New Developments in Treating Mental Maladies

By Afifa Zahid

Published 8:22 PM EST, Sat February 6, 2021

Introduction

The growing conversation about mental health in the United States has sparked necessary change in treating mental health.

Patients at Taube Pavilion wake up with views of the scenic Santa Cruz Mountains and the sun flooding through the massive windows in their private rooms. Upon awakening, patients can choose to have their meals or coneven together in communal spaces and courtyards. While this description may initially sound like that of a holiday resort, it’s actually a new mental health facility at El Camino Hospital in Silicon Valley. 

Approach

The shift from the grim and sterile environment previously associated with mental health facilities has been a long time coming. As the mental health conversation in America continues to spread, several experts have inquired if solitude has been the best way to tackle the mental health crisis in the United States. This new approach, embodied by the Taube Pavillion, is one that is focused on fostering healing and therapeutic experiences for the patients. In order to create these experiences, these new centers try to replicate residential areas. Meaning, Taube Pavillion, has large entrances, gathering spaces, and welcoming bedrooms — a stark contrast to the crowded rooms common in psychiatric hospitals for decades. Additionally, nature played an important role in its design choices. Patients have extensive views of greenery and access to a vast array of outdoor areas. 

Mardelle McCuskey Shepley, the chair of the department of design and environmental analysis in Cornell’s College of Human Ecology stated, “We’ve been talking about this for a really long time. It’s only now that it’s gaining momentum.” Not only does Shepley emphasize how switching to a more patient-experience centered change to mental institutions is a necessary change, she also brings up an important point: reforming these facilities has gained traction due to the COVID-19 pandemic and while it has unfortunately increased mental health struggles in the United States, America has been dealing with the mental health crisis long before. Prior to the pandemic, 1 in 5 Americans were affected by mental illnesses such as depression, bipolar disorder, schizophrenia, post-traumatic stress, and other ailments. Furthermore, a study, conducted by the National Institute of Mental Health, has also revealed how mental health  disproportionately affects many communities: mental health maladies affect about 50% of adolescents and 30% of young adults. Additionally, young adults in Black and Latino communities have reported higher levels of depression, anxiety, and substance abuse. Lastly, a Gallup poll conducted in December of last year, revealed that a significant portion of Americans reported that their mental health was “worse than it has been at any point in the last two decades.”. 

The emotional toll the pandemic has caused increased the desire for effective mental health treatment. In fact, in 2020, 40% of the speciality hospitals under constructions were psychiatric hospitals and related to behavioral health. 

New Measures

However, designers of new mental health facilities face a number of challenges in creating new and improved facilities. The first of which is safety — for both patients and healthcare staff. Traditional mental health institutions have harsh rules and features  in the name of patient safety. These amenities include window glaze made out of polycarbonate compounds to prevent breakage, quick release door hinges for east entry, and plumbing fixtures have been altered to prevent the possibility of patients inflicting self harm. Safety measures for all parties are a crucial aspect of running effective mental health facilities, so it becomes difficult to balance patient autonomy and necessary precautions. Some design firms such as Hammel, Green, and Abrahamson have found some remedy to this dilemma. For example, they implemented manual thermostats and dimmer switches in order to give patients some control over their surroundings.

The second challenge they face is the fact that mental health does not have a “one size fits all” solution. Unlike other medical ailments which can be treated with a standard set of medication or surgical procedures, mental health is an incredibly personal and nuanced experience. It cannot be expected that the same approach can be used for every person. Despite these significant challenges, new facilities have been taking efforts to make the patient experience as pleasant as possible by trying to eliminate stress. Directors of these institutions have taken conscious efforts in order to eliminate stress — few to none crowded places and lowering/controlling excessive noise to name a few. The idea behind these steps is to reduce the potential for patient and employee aggression. If patients are not stressed, they may experience a faster recovery process  during treatment.  

Though, those aren’t the only modifications; the location of these facilities have been changing as well. Previously, these centers were located in remote areas. However, today, they are conveniently located or attached to a hospital. For example, Montage Health, a non profit provider, recently unveiled plans for  a new psychiatric center named Ohana — the Hawaiian word for family– in California. Their state of the art approach includes a collaborative effect from friends and family. Further, they particularly concentrate on treating young adults and adolescents. This is because 50% of all lifetime mental illnesses present themselves by the age of 15 and 75% by the age of 24. With these statistics in mind, Ohana contains classrooms, treatment wings, areas for yoga and spaces for group and individual therapy. Further, the building itself will be surrounded by cedars, pines, rosemary, & lavender  and overlook a verdant valley. 

Ohana and Taube Pavillion are just two of the many new mental health centers challenging the status quo of psychiatric centers. Further, they represent tangible effects of the growing awareness surrounding mental health. As research into the health effects of these innovative facilities becomes more accessible, the United States will be able to properly tackle the mental health crises. 

Afifa Zahid, Youth Medical Journal 2021

References

1. Margolies, Jane. “A New Tool in Treating Mental Illness: Building Design.” The New York Times, The New York Times, 5 Jan. 2021, http://www.nytimes.com/2021/01/05/business/mental-health-facilities-design.html?searchResultPosition=12. 
2. “Mental Illness.” National Institute of Mental Health, U.S. Department of Health and Human Services, http://www.nimh.nih.gov/health/statistics/mental-illness.shtml. 
3. “Montage Health.” Ohana, http://www.montagehealthohana.org/ohana.html. 
4. Ulrich, Roger S., et al. “Psychiatric Ward Design Can Reduce Aggressive Behavior.” Journal of Environmental Psychology, vol. 57, 2018, pp. 53–66., doi:10.1016/j.jenvp.2018.05.002. 
5. Czeisler MÉ , Lane RI, Petrosky E, et al. Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic — United States, June 24–30, 2020. MMWR Morb Mortal Wkly Rep 2020;69:1049–1057. DOI: http://dx.doi.org/10.15585/mmwr.mm6932a1external icon

.