Emergency rooms are hectic. As a point of first access for patients, they’re responsible for handling an unbelievably diverse range of illnesses with differing levels of severity. But that's not to say that there aren't trends and commonalities. Quite to the contrary; more and more hospitals are seeing the need to tackle behavioral health problems in the emergency room through design in order to keep up with the increase in mental health issues in our society. But how should this be done?
Problems with Current Mental Health Care in Emergency Departments
There's a whole host of challenges that plague an emergency department’s ability to effectively care for mental health patients. While there's a significant increase in the amount of patients seeking help, there just aren't enough resources available for them. This can be seen clearly in the lack of both trained staff and funding. But that's to be expected, right? After all, hospitals are created primarily for medical care, not mental health care. But this lack of resources causes a gap in care options for mental health patients, resulting in long wait times before they can be admitted or transferred, during which time they must be managed within the emergency department.
Some patients who are experiencing an extreme mental health crisis may become disruptive while waiting or being treated for medical issues, interfering with the care of other patients, or even becoming combative. This poses a safety risk to themselves, other patients, and staff members. While this is an issue that requires thoughtful treatment options, there are some design solutions that can help to address these situations...
Designing for Better Mental Health
It's time for solutions. Here are some ways that hospital design can address the problem of mental care in emergency departments:
Make the Check-In Process Easier.
This is important for all patients, but especially important for severe illness and injuries, as well as mental health patients. Your hospital's design can aid in this by offering a direct line of sight from the front desk to the door. This allows staff to make quick decisions about the patient’s condition, and where best to direct them for the care they need.
Consider Adding a Psych Holding Area.
In many cases, it's a good idea to create an area specifically for mental health patients. This gives them a place to stay while awaiting treatment or diversion to another facility, which is secure, contains safe spaces, and is supervised by trained personnel. Designed with anti-ligature fixtures and restraints which can be used if needed, this area clears emergency waiting and treatment spaces, freeing them to be used for medical patients.
Create a Calming Atmosphere.
The importance of a calming atmosphere cannot be overstated. With thoughtfully designed furnishings that have a variety of layouts, a waiting patient can find the type of seating option that's right for them. The shape of the room can also contribute, and making design decisions such as varying the ceiling height and being deliberate with lighting all helps to create a calming atmosphere for waiting patients.
Include Spaces for Rapid Assessment.
It’s sometimes easy to just leave patients in treatment rooms, as they don’t have an appropriate space to go when they’re done being examined, but not ready to be discharged. By allocating “rapid assessment” spaces for triage upon arrival, which can also be used for post-exam interviews, the hospital can free up treatment rooms for patients needing medical care.
Patient and Staff Safety.
The safety of patients and staff always comes first, and a few careful design decisions can go a long way in improving safety. Making the decision to choose heavy, secure furniture that can’t be thrown is a simple solution, but it’s also important to make sure that grab bars, door handles, faucets and other fixtures are anti-ligature – meaning that patients are unable to loop anything around them for the purpose of self-harm. Medications and sharp objects need to be locked away, and drop-tile ceilings shouldn’t be used, as the tiles can be used as weapons or patients can crawl up into the ceiling. Creating clear sight lines and installing security cameras so patients are always visible is also important for safety.
Every patient is different, and each patient with mental health issues has unique needs and their behavior may be unpredictable. But, a well-designed emergency department can help care providers and the public stay safe and aid them in getting patients the treatment they need.