Designing behavioral health facilities requires a careful balance between safety and comfort. Patients dealing with mental health issues need secure environments, but these spaces must also promote healing without feeling overly restrictive. As MEP engineers, we play a critical role in ensuring these spaces are designed with technical precision to meet the unique demands of behavioral health care. In this blog post, we'll dive into several key areas that impact the safety and comfort of these facilities, including the FGI levels of concern, sound control, pressurization challenges, and how to create therapeutic spaces that prioritize both patient and staff well-being.
Understanding the Facility Guidelines Institute (FGI) Levels of Concern
The Facility Guidelines Institute (FGI) provides multiple levels of concern for behavioral health spaces, each with specific MEP considerations. These levels inform us of how to design systems to meet both safety and therapeutic needs.
- Level I: These are areas where patients are not permitted, such as mechanical rooms or staff-only spaces. While there is no immediate concern for patient safety in these areas, maintaining safe access for staff and minimizing equipment noise to surrounding areas is essential.
- Level II: These areas, such as counseling rooms and activity rooms, are highly supervised, with patients under constant observation. While ligature-resistant devices are not always necessary, we must still ensure that systems like lighting and HVAC controls are intuitive and don’t interfere with therapeutic activities.
- Level IV: In spaces where patients spend extended periods of time alone, such as patient rooms and restrooms, we employ ligature-resistant fixtures and devices to reduce opportunities for self-harm. MEP systems must support a comforting, non-institutional atmosphere while maintaining the highest level of safety.
- Level V: This includes spaces like seclusion rooms and admission areas where staff may interact with patients in crisis. These environments require robust safety features, including pressurization systems to control airflow and minimize contamination, and highly durable, tamper-proof fixtures.
Acoustic and Sound Control: Ensuring a Quiet Healing Environment
Sound control is critical in behavioral health settings, where loud noises or mechanical equipment vibrations can increase anxiety or agitation in patients. Careful placement of equipment, particularly HVAC systems and air handlers, is essential to avoid noise disruption. Additionally, sound-absorbing materials in ceilings, walls, and floors can mitigate unwanted noise, creating a quieter, more calming atmosphere for patients.
Pressurization and Safety: Keeping Doors Closed and Secure
Proper pressurization is vital for both patient safety and staff security. Behavioral health facilities often have areas where doors must remain securely closed to prevent elopement or unauthorized access. Improper pressurization can cause significant issues, such as the security doors failing to close properly—an issue we encountered on a recent commissioning job. In behavioral health environments, especially where safety is paramount, pressurization imbalances can’t be overlooked. Our team ensures that the airflows are appropriately designed and balanced to avoid such problems.
Creating Safe, Therapeutic Spaces
Perhaps the greatest challenge in behavioral health design is striking the right balance between safety and comfort. These spaces need to offer the necessary security to protect patients and staff, while also fostering a healing environment. The goal is not to create an environment that feels restrictive, but rather a space where patients feel supported and respected.
MEP engineers play a crucial role in achieving this balance by integrating ligature-resistant devices, ensuring proper sound control, and maintaining secure pressurization systems. Our technical expertise allows us to create spaces that are safe, secure, and supportive of patient healing, all while providing the functionality required for staff to do their jobs effectively.
At EMA Engineering & Consulting, we are committed to designing behavioral health facilities that serve as both safe havens and healing environments—spaces where patients and staff alike can feel protected without sacrificing comfort or dignity
Our team recently completed work on the UT Health Science Center Behavioral Health Unit renovations, so we sat down with Cameron Baker, the project manager, to discuss how our healthcare team implemented the MEP design considerations outlined in this blog.
Question: How did your design approach balance patient safety while maintaining comfort and a therapeutic environment at the UT Health Science Center project?
Cameron: Firstly, we had extensive conversations with the owner to clearly understand the different safety levels required throughout the facility. For example, in the patient rooms where patients would be left alone for periods of time, we knew we needed a higher level of safety, so we focused on using ligature-resistant fixtures and devices for anything the patients could interact with - plumbing, lighting, ceiling-mounted equipment, etc.
For the seclusion rooms, which were designated as Level 5 high-risk areas, we had to be even more stringent. We went in and removed all standard electrical outlets, light fixtures, and other potential ligature points, replacing them with specialized tamper-proof, ligature-resistant alternatives to ensure the highest level of patient safety.
We also renovated a visitor's restroom to meet these stringent Level 5 safety requirements, so patients could safely use the restroom during visits with family members.
Another key challenge was the outdoor courtyard space. While this was meant to provide a therapeutic, nature-connected environment for patients, we still had to address safety concerns, like removing an exposed exhaust fan that could pose a risk. Our solution was to replace it with a flat, ligature-resistant exhaust system that maintained the required airflow without compromising patient well-being.
Throughout the project, our focus was on creating spaces that felt comfortable and non-institutional, while rigorously addressing safety factors through our MEP designs. It was all about striking that careful balance to support the healing process.
Question: How did you ensure proper pressurization and sound control in the behavioral health environment?
Cameron: Pressurization was critical, especially in areas like the seclusion rooms where doors needed to remain securely closed at all times. We put a lot of emphasis on getting the airflow dynamics right, ensuring the pressurization was properly balanced so the doors would seal tightly and not have any issues closing.
Sound control was another major consideration. We knew that excessive noise or vibrations from mechanical equipment could increase anxiety and agitation in patients. So we paid very close attention to the placement and sound-dampening of HVAC systems, air handlers, and other equipment. We also incorporated sound-absorbing materials in the ceilings, walls, and floors to create a quieter, more calming environment overall.
Achieving the right balance of pressurization, airflow, and acoustics was crucial in making these spaces feel safe and therapeutic for the patients.
As we continue to advance in the field of behavioral health design, it's clear that achieving a balance between safety and comfort is key to creating spaces that truly support healing. Through thoughtful MEP design, we help ensure that every space serves its purpose—providing security without compromising the therapeutic atmosphere necessary for recovery. At EMA Engineering & Consulting, we are proud to contribute to this important work, and we look forward to supporting future projects that help make a meaningful difference in the lives of those who need it most
