down the silos, talk to one another and plan together.

Q: How does the continuum of care play a role in smart justice design and behavioral health? How do you see this being leveraged to address larger issues within the justice system?

DB: Smart justice focuses on the criminal justice system and how incarceration is used within the system. There is a significant difference between the terms incarceration and jail — incarceration is a judicial system tool, whereas the jail is the physical place where one is incarcerated. Smart justice seeks answers to questions about the jail and the use of incarceration: What is the purpose of the jail? Who are the people in the jail? Why are they in jail? Should they be in jail?

If a justice system closely evaluates its continuum of care prior to design considerations, it will likely find that there are alternatives in the community better suited to care for people with behavior health issues. But often times, while there might be community resources available, there are gaps in accessibility and people, by default, end up in jail instead of a community mental health provider. Smart justice aims to help the judicial system find more appropriate alternatives for people with behavioral health issues.

Q: How does behavioral health factor into housing unit design? And what design trends have you seen developing in this area?  

DB: The jail’s classification system and housing unit design go hand in hand—one really cannot be considered without the other. The classification system establishes the risks and needs of the inmates and the housing unit must then match those risks and needs in terms of its physical design and level of security. A good classification system seeks to house individuals in the least restrictive environment.

Behavioral health is an overlay in classification and design. It factors into and informs our use of color, furnishings and the housing type we use (single cells, multiple-occupancy cells and dormitories). The newer trends that we include in our new facilities focus on the use of cool colors (greens and blue) and views of nature through landscaped courtyards, large murals and biophilic design elements. Research has shown that more normalized environments and an abundance of natural light positively impacts one’s health, so we incorporate these important elements into our designs.