By Josh Ripplinger, Andrew Jordan & Rachel L. Hendrickson
For too long, the spaces meant to support people in their most vulnerable moments were not designed with them in mind. Emergency departments were ill-equipped to handle psychiatric crises, inpatient units looked institutional rather than restorative and outpatient services were tucked away with little attention to the role space plays in healing. That landscape is changing rapidly. As stigma fades and awareness grows, providers and communities are calling for facilities that treat behavioral health not as an afterthought, but as an essential part of whole-person care.
Wold Architects and Engineers’ State of Community Facility Design survey, conducted by Wakefield Research, revealed insights into how design can transform mental and behavioral health outcomes. The findings were clear; 86% of Americans believe mental health and wellness should be prioritized in design.
It is imperative to recognize the distinction between mental health, which addresses conditions like depression or anxiety, and behavioral health, which reflects the broader connection between daily actions and overall well-being. That distinction makes clear that design cannot stop at safety or stabilization; it must actively promote environments that restore dignity, reduce stigma and support lasting recovery.
Meeting patients in crisis
Emergency care remains one of the most pressing areas in behavioral health design. When patients arrive in crisis, the environment they encounter can either escalate distress or provide a critical first step toward stability. New models such as Emergency Psychiatric Assessment, Treatment and Healing (EmPATH) units offer flexible spaces that adapt to patient acuity in real-time. For those at higher risk, suites can quickly convert into secure rooms, with protective grills that roll down from the ceiling. Unlike older models where entire wings had to be locked down, this flexibility protects safety while keeping valuable beds available for others.
For lower-acuity cases, open, calming environments prove far more effective. Instead of being placed in a locked unit, patients can sit in a welcoming space, receive counseling and begin care in surroundings that feel human rather than punitive. State of Community Facility Design survey data supports this; 90% of respondents want calming spaces, green areas and even simple amenities like cafés integrated as standard features, not afterthoughts. Ultimately, supportive environments encourage people to seek and continue care.
Balancing safety and dignity
Intermediate care requires a slightly different balance. Inpatient behavioral health units often need to support 24/7 supervision while also creating opportunities for progress and healing. Modern hospital suites should be designed to flex between higher and lower levels of control, maintaining safety without sacrificing dignity. Surrounding these suites, patients may access sensory rooms, group activity areas, exercise spaces and game rooms. Beyond “nice to have” amenities, these features provide incentives, foster community and help patients practice coping skills in safe settings.
Bridging care through crisis recovery: For individuals in transition, crisis and recovery centers offer an essential bridge between inpatient and outpatient treatment. The Dakota County Crisis and Recovery Center demonstrates this approach, with every detail designed to feel familiar and home-like. Kitchens, living rooms and residential finishes reduce stress and create a sense of normalcy, while anti-ligature measures ensure patient safety.
Sustaining long-term wellness: Long-term and maintenance care settings present another dimension of behavioral health design. Outpatient centers such as Allina Health – United Mental Health provide ongoing support for individuals who no longer require constant supervision but still need regular access to services. These environments resemble traditional clinics but intentionally avoid sterile, institutional cues. The goal is to create calming, soothing spaces where patients feel comfortable returning without being reminded of their hospitalization.
Principles that span every setting: Across all levels of care, certain design considerations remain constant. Acoustics, for instance, play a crucial role in ensuring patient privacy and comfort. Even open layouts can preserve confidentiality when materials such as ceiling tiles, wall treatments and sound masking are thoughtfully applied. Small nooks and semi-private areas within larger rooms allow for private conversations without isolating patients in confined spaces. Equally important is the aesthetic dimension. Today’s behavioral health environments move away from clinical sterility, embracing natural light, color, artwork and sensory elements that put patients at ease.
Shaping the future of behavioral health design
Behavioral health design will continue to evolve, reshaping how communities respond to mental and behavioral health needs. The most effective environments go beyond treatment to restore dignity and foster healing in moments of vulnerability. From EmPATH units to crisis centers to outpatient clinics, today’s facilities illustrate a new standard for behavioral health — one that places people, not conditions, at the center of design.
Josh Ripplinger, Andrew Jordan and Rachel L. Hendrickson are healthcare practice leaders at Wold Architects and Engineers.
