HOK’s Behavioral Health practice leader reflects on the trends and challenges influencing design for behavioral care environments.
In 2023, HOK launched its Behavioral Health Center of Expertise after seeing a need for trauma-informed wellness design in projects beyond just healthcare. Here are some of the lessons we’ve learned about designing spaces that support behavioral and mental health needs since forming our dedicated practice.
Expanding the Reach of Behavioral Health Design
The growing emphasis on behavioral health has broadened its integration into diverse building typologies. Once confined to standalone facilities, behavioral health design is now influencing schools, workplaces, housing, correctional centers and more. This shift responds to a rising awareness and the destigmatizing of mental health issues. Teletherapy, resilience apps and community-based care networks have become vital tools for supporting mental well-being. So, too, has architecture.
Behavioral health design plays a role in addressing challenges like homelessness and incarceration through access to programs that foster stabilization, assist recovery and decriminalize mental illness. This integration aligns with HOK’s mission to create environments that are culturally aware, patient-centric and engaging. Design for these facilities supports activity-based therapies such as art, music, movement, cooking and horticulture to provide a multitude of positive engagement opportunities.
The Healing Power of Trauma-Informed Design
Trauma-informed design has emerged as a cornerstone of behavioral health architecture. It’s important to recognize the impact of trauma—whether individual or generational—when designing environments that promote trust, safety and empowerment. Features such as natural light, biophilic elements, noise mitigation and adaptable spaces help reduce stress and encourage healing.
This approach extends beyond healthcare facilities. Schools, workplaces and community centers increasingly adopt trauma-informed principles to support broader mental health needs. By considering the physical and psychological well-being of occupants, architecture can foster resilience and recovery.
Innovative Projects Driving Change
HOK has had the privilege of contributing to several transformative projects that exemplify our commitment to behavioral health design:
BayCare Saint Joseph’s North Med-Psych Unit (Tampa, Florida): This integrated unit addresses the dual needs of psychiatric and medically acute patients. With safety as a priority, the design incorporates ligature-resistant fixtures, sensory rooms and remote monitoring technologies. By blending medical and psychiatric care and relying on cross-trained staff, the unit provides an environment that prioritizes holistic patient needs.
Emergency Stabilization Units: HOK has worked with several clients to add emergency stabilization units to their trauma care. These facilities, either co-located with emergency departments or as stand-alone units, provide specialized care for behavioral health emergencies. Open layouts enhance observation and patient engagement, allowing for assessment, treatment and healing. This reduces reliance on restraints—physical or chemical—and inpatient admission, improving efficiency and outcomes for those in crisis.
Davidson County Behavioral Care Center (Nashville, Tennessee): Designed as a diversion unit for low-level offenders, this facility integrates trauma-informed principles to stabilize patients and connect them with community support systems. Upon admission to the Behavioral Care Center, patients follow their individualized treatment plan and begin therapy with providers. The BCC’s process and design allow for most patients to be discharged in three to seven days with continued support from social service agencies. The diversion environment includes extensive daylighting, nature murals and acoustically optimized spaces to create calm in a typically stressful situation and facilitate recovery and reintegration.
Forensic Psychiatric Facilities & Competency Restoration Units: HOK has worked with several clients to develop high-security psychiatric hospitals dedicated to forensic psychiatric services. As states address behavioral health issues in the criminal justice system, the need for specialized facilities is growing—both for people requiring long-term commitment and for those undergoing competency evaluation and restoration. Some are adding these services within the detention setting. Others are building dedicated high-security beds that balance competency restoration with long-term therapeutic goals and the security needs of this unique population.
Trends Shaping the Future
Looking ahead, several trends are shaping our approach to behavioral health design. These include:
- Integrated Care Models: The line between behavioral health and physical healthcare services will continue to blur, with more facilities adopting integrated models that emphasize holistic, patient-centered care.
- Community-Centered Solutions: Facilities will increasingly serve as hubs for community engagement, fostering collaboration among healthcare providers, social services and local organizations.
- Technology-Enhanced Spaces: Telehealth capabilities, remote monitoring and advanced safety systems will become standard features in behavioral health environments, enhancing accessibility and care quality.
- Cross-Typology Adoption: Behavioral health principles will influence a wider range of building types, from workplaces to educational institutions, reflecting a societal commitment to mental well-being.
Going Forward
Our journey underscores a critical truth: The integration of behavioral health principles into healthcare facilities, justice settings and beyond is essential to creating spaces that connect, empower and heal. HOK’s Behavioral Health Center of Expertise remains committed to advancing design solutions that address the complex and evolving needs of behavioral health care. The challenges ahead are significant, but so is the potential for thoughtful, evidence-based design. By integrating these principles, fostering innovation and collaborating with communities, we aim to create environments that empower individuals and embody the importance of the built environment as a factor in healing.