Dignified Healing Spaces

May 18, 2023
Supportive Housing, Mental Health, and Addictions Treatment & Recovery

Does design have the power to enhance dignity?

 

Many of us have the privilege to go about our daily lives unaware of the powerful role the built environment plays in supporting our feeling of being celebrated and respected. As architects and designers, we must place inhabitants’ dignity at the forefront of our design priorities. Our work has the power to create spaces that have far reaching and lasting impacts. Few places need this perspective more than spaces that serve predominantly underserved, underrepresented, or socially stigmatized communities.

 

To start, what is dignity?

 

Dignity is the right of a person to be treated ethically as well as being valued and respected for who they are. For healthcare professionals dignified care means recognizing and honoring patients’ capacities and ambitions. While patient dignity is a core tenant of healthcare staff training, it is also critically important to consider the role of the built environment to support dignity for both patients and staff.

 

Dignity can be defined by four main factors:

 

  1. Respect – Respect includes self-respect, respect for others, respect for peoples’ privacy, and confidentiality.
  2. Autonomy – Autonomy includes having choices, being able to make decisions, rights, needs, and independence.
  3. Empowerment – Empowerment includes feelings of being important and valuable, self-esteem or self-worth, and pride.
  4. Communication – Communication includes clear information, language, intuitive wayfinding and directional cues, and privacy.

 

Here are five considerations for designing dignified environments:

 

Design as a Beacon

 

Too often, mental health and treatment program facilities exist in hidden spaces kept out of sight from the public. We aim to create spaces which bring a sense of pride to those who enter. By considering each step of the end-user experience, from the street approach to the quality of finishes, we aim to thoughtfully apply design aesthetics to create a welcoming facility from the very earliest interactions. Welcoming patients, clinicians, and the community into a space that is beautifully designed to support the specific needs and identity of the users is a meaningful way to communicate the intrinsic value of the patients and clients within those spaces.

 

In initial design discussions, Compass Health requested a sense of grandeur within their new facility located in Everett, Washington. After years of making do with an aging building, the goal for their Phase II building, housing both inpatient and outpatient behavioral healthcare, was to create a space that anyone would feel proud to enter. The stigma of mental health treatment was stripped away by prioritizing a grand, double-height entry and foyer that highlights exterior garden space. The exterior finishes were selected to be warm and welcoming.

 

 

Entry design of Compass Health's Phase II.

 

 

Compass Health’s Phase II: The entry design uses scale, richly colored materials, and nature to evoke a warm welcome to all who enter.

 

The Power of Choice

 

In design, when we do not acknowledge the vast spectrum of human needs, we strip away the ability to exercise autonomy and control over our surroundings. Design that is mindful of autonomy, considers a variety of mental states, capabilities, traumas, and preferences to create dynamic spaces which allow people to choose the experience that fits their needs best in that moment. Avoiding the stress of being in an uncomfortable space allows patients and clients to receive care while in the best possible mindset. It also reduces negative associations that may become barriers for seeking care in the future. In many cases, mental health, housing, or medical facilities unintentionally strip away the opportunities for personal choice due to logistics and procedures, but thoughtful communication with providers allows designers to construct opportunities for choice and autonomy within even the highest acuity patient types.

 

The design team on the Alameda Senior Respite and Primary Care Facility acknowledged the importance of choice and autonomy in the design of the new 30,000 sq. ft. facility serving Alameda County in California. The design, which creates permanent supportive housing for an aging subset of the local homeless population, thoughtfully addresses the need for individual choice by completely rethinking the approach to lighting design throughout the building. Acknowledging the impact of harsh or bright lighting, uncomfortable lighting when resting, or a lack of lighting when trying to read and relax, the design team prioritized indirect lighting throughout all patient spaces, designed hallways outside of bedrooms to dim to the lowest levels allowed by code during quiet hours, and coordinated a wall sconce with controls at each bedside for residents. These simple, yet impactful, solutions allow residents to have autonomy over their surroundings in a way many of us would take for granted.

 

 

Safety over Security

 

We deserve to feel safe in our environments, and increasingly, facilities are moving towards providing a friendly face at entry points to help visitors feel welcome in lieu of uniformed security, which can be particularly traumatizing for many populations. Through collaboration with staff and clinicians, we can facilitate safety by designing clear pathways of visibility for observation and engagement that does not feel intrusive. Doing so allows visitors and residents to maintain their sense of independence and autonomy while remaining safe. Intentionally designed spaces which focus on relationship building increase the safety of patients while also increasing the likelihood of positive experiences and returns for subsequent care in the future.

 

The inpatient floors for Compass Health were laid out around a central nurse station allowing care teams to maintain a direct line of sight to all patient spaces, including the outdoor patient areas. Whereas other facilities require patients to be accompanied by a staff member to outdoor or group spaces, the clear paths of visibility allow patients to move from space to space unaccompanied, fostering independence while ensuring staff are aware of any interactions which may require their attention. Similarly, opportunities for passive observation in outpatient areas allow for easy circulation and a friendly face at various reception desks to assist first-time visitors and clients, as well as to foster connection with staff in various areas throughout the lobbies.

 

 

The massing and interiors of Compass Health Phase II, dedicated to creating connections between staff and patients.

 

 

Compass Health Phase II: The building massing prioritized sightlines for the on-unit nursing and care team from the earliest diagrams (left). Interior design focused on maintaining the connection between staff and patients (right).

 

 

Whole Person Healing

 

If we consider the physical, mental, emotional, and social determinates of health in the design and programming process, we can create transformational facilities that help bolster the entire community. By creating space for additional programs and prominently locating basic needs near entries, each visitor can easily access support. Furthermore, designing medical care with counseling and housing opportunities provides a holistic approach to wellness that caters to a vast spectrum of needs, removing the barriers of care that occur when visiting many different facilities for the same services. Integrating community spaces into our designs allows additional social needs to be met that may not be related to specific medical needs, while inviting the community into spaces shared by diverse populations humanizes the experience of those seeking treatment in those spaces.

 

The core tenant of Central City Concern’s Blackburn Center is to “help people’s health through comfort, community, and safety.” The center, which serves people experiencing homelessness, poverty, and addiction in the Portland, Oregon area also aims to create a supportive housing project which incorporates mental and physical health resources under the same roof. The design carefully integrates a complex series of support systems that begin on the ground floor with commons area, teaching kitchen, pharmacy, and community services. Moving up a floor, the medical clinic supports the housing residents onsite. Housing includes palliative care, two floors of single room occupancy housing, and a floor of apartments for permanent housing, which supports people nearly ready to live on their own. The design aesthetics and function aim to create a fulfilling and enriching home-like experience that bolsters residents in all aspects of health and wellness, truly treating the whole person.

 

 

Nature as Medicine

 

Biophilia states that we, as humans, are part of nature and are inherently attracted to, and supported by, natural environments. Using nature as a tool to promote healing and wellness is a key part of providing users with the respect and dignity they deserve. Many at-risk populations receive care and housing in aging spaces that do not receive quality daylight, and access to outdoors is deemed too unsafe and difficult to monitor. By incorporating nature connections such as views, natural materials, fresh air, and plants into the requirements for healing spaces, we ultimately acknowledge the humanity of the occupants within a space. Whether they are patients, residents, visitors, or staff, everybody benefits from contact with nature through positive distractions, lowered blood pressure, increased resilience to environmental stressors, and the benefit of aligning our sense of time and place with the observable natural rhythms of the world around us.

 

Early on in Compass Health’s design process, the importance of fresh air and contact with nature was identified by the client and design team. As a result, the earliest building massing schemes explored how to bring nature as far into the building as possible. The resulting form for the inpatient floors is two separate wings positioned beside deeply cut rooftop gardens with a central connection space that serves as the primary gathering and dining area for the inpatient population. Each of the two floors of inpatient treatment have access to dedicated outdoor garden spaces that are designed to allow residents to move freely between interior living spaces and outdoor areas. Beyond the patient outdoor spaces are extensive green roofs which are visible from interior spaces in the public, staff, and patient spaces. This impactful design decision will support the healing and restorative vision of Compass Health’s mission to treat the whole person.

 

 

Compass Health's Phase II Design provides views of nature by way of a green roof.

 

 

Compass Health Phase II: Both inpatient floors provide residents, staff, and visitors views of nature by utilizing the space between buildings for extensive green roofs.

 

Why design for dignity?

 

By implementing these five strategies, designers can create spaces that honor the core aspects of dignity by respecting each visitor and their unique place in the world, supporting their autonomy through choice, empower occupants as they move through the space, and ultimately communicate equitably inhabitants. The resulting designs are spaces which can be as meaningful as they are beautiful while actively participating in the health and growth of our communities.

 

 

Ashlee Washington's headshot

 

By Ashlee Washington, Senior Associate

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Interior Design Camp
One of the most rewarding aspects of my career in interior design is sharing it with young people. Many years ago, when my, now, college-age...
One of the most rewarding aspects of my career in interior design is...
CULTURE
INTERIOR DESIGN
WORKPLACE
Sustainability & Ankrom Moisan Interiors
Q: What efforts are Ankrom Moisan making to provide better information and resources when it comes to...
Q: What efforts are Ankrom Moisan making to provide better...
INTERIOR DESIGN
WORKPLACE
Designing for Inclusivity
Designing for inclusivity is something that is always on interior designers’ radar.  ADA regulations instituted in 1990 blossomed into the...
Designing for inclusivity is something that is always on interior...
ARCHITECTURE
INTERIOR DESIGN
SUSTAINABILITY & WELLNESS
WORKPLACE
Mass Timber: 38 Davis
At 38 Davis, work and home is integrated through mass...
At ...
ARCHITECTURE
CULTURE
Employee Spotlight: Keith Larson
Did you know Ankrom Moisan has an in-house model maker?   Meet Keith Larson. While he’s been working as a professional...
Did you know Ankrom Moisan has an in-house model...
INTERIOR DESIGN
URBAN LIVING
Convenience Factor
The new standard is that services, products, and conveniences are available to people in a matter of minutes. Residents demand their communities...
The new standard is that services, products, and conveniences are...
ARCHITECTURE
SUSTAINABILITY & WELLNESS
Insights from the Advancing Mass Timber Construction Conference
Mass timber technology continues to develop rapidly as more and more projects seek to implement this beautiful, sustainable, and durable material....
Mass timber technology continues to develop rapidly as more and more...
INTERIOR DESIGN
WORKPLACE
Project Materials Spotlight
A trend our workplace team has been observing lately: landlords are considering their tenants more like customers and creating spaces as a...
A trend our workplace team has been observing lately: landlords are...
INTERIOR DESIGN
WORKPLACE
Office Design that Supports Employees Holistically
With more employers offering the ability to work from home—and ...
With more employers offering the ability to work from home—and ...
INTERIOR DESIGN
WORKPLACE
Lifestyle Experiences at Work
Natural light. Fresh air. Lush greenery. Hospitality-inspired amenities. Companies want to give employees a lifestyle package that makes people...
Natural light. Fresh air. Lush greenery. Hospitality-inspired...
INTERIOR DESIGN
WORKPLACE
Technology-Rich Workplaces
Before the pandemic, relaxing with coworkers in the office breakroom or preparing meals in the communal kitchen were typical, stress-free, even...
Before the pandemic, relaxing with coworkers in the office breakroom or...
INTERIOR DESIGN
WORKPLACE
Project Materials Spotlight
In...
...
INTERIOR DESIGN
WORKPLACE
Simplifying the Specification Process
Within my design passion comes a desire to learn about how spaces and their materiality affect people mentally, psychologically, physiologically,...
Within my design passion comes a desire to learn about how spaces and...
ARCHITECTURE
HOUSING
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Designing for Comfort
Our homes should be comfortable, should rejuvenate us, and they can make or break our capacity for resiliency. Designing for comfort goes far...
Our homes should be comfortable, should rejuvenate us, and they can...
INTERIOR DESIGN
WORKPLACE
Discovering a Love for Design
This is a familiar story for many interior designers. I wanted to be an interior designer since I was in grade school; the signs were there from...
This is a familiar story for many interior designers. I wanted to be an...
INTERIOR DESIGN
WORKPLACE
Human Centered Design
...
...
INTERIOR DESIGN
WORKPLACE
Symbiotic Communities
Before the pandemic, it was common for businesses and office workers to have an insulated experience within the...
Before the pandemic, it was common for...
INTERIOR DESIGN
WORKPLACE
Civic Pride
...
...
INTERIOR DESIGN
WORKPLACE
What’s Next for the Workplace?
What will it take to revive central business districts across the US? What role will your workplace play in this recovery?  What makes a...
What will it take to revive central business districts across the US?...
HOUSING
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Looking Ahead
Ankrom Moisan’s Jeremy Southerland, Alissa Brandt, and Chris Ebert led a presentation ...
Ankrom Moisan’s Jeremy Southerland, Alissa...
INTERIOR DESIGN
URBAN LIVING
Multi-Faceted Life
Apartment buildings are micro-neighborhoods, offering residents opportunities to connect to the community around them. And as individual unit...
Apartment buildings are micro-neighborhoods, offering residents...
ARCHITECTURE
HOUSING
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Fitness is Integral to Wellness
The connections between exercise and overall wellness are well established—but how can we, as designers, create senior communities that...
The connections between exercise and overall wellness are well...
ARCHITECTURE
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Balancing Elements of Design with Light in Mind
With access to natural daylight, we’re sharper and happier during the day, we sleep better at night, and we recovery faster when we’re sick....
With access to natural daylight, we’re sharper and happier during the...
INTERIOR DESIGN
URBAN LIVING
Adaptive Living
There’s a new focus on the changing needs of residents in an evolving world. Future-ready units with practical and customizable features will...
There’s a new focus on the changing needs of residents in an evolving...
INTERIOR DESIGN
URBAN LIVING
Leading the Evolving Market
As people adapt to the shocks of the pandemic, multi-family communities are responding to the long-term shifts in residents’ daily...
As people adapt to the shocks of the pandemic, multi-family communities...
ARCHITECTURE
HOUSING
INTERIOR DESIGN
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Vitality in the Village
Understanding the connection between a well-designed community and people’s overall resilience and health, our campus master plan for Mary’s...
Understanding the connection between a well-designed community and...
ARCHITECTURE
HOUSING
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Approaching Air Quality Holistically
Fresh air and wellness are intrinsically connected. With ready access to fresh air, people are more alert, physically healthier, able to heal...
Fresh air and wellness are intrinsically connected. With ready access...
INTERIOR DESIGN
URBAN LIVING
[Home]Work
With the rapid acceptance of remote work, we are examining how residents’ needs are changing in multifamily communities. Building amenities...
With the rapid acceptance of remote work, we are examining how...
INTERIOR DESIGN
WORKPLACE
Re-Connect
What is the purpose of the office now? And in the future? To answer these questions, we surveyed nearly 400 people from various industries and...
What is the purpose of the office now? And in the future? To answer...
INTERIOR DESIGN
WORKPLACE
The New Suburban Office
Natural ventilation and access to fresh air are priorities for post-pandemic office spaces. With people’s growing interest in shorter commutes,...
Natural ventilation and access to fresh air are priorities for...
INTERIOR DESIGN
WORKPLACE
Evolution of Office Amenities Q&A
COVID-19’s influence on the future of office space is one of the real estate industry’s million-dollar questions today. With many employees...
COVID-19’s influence on the future of office space is one of the real...
ARCHITECTURE
HOUSING
Feasibility Studies
We conduct site feasibility studies for our clients, which are divided into three tiers. From Tier 1 to Tier 3, each tier deals with increasing...
We conduct site feasibility studies for our clients, which are divided...
ARCHITECTURE
HOUSING
SENIOR COMMUNITIES
SUSTAINABILITY & WELLNESS
Accommodation Around Dining
Sharing meals is essential to people’s social and emotional wellness. Our insights support safer communal meals in senior living campuses that...
Sharing meals is essential to people’s social and emotional wellness....
CULTURE
AM Design Week 2020
For Seattle Design Festival’s 10th anniversary in August, 2020, our Portland, Seattle, and San Francisco offices celebrated Design Week...
For Seattle Design Festival’s 10th anniversary in August, 2020, our...
INTERIOR DESIGN
WORKPLACE
Re-New
Our wellness solutions are realistic and evidence-based. By investigating how the coronavirus affects workplace design, setting clear outcomes,...
Our wellness solutions are realistic and evidence-based. By...
ARCHITECTURE
HOUSING
Apartment Innovation Insights
After interviewing hundreds of apartment residents, we distilled their responses and refined our observations into practical design...
After interviewing hundreds of apartment residents, we distilled their...
INTERIOR DESIGN
WORKPLACE
Re-Entry
Ankrom Moisan has spent decades designing healthy, empowering workplaces. Working quickly and cost-effectively, we design and implement strategies...
Ankrom Moisan has spent decades designing healthy, empowering...
INTERIOR DESIGN
WORKPLACE
Re-Imagine
Our own reentry strategy for 38 Davis, Ankrom Moisan’s Portland headquarters, puts our design insights into practice. Discover how we...
Our own reentry strategy for 38 Davis, Ankrom Moisan’s Portland...
INTERIOR DESIGN
WORKPLACE
Re-Set
We surveyed 300+ people about returning to the office, and their responses were loud and clear. A holistic, employee-centered approach is...
We surveyed 300+ people about returning to the office, and their...
ARCHITECTURE
HOUSING
High-Rise Design
Download our latest (2020) lookbook on urban high-rise design. – – – – > UPDATE: Click to view the ...
Download our latest (2020) lookbook on urban high-rise design. ...
ARCHITECTURE
HOUSING
Design for Living: Mid-Rise
Download our inspiring 2020 lookbook on mid-rise living.   ...
Download our inspiring 2020 lookbook on mid-rise...
ARCHITECTURE
HOUSING
Apartment Innovation Survey
Our survey, conducted from May 28 through June 17, 2020, yielded over 400 responses and 1,635 written comments about apartment living...
Our survey, conducted from May 28 through June 17, 2020, yielded over...