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.
