Striking the “Golden Mean”

In philosophy there is a term called the “golden mean,” described by the great philosophers as an approach to ethics that emphasizes finding the appropriate medium, or middle ground, between extremes.  It’s the desirable ‘midpoint’ between two extremes, one of excess and the other of deficiency.

This principle can be applied when designing and retrofitting behavioral health facilities as well.

This “midpoint” can serve as a blueprint for designing better behavioral health facilities. There is a challenge behind striking the balance between a safe—but sterile, versus comfortable—yet high-risk space.

Facilities designed purely for comfort often feature dangerous objects that increase the likelihood of a suicidal event involving a psychiatric patient.

Minimalist facilities lacking little to distinguish them from a prison cell are not the answer either—as they feel isolating and confining, further exasperating the conditions of psychiatric patients.

When designing in-patient units, the goal should always be to maximize mental wellness in addition to deterring suicides.

Designing Safer Facilities

In recent years, various authorities, including The Joint Commission, The Federal Department of Veterans Affairs (VA), and the Facility Guidelines Institute, have formulated recommendations and mandates aimed at reducing the risk of suicide within the physical infrastructure of behavioral health facilities. The Joint Commission consistently updates its guidelines to ensure compliance with existing standards.

Hospital administrations are now enforcing measures to mitigate the risk of suicide. Multiple ligature-resistant features such as hinges, handles, and locks on doors connecting patient rooms and hallways are being installed in new and existing facilities.

Additionally, measures such as replacing closet doors with shelves, installing solid ceilings in patient rooms and bathrooms instead of drop ceilings, using breathable paper trash-can liners, and substituting towel racks with hooks capable of supporting only a bath towel are being taken to enhance safety.

Positive Change On The Horizon

With the continual evolution of hospital safety and facility design, devices such as over-the-door sensors and top-of-the-door alarms make all the difference in the event of a hanging suicide attempt.

The concealed design of these alarm systems affords patients the enhanced dignity and respect they deserve.

The time is now to strike the golden mean by humanizing— not dehumanizing—our behavioral health facilities.