Safe and Dignified: Key Considerations for Behavioral Health Furniture and Fixtures

Behavioral health environments demand a delicate balance between prioritizing patient safety while providing dignity and therapeutic support. As designers, our responsibility extends beyond meeting regulations—we must also create facilities that are healing, comforting, and human-centered. A critical part of this process involves the thoughtful selection of furniture and fixtures, customized for each unique behavioral health space.

Grounded in Best Practice

Many design teams, including BWBR, look to standards like the New York State Office of Mental Health for guidance. Their regularly updated guide not only sets a regulatory benchmark but also tests and rates behavioral health furniture for safety and durability. These standards inform our internal design guides and help our designers select products that have been rigorously vetted for behavioral health applications and risk levels.

Selected for Safety

Furniture used in behavioral and mental health settings must be specially designed to minimize the potential for harm. Many of these pieces are intentionally weighted and oversized so they cannot be easily lifted or thrown. As a result, room layouts must be thoughtfully planned to account for the scale of these items, allowing adequate circulation while avoiding overcrowding or overstimulation.

Designers must also consider how components of furniture could be broken down or misused. For example, avoiding furnishings and fixtures with removable parts or sharp corners helps prevent weaponization. Rounded edges, smooth surfaces, and tamper-resistant materials are essential, not only to reduce opportunities for self-harm but also to enhance cleanliness and durability.

Other safety features include anti-concealment strategies. Upholstered furniture is often designed with sealed seams, and casework is designed with continuous panels between drawers to prevent hiding objects. In many cases, items are anchored or built flush to the floor to eliminate gaps and voids.

M Health Fairview Southdale Hospital EmPATH Unit

Warm and Welcoming

Focusing only on physical safety can lead to sterile, institutional environments that feel punitive—an approach that undermines healing, particularly for patients in crisis. Instead, human-centered safety considers the whole person, including their emotional, psychological, and social needs.

There are many ways we can integrate warmth and personalization into behavioral health environments while maintaining safety and security. Elements like marker boards or chalkboards allow individuals to express themselves and customize their environment. Similarly, incorporating open shelving to display personal items gives patients a greater sense of ownership over their space. Material and color choices also play a role. Warm wood tones, calming colors, and tactile textures can soften the environment, making it feel more residential and less clinical. Access to daylight, views of nature, and biophilic design features help to promote well-being and reduce stress.

These elements not only enhance the physical environment but also reinforce a sense of agency, identity, and comfort for patients—key components of emotional healing. By designing spaces that reflect care, empathy, and respect, we move beyond simply managing risk and begin to support meaningful recovery.

University of Maryland Medical Center Child and Adolescent Inpatient Psychiatry Unit

Providing Autonomy and Choice

Welcoming aesthetics are only one piece of the puzzle when creating spaces where healing can happen. In environments where patients’ autonomy has been limited for safety, it’s critical to provide opportunities to make choices and feel a sense of personal control. Task lighting in rooms is one example of a small design element that makes a big difference in patient satisfaction, providing the ability to control lighting level.

For BWBR’s behavioral health team, the best design comes from patients themselves. Involving patients in the design process has been shown to improve satisfaction, helping patients feel heard and valued while helping designers understand the experience of the facility.

Ultimately, behavioral health environments are most effective when they are shaped by the very people who use them. By integrating patient voices and prioritizing elements that enhance choice and autonomy, designers can create spaces that prioritize comfort throughout the healing process. 

Risk-Informed Design

Not all behavioral health spaces carry the same risks, which is why design should be tailored to match risk levels. For example, spaces like staff offices and other non-patient areas are classified as level one and may safely use standard commercial furnishings. Level two spaces, such as exam rooms, have heavy staff supervision and require some added safety considerations. Level three is considered the baseline for most patient areas—lounges, dining areas, and other spaces that are open, visible, and have less intensive supervision fall under this level. These areas require tamper-resistant, durable, and ligature-resistant furniture.

Levels 4 and 5 encompass very high-risk areas where patients may be experiencing high stress and agitation, such as intake areas or seclusion rooms, and private spaces like bedrooms and bathrooms. As environments where patients are frequently alone and unsupervised, data has shown that toilet and shower rooms are the highest risk places in behavioral health facilities. Each of these areas demand rigorous safety features such as fully ligature-resistant and anti-concealment designs, as well as highly durable and fixed furnishings to minimize all forms of risk.

By understanding how different spaces function—and the level of supervision each receives—designers can apply appropriate strategies without unnecessarily restricting more flexible environments.

Design for Diverse Populations

Behavioral health settings serve a wide range of patients—from young children to older adults. Design decisions must be sensitive to each demographic.

Child and adolescent units must accommodate a wide age range, sometimes serving patients from as young as five up to 17 years old. Because of this, spaces should be engaging and child-friendly without feeling childish. In some facilities, providing separation between child areas and adolescent areas is appropriate. In other settings, designers can identify solutions that appeal to both young children and older teens.

When considering adult units, designers work closely with behavioral health providers to determine appropriate levels of privacy and environmental control. Safety is still paramount, but solutions can be more tailored and less restrictive for adult populations, allowing for greater autonomy and dignity. Geriatric patients may benefit from additional mobility support, clear wayfinding, or accommodations for memory and sensory impairments, all while maintaining a calm and dignified environment.

Designing for all demographics means recognizing that healing looks different at every stage of life. A one-size-fits-all approach can overlook critical developmental and emotional needs, potentially limiting the effectiveness of care. By tailoring design strategies to each age group, we create environments that foster a greater sense of comfort and well-being for every patient.

Unitypoint Health – Meriter Child & Adolescent Psychiatry Program

A Customized Approach

Behavioral health environments are among the most complex and sensitive spaces to design. Every decision has the potential to impact patient safety, dignity, and recovery. By grounding our work in evidence-based safety best practices and layering in empathy, creativity, and nuance, we can design environments that truly support healing.

Thoughtfully selected furniture and fixtures are not just tools for risk mitigation—they help create spaces that feel safe without being restrictive, secure without being sterile, and supportive without feeling clinical.

Sides Notes: Healthcare’s Holistic Shift

In the latest episode of Side Notes, the bite-sized version of Side of Design, BWBR’s Healthcare Practice Leader Ryan Johansen joins us for a quick but impactful discussion on the state of the healthcare market. In less than 15 minutes, we explore how the industry is shifting from a model centered on treating illness to one focused on promoting wellness—and how design can support this transformation by addressing the needs of patients, families, and healthcare staff in holistic ways.

A Broader Definition of Health

When asked what excites him most about healthcare today, Ryan refers to the important evolution happening in care. “What excites me about the market itself is that shift from treating the sick to keeping people healthy. Physically, mentally, spiritually, it covers it all,” he says. “Physical health is going beyond just prevention and focusing on being well.”

He highlights the growing emphasis on lifestyle factors like exercise and nutrition, along with advancements in technology such as wearable fitness trackers, as empowering tools for people to take control over their own health. Mental health, he notes, has also become central to how we think about overall well-being. “The stigma is still there. We haven’t gotten over that yet, but the momentum towards openness, support, and innovation is stronger than ever,” he says.

And, as Ryan shares, spiritual health is increasingly being recognized as a social determinant of health—influencing resilience, motivation and emotional well-being. “So, what that means for me is that every project is a healthcare project. Because every project has a human interaction and can affect all three of those physical, mental and spiritual health.”

Pressures Amid Progress

While the shift toward holistic wellness is encouraging, healthcare organizations are still facing significant hurdles. “If you were to ask me to pick one challenge in healthcare—not possible,” he says. However, financial pressures are a difficulty Ryan consistently sees among clients.

Hospitals are operating under immense strain. Ryan explains that costs for staffing, materials, and construction continue to rise, while reimbursements often lag behind—creating a financial gap that many healthcare systems are struggling to bridge. “Hospitals run on razor-thin margins,” he says. “So, every change that happens requires a reaction from the organization, and there’s a lot of changes happening right now.”

Beyond finances, staffing shortages and burnout are major concerns. Healthcare workers are stretched thin, and many are facing emotional exhaustion. “The amount of change that’s coming at them at any one given time, plus those staffing shortages and burnout—that’s a big deal,” Ryan says.

Creating Spaces That Support

The current landscape demands resilience not just from healthcare leaders and staff, but from the systems and spaces designed to support them. For Ryan, it starts with a deep understanding of the healthcare market itself.

“At BWBR, we really try to understand how a business operates,” he says. This means looking closely at patient volumes, payer mixes, and department-specific reimbursement rates—factors that influence how an organization functions financially. “That really helps us design a facility that is not only sized appropriately to meet their community needs but also allows the facility to optimize those reimbursements that they do receive for providing care.”

But financial sustainability is just one piece of the equation. Ryan emphasizes that thoughtful design must also address the rapid evolution of technology, patient needs, care models, and more. “Change is constant, so if we build a static building, that’s not doing them any good,” he explains. “Designing resilient spaces that are flexible and easily adaptable—that’s where we can make a real difference,” he says.

And ultimately, design must prioritize the well-being of everyone who interacts with the space. “That’s from a patient to a family visitor to the staff that work there day in and day out,” Ryan notes. The right design can reduce stress, support better outcomes, and create a more human-centered experience for all.

Designing with Purpose

Healthcare environments touch everyone’s lives. “It’s not just the patient, it’s not just the family, it’s the staff, it’s everybody,” he shares.

That’s what makes great healthcare design so important to Ryan. He shares the story of his grandmother Laura, who suffered from Alzheimer’s at a time when treatment options were limited and healthcare environments were far less developed. He also remembers his grandmother Thelma, who experienced a brain aneurysm that dramatically altered her mobility for the rest of her life, as well as family members and close friends who have undergone cancer treatment, spending long hours and days in treatment rooms.

These weren’t just medical conditions, they were defining events that deeply impacted his loved ones’ lives. This is what inspires Ryan to create better spaces for healing. “Anything that we can do to make their experience more pleasant. To help them relieve stress, help them provide quality care and receive quality care,” he says. “To help improve their outcomes and help promote wellness to get them healthy—and to keep them healthy moving forward.”