Optimizing Mental Health Facilities for Inmate Populations
By Jeff Goodale
The transition is on. A whole new treatment model for mental health is creating a growing demand for updated and new mental health facilities. At the same time, the transition to new treatment models is also causing some of the longstanding law enforcement and mental health professionals to adapt to new strategies.
Among the myriad changes is a shift away from isolation to a more communal approach with direct supervision. Working closely with mental health professionals on how and what is needed to transition into this approach has been a critical step in the development of this initiative.
Today, the goal is to allow as much normalcy as possible, while still promoting a safe environment for patients and staff. Here are insights.
Context + Transition Achievement
Capture their input, win their buy-in. To make a clinical paradigm shift to a facility that requires more direct supervision, one of the best places to start is to get everyone on the same page with the project’s goals. It is important to consult with the staff to gain insights into how treatment will be delivered, what programs will be offered, and what type of facility is needed to support those objectives.
Getting staff buy-in for operational changes is paramount to giving project teams insights into how to design a building that maintains safety and security, and promotes effective outcomes.
At the same time, as project leaders are assembling and factoring data, translating such data into a built environment that facilities the program vision is key in order to glean its value. All too often, over emphasizing data in the planning process runs risk of unnecessarily overcomplicating a project.
From a therapeutic perspective, it is ideal for clinical staff to be directly available to the inmates. Older buildings designed under the isolation paradigm are not suited to this new approach, which more than likely will cause issues with staff trying to adhere to the newer proposed operating initiatives.
As previously mentioned, that is why it is imperative to get everyone involved—leadership and staff—on the same page as early as possible. Project teams can help maintain project momentum, which, in turn, maintains a clear vision of the project and builds consensus where there is inconsistency.
Flexible planning, flexible design = optimized built environment. A key strategy for optimizing the space is flexibility in design. This will enable spaces to be used with a broad spectrum of inmates for different programs.
For example, a facility might have a day room space associated with mental health housing, and separate group rooms for group treatment. If there is flexibility in the design process, the day room could be utilized for the group—with the right furnishings—and the larger spaces could be available for dual uses.
It is important to remember that not all groups are the same. For example, a group that is prone to volatility will need to be spread out and may need restraining chairs, which will require a larger space for the same number of people. The more scenarios the project team considers, the more opportunities they have to make the space flexible.
Flexibility is not only key in the building’s design itself, but also in planning as priorities evolve. Take a project in the western US, where a previous undertaking had filled an immediate need for maximum security and mental health beds. A master plan had featured large, expensive footprints for the buildings—a plan that conflicted with the project budget. A new project team created alternatives that were leaner in terms of square footage and more efficient in terms of operability and management – doing more with less. The changes helped create a surplus in the budget, funds that were diverted to another project within the same system.
Understanding Current State = Valuable Steps + Perspectives
One of the most critical parts of planning is understanding the current state, which will help create a roadmap for the project.
Precisely define goals + benchmarks. Clearly defined goals, such as reducing the number of beds, or returning people back to society in meaningful ways, can help set goals.
Using similar facilities in other jurisdictions as benchmarks can help the project team envision the goals in action. In addition, looking at the metrics can help target their approach.
Understanding the current state requires gaining direct input from the staff who live it every day. While there are goals for the project, there often are underlying personal objectives that vary by work function. Leaders want to drill down to understand the broad scope of different perspectives from different areas of the organization, being mindful to not allow the loudest voices to become a focus.
Establish a cross-functional steering committee. One way to do this is to designate a cross-functional steering committee. The committee can act as a central hub for feedback from various areas, and extend the reach of the committee by gathering feedback from meetings across the organization and consolidating the data.
Set a constructive, facility-focused tone. Project leaders find inherent challenges when gathering input from a diverse group of people from within an organization. This is especially true in law enforcement, as there is a culture of rank, so subordinates may be uncomfortable being candid in front of leadership, even when their feedback is directly solicited.
Leaders can help by keeping the tone of the questions constructive, non-threatening and focused on the physical facility, rather than organization and leadership directives. People also will be more likely to share feedback if they feel like someone is listening and will drive solutions.
Key Considerations + Drivers
Factor cost through balanced decision making. Cost always is a factor in construction projects. While renovation seems like a cost-conscious choice, implementing sweeping changes to a facility’s design in light of changing mental health protocols may actually cost more than building a new facility.
Considering such dynamics, balanced decision making becomes especially important. A new facility can easily incorporate all the latest technologies to support programming needs. And, with smarter process planning, teams can get more done in a smaller footprint with less staff, which helps save money long-term and makes a new building a much smarter investment.
Take the example of a facility in the central US that lacked a viable medical facility on site and had to have its staff transport inmates to the county hospital. The exercise was expensive and time-consuming. Facility managers elected to build a new facility with a fully staffed on-site medical center where the providers knew the inmate population and were better suited to respond to their needs. Bringing those services in house and reducing inmate movement outside the facility saved money in practice, justifying the higher initial investment with a rapid ROI.
Develop preference standards and conduct a visioning exercise to navigate priorities. For budget-based decisions, establishing preference standards early on in the process provides a baseline of priorities that can drive budget decisions. When there is a scope, project leaders can revisit preferences that decision makers said were important in the beginning and ask if they are still a priority.
Preference standards also set the tone for discussions that evaluate the wisdom of changing course as consistent answers to these questions over time will help refine the project road map.
In addition, a visioning exercise also helps to determine priorities. Teams can provide several examples across different subjects and have stakeholders vote on such examples to further drive productive decision making.
Decisive Process Insights
Keeping the goal in sight. Ultimately, the main driver of maintaining a successful mental health facility is keeping a consistent focus on the common goal. It is important to be inclusive and solicit feedback from a broad spectrum of individuals with different experiences and roles. Make sure that feedback gets utilized to the fullest by organizing it into usable data points. Always keep the goal in mind and design a facility that conforms to that goal. Policies drive the facility, not the other way around.
Flexibility and sustainability extend lifecycle. Industry trends are cyclical, which means they are constantly changing. What is trending at the time a new facility is built may change during its lifespan. Designs that exemplify flexibility and long-term sustainability will outlast today’s trends and continue to bring value for decades to come, thereby Optimizing Mental Health Facilities for Inmate Populations.
Jeff Goodale, AIA, ACA, is director of HOK’s Global Justice Group and a member of the Correctional News Editorial Advisory Board. He can be reached at firstname.lastname@example.org.