Equity in Design: Creating Thoughtful and Inclusive Spaces

Design plays a critical role in making people feel welcome and safe. From accessibility to gender inclusivity, design is about more than who can enter a space – it also sends a strong message about who is warmly invited to enter a space, just as they are.

To discuss the intersection of design and social justice, particularly when it comes to issues of gender equity, BWBR sought input from a special guest. Dr. Kathryn Anthony serves as a national spokesperson on gender issues in design. She’s the longest serving female faculty member at the School of Architecture at the University of Illinois at Urbana Champaign. She’s the author of several books on inclusive design and the recipient of numerous awards, including the 2020 Lifetime Achievement Award from Chicago Women in Architecture, and the 2021. Topaz medallion for excellence in architectural education. Dr. Anthony has been featured on ABC World News with Diane Sawyer, CBS Sunday Morning, CNN, NPR, the LA Times, and The Wall Street Journal, to name a few. She has even testified before Congress on gender equity in public restrooms.

The Personal Becomes Political

Dr. Anthony is a pioneer in this field. While her interest in this topic goes back several decades, she can point to two moments that underscored the need for this type of work – one public, and one personal. In the late 1990s, headlines were dominated by the horrific murder of a 9-year-old boy who used a public men’s restroom at a beach in California. His aunt was waiting outside for him when the perpetrator, a stranger, entered the restroom and slashed the boy’s throat. It sparked a conversation about safety, particularly the fact that the boy’s aunt couldn’t accompany him and thus he was left vulnerable.

Around that same time, Dr. Anthony’s husband was being treated for cancer, and was wheelchair-bound for a short time. Using public bathrooms was prohibitively difficult for him, and yet Dr. Anthony couldn’t join him in the restroom to assist him. “It made me think, this is not right. And what about people who must go through this every day of their lives? Something is wrong with the typical men’s and women’s rooms. When people need help and caregiver attendance, they shouldn’t be forced with the choice [to violate rules or leave someone unattended].”

These issues tap into not only gender but also ableism and even time equity – demanding additional time for certain groups of people to complete tasks when that time isn’t equally demanded of others.

And of course, the incidents Dr. Anthony refers to took place more than 20 years ago. Does that mean we’ve figured out all the solutions? Far from it. “In a nutshell, I’d say the current state of equity and inclusion in design is definitely getting better, but it has a long way to go,” says Dr. Anthony. She notes that part of the progress stems from a significant increase in the number of women and persons of color entering the architecture field. Yet, again, there is much work to be done.

Opportunities for Equity Everywhere

We at BWBR recognize the issue as a profession – we have a long way to go both in terms of inclusivity of the people who get a voice at the table. And also in terms of looking at the ways that our buildings currently serve people, and how they can be re-imagined to serve and include an even greater percentage of the population.

One clear area of opportunity: inclusive restroom design. As a firm, BWBR is exploring ways that restroom layouts can be adapted to serve people with a variety of needs, and across a whole host of spectrums from gender to ability.

When Dr. Anthony thinks of her “favorite restrooms” in terms of inclusion, she thinks of those at La Jolla Shores in California, where there are two sets of “beautifully designed” all-gender restrooms. “Everyone waits in the same line, so either nobody waits or everybody waits.” This, Dr. Anthony explains, eliminates the common burden on people who identify as women and girls needing waiting in longer public restroom lines. This can be adapted elsewhere. BWBR is currently working with St. Paul Public Schools to design restrooms with open sink areas and private toilets. We’re also working on the Family Partnership Project to implement a series of all-gender, inclusive restrooms that have a toilet and sink in a single, enclosed space.

“I give my compliments and kudos to BWBR, for taking the time to really address these issues. And, BWBR’s emphasis on Diversity and Equity and Inclusion is really important.”

Dr. Kathryn Anthony

Other ways to improve: designating all single-unit restrooms as all-gender rooms, accessible to everyone, as is mandated in California. Dr. Anthony also emphasizes the importance of family restrooms with accessible amenities such as toilets and sinks that can be accessed easily by children or individuals with disabilities.

Forging a More Inclusive Future

How do we get to a place where restroom equity is the norm? It starts with thought leaders in architecture and design making it a priority. Funding is also a motivator. Dr. Anthony has advocated for economic stimulus dollars to be used to improve sanitation and rebuild our nation’s restrooms. As for how those dollars would best be spent? It’s simple: Clean. Safe. Accessible to all. “Public restrooms are an extremely important public health issue, and a civil rights issue that affects all of us,” she says. “It’s not just a women’s issue. It’s not just a persons with disabilities issue. It’s not just an issue for the elderly population. And it’s not just an issue for people who are transgender, though it’s important to note that we are grateful to the transgender population because I think if it were not for their advocacy of this issue, the all-gender restroom movement would not have had as much traction.”

The final takeaway: “Let’s bring restrooms into the 21st Century and make them wellness centers and refreshment centers, not just restroom centers.” For everyone.

Breaking Barriers to Pediatric Behavioral Health Services

BWBR was thrilled to host Dr. Sarah Edwards from University of Maryland School of Medicine and Heather Treib from Pine Rest Christian Mental Health Services for a recent moderated conversation and Q&A focused on the barriers to pediatric behavioral health care and the movement to more family-centric solutions that make real differences for patients and caregivers. (You can view the full recording at the bottom of this page.)

Understanding the Challenges

Suicide is the second-leading cause of death among people ages 10-24 and the CDC reports the number of children aged 5-11 seeking behavioral health services has increased 24% (with ages 12-17 up 31%) from pre-pandemic levels. Organizations are struggling to meet this demand–families can wait months for psychiatry or therapy appointments, and in some cases are even turned away completely due to lack of capacity. The obstacles can be even greater in rural areas, which suffer from a lack of providers and can require families to travel for hours to access their nearest behavioral health resources.

One of the biggest barriers to care, now more than ever, is limitations in staffing. In the face of huge amounts of burnout, finding and keeping staff in all roles is a significant challenge. Aside from focused recruiting, retention, and recognition efforts, facilities need to think creatively and flexibly about how staff are deployed, how best to support them in their day-to-day work, and how to maximize patient care with the staff available. The pandemic has also added new safety concerns to the mix, making it more difficult to move or combine staff from different areas without increasing the risks for cross-contamination. It really does take a village to ensure safe programming and quality clinical care, and providers must work to address this shortage from as many angles as possible.

Seeking Solutions

Children with mental health needs do not exist in a bubble, so disconnecting them from their family and support structure is not conducive to long-term improvement. As facilities expand and pilot new services, they must make an active effort to incorporate family in a meaningful way. For example, the University of Maryland offers the option for a caregiver to stay overnight with a patient and connects families to a “peer navigator” who has been there themselves and who checks in weekly by phone to offer support. Stabilizing the immediate crisis is vital, but so is helping families understand the hard work to come after the patient is discharged.

Besides considering the entire family unit, it’s also important to broaden the continuum of care and consider how to treat each patient in the least restrictive appropriate environment—greater need and more acuity does not just mean a need for more beds. This can also mean pursuing proactive early-intervention strategies rather than waiting for patients in crisis to seek care, working upstream to support parents and increase early childhood intervention. A parent’s mental health has a huge impact on their children, so early, non-stigmatized support services around addiction and mental health care can change the trajectory for the whole family. It also helps families form connections with resources they can call on again later as needed, increasing their overall support system.

Technology also has a vital role to play in filling some of these critical access gaps. Pine Rest, which serves a large geographical footprint, including many rural areas, has seen a huge benefit to the increase in telehealth adoption and reimbursement since the pandemic started, greatly expanding their organizational reach and increasing patient and provider acceptance levels when there might previously have been resistance. While a hybrid model might always be ideal, virtual visits are breaking down many of the barriers that families previously had to face including long travel times, long waits for in-person visits, and scheduling conflicts with work and other commitments.

Designing for a Collaborative Future

Design also has an important role to play in enhancing patient care and optimizing support services. Safety will always be #1, but close behind it is providing a warm, welcoming, therapeutic environment. By investing in the physical environment as a member of the treatment team and providing natural light, reduced social density, and interactive elements that offer patients some choice and control, facilities can avoid the “us against them” mentality and instead move forward from a place of partnership.

Every organization that delivers pediatric behavioral health care needs to take an honest look at their current state and start anticipating future needs by challenging previous ideas, listening to the community (both staff and patients), seeking out new partnerships and collaborations, and not being afraid to make big changes. None of us can tackle this complex issue in isolation.

BWBR Enters its 100th Year Appointing Stephanie McDaniel to President and CEO

BWBR, an architecture firm designing solutions to enhance how people work, heal, learn, pray, and play nationwide, is proud to announce the upcoming appointment of Stephanie McDaniel, AIA, LEED AP, to President and CEO effective December 15.

McDaniel, a 25-year veteran of the firm, represents the 8th generation of home-grown BWBR leadership and brings a passion for people, design, and the firm. Having earned her undergraduate degree from Washington University and her Master of Architecture from University of Texas-Austin, McDaniel is a registered architect in Minnesota, Iowa, North Carolina, North Dakota, South Dakota, and Wisconsin. As a highly skilled planner with excellent communication and facilitation skills, her work has focused on planning and design for complex laboratory and higher education projects.

Under McDaniel’s leadership, BWBR will continue to operate under its guiding principle of transforming lives through exceptional environments. This commitment has sustained the firm through decades of exceptional architecture, bolstered by a sense of community and a growing dedication to equity and sustainability in the built environment, all of which McDaniel will carry forward.

McDaniel says, “I’m so honored to be taking on this role. BWBR’s talented team is deeply committed both to serving our clients and to design excellence, and I look forward to supporting them in every way I can. Architects and designers have the expertise to create spaces that make our clients better — to transform the lives of those who use our buildings. As the designers of our future communities, together we can create spaces and environments that are sustainable and equitable.” 

Outgoing President and CEO Peter Smith, FAIA, retiring after nearly 35 years with the firm, said: “This transition has been a long time in the planning, but now the baton is being passed to the next generation and I’m excited to see where the firm goes next. Under Stephanie’s guidance, BWBR is poised to do something transformational within the business itself, for our clients, and for the industry at large. I’m most excited for the things to come that I can’t even imagine.”

Heading into its 100th anniversary, the firm is embracing change while still relying on the deep commitment to community and culture that is the bedrock of BWBR, combining a sense of continuity with excitement for the possibilities of the future. McDaniel said, “The heart of BWBR’s mission has always been our commitment to serve, empowering our clients to achieve their missions. To meet that challenge, we must innovate to meet our clients’ evolving goals while at the same time reducing our collective impact on the environment.”