As manager of the social workers in the emergency department at Nebraska Medical Center in Omaha, Neb., Jennifer Sparrock, saw firsthand the rise of patients experiences mental health and substance use crises coming into the healthcare facility.
“Nationally, one in eight visits to an emergency room or an emergency department (ED) are for somebody presenting with mental health and or substance use issues,” she says.
The increase was creating a backlog in the Level 1 trauma center’s ED. Some mental health patients who might simply need a space to de-escalate or wait for transfer to a community mental health organization had to wait in the ED until their episode ended or a treatment bed was found. At times, the process could take several days.
Additionally, the busy environment with its variety of noises, lights, and activities wasn’t ideal for a person in crisis. “There were lots of reasons to look at doing something better and different,” Sparrock says.
Psychiatric Emergency Services Unit
In 2019, Nebraska Medicine, the private not-for-profit healthcare system that operates the medical center, began developing a new Psychiatric Emergency Services Unit (PES) to provide a calming and safe environment focused on stabilizing patients while also alleviating the space crunch at the hospital and filling a void in the community.
Working with DLR Group, the healthcare organization identified a former imaging suite on the ground floor of one of patient towers for the project.
Recognizing that patients would be presenting with a wide range of conditions and needs, Adam Post, project manager and architect at DLR Group (Lincoln, Neb.), says the project team designed the 8,895-square-foot suite to offer a variety of settings for patient diagnosis and recovery, depending on the acuity needs of the patient.
For example, a large, open community room with a variety of seating arrangements is designed for those who don’t need to be isolated or who prefer a more social environment.
Two other clinical areas provide a more controlled environment, including three individual treatment rooms that utilize color light therapy and another six treatment rooms for higher-acuity patients.
Designing for safety
To address the safety needs of patients and staff, anti-ligature door handles and hinges and weighted furniture are used throughout the unit.
One of the biggest challenges on the project, which began treating patients in October 2021, was the lack of natural lighting because of its ground-level location. To address this, the project team utilized tunable cove lighting to provide varying light levels throughout the day and create a more normative environment, Post says.
A color palette of blues and greens along with large-scale graphics of nature scenes add a sense of calm and familiarity within the setting, as well.
Future of mental health care
Because of COVID-19 screening requirements, Sparrock, who became manager of the unit in January 2020, says patients are still coming through the ED to the unit. However, the goal is to take walk-ins eventually.
Still, she says, the deinstitutionalized setting is expanding care options in the community while helping address the stigma of mental health care.
“It was really important that is feels more like a place of refuge, where somebody can come when they’re feeling overwhelmed and in crisis and feel affirmed that they made the right choice to seek help,” she says.
Anne DiNardo is executive editor of Healthcare Design. She can be reached at anne.dinardo@emeraldx.com.
