10 Design Features to Minimize Aggression in Behavioral Health Facilities

vistaII_01Patients arriving at a behavioral health facility may already be stressed due to their medical state or the fact that they may be admitted involuntarily. Often stress can lead to aggression in this type of environment, making it difficult for staff to perform optimally. It is reported that 32.4% of patients admitted to behavioral health facilities engaged in aggressive behavior or violence.

The thought is that if the built environment had design features to minimize aggression, then there would be an increase in the safety and well-being of patients and staff.

An article titled Psychiatric ward design can reduce aggressive behavior that was recently included in the Journal of Environmental Psychology highlights 10 design features to minimize aggression in behavioral health environments:

Minimize Crowding

  1. Shared bedrooms cause higher crowding stress, reduced privacy, more aggression, increased illness complaints and social withdrawal. Therefore, single patient rooms with private bathrooms lessen the stress associated with crowded spaces.
  2. Communal areas with seating options and ample space to regulate relationships are important. Since personal space intrusions can trigger aggression, it’s vital for patients to have ample personal space with seating options. This allows them to monitor their interactions with others and can keep greater distances.
  3. Design for a low ratio of patients to the number of rooms available. This will help reduce crowding and allow patients the ability to move between different rooms comfortably – regulating relationships and avoiding stressors.

Reduce Noise, Increase Control

  1. Uncontrollable or random noise increases stress and can trigger aggression. Therefore, noise reducing design can lessen stress and improves communication between staff and patients. Design measures for reducing noise include walls and doors that block noise, as well as sound-absorbing environmental surfaces that diminish echoing.
  2. A patient can become stressed when exposed to environmental conditions that are out of their control. Therefore, patient rooms should be designed with a certain level of control. Design features may include ways a patient can personalize their room or have operable features such as lighting and windows.

Positive Distractions

  1. It is well documented that gardens accessible to patients can reduce stress and improve emotional well-being. Gardens designed with informal natural styles that include vegetation and flowers are more effective in reducing stress than structured or geometric gardens with prominent hardscape.
  2. Nature window views can also reduce stress and diminish anger. Although not as effective as physically being in a garden, it is still beneficial.
  3. When selecting accessories for behavioral health facilities, realistic nature art should be considered. It is more effective at reducing stress and aggression than abstract artwork.
  4. Patients exposure to daylight may have shorter stays and staff exposed to daylight report less stress, better health, and higher satisfaction.

Design for Observations

  1. Final design features to minimize aggression include communal spaces and bedroom doors observable from a central area to help staff anticipate and prevent aggressive behavior. Floor layouts with a central area for observation should be considered over corridor-dominated designs.