Safety Unseen: Leveraging Design to Improve Inpatient Mental Health-Care Practices

When a patient attacks a nurse, there is more than physical trauma that occurs. The consequences of the violence can manifest in anger, fear, anxiety, shame, blame, and post-traumatic stress disorder symptoms that can have negative effects on patient care and job satisfaction. In the past, design strategies in inpatient psychiatric centers upheld safety by erecting barriers between patients and staff, or over-using restraints and seclusion, strategies that communicated fear and distrust. Now, understanding of how people respond in a state of crisis is changing how care can be delivered in inpatient settings. Once seen as counterintuitive, eliminating physical barriers and opening connections between staff and patients are elevating safety by reducing the psychological walls that keep patients from feeling trusted and respected. By recognizing the human need to have choice and a sense of control in a world that feels out of proportion, health-care organizations can leverage design strategies that address aspects such as spatial density and zones of personal comfort, improving safety by elevating choice and dignity in a therapeutic healing environment.