Providing treatment for Children and Adolescents who are experiencing psychiatric crisis is at once challenging and rewarding. As designers, it breaks our hearts to see young children in desperate need of psychiatric attention and we are acutely aware of the toll this illness takes on their parents. Our goal is to support the providers by designing a space that is supportive of the healing that needs to take place there. It isn’t enough just to keep these patients safe from harm (as important as that is). It is essential that we create therapeutic environments which are carefully tuned to the needs of these age groups.
Pediatric Inpatient units
With numerous children and adolescent units under our belts, we have learned some important rules about designing for this population. The first is so simple it is obvious: Children need to play. Anyone with kids knows that you can’t give them a room full of chairs and ask them to sit still until the next organized activity. Regardless of any psychiatric crisis, that is just too much to ask. The space we design for these patients should encourage play and activity in a safe and appropriate way. It is also important to provide a variety of options from quiet reading, to active sports time.
The second is also very important: Children need to be in a peer group that isn’t threatening. Creating smaller units or dividing units into pods can help to limit the peer group and allow providers to place kids in the most appropriate setting. Age appropriateness is also important. A young child may be intimidated by a teenager, especially if the teenager is experiencing crisis that results in inappropriate behavior. As designers, we can’t just think about segregated units. How will the common spaces be shared? Is there enough gym space to be divided up amongst all of the units without mixing misaligned groups in the same space? What about outdoor time? Is it better to have one larger play area, or to divide it into smaller separate areas?
The third might be the most important of all: Children aren’t adolescents and vice versa. There is a tendency to lump anyone under 18 in the realm of “pediatrics”. The reality is that a 17 year old has more in common with an adult than with a 7 year old. As designers we face an interesting challenge. We know that the best environment for any child is the one finely tuned to their demographic. We also know that the best environment for the business needs of the hospital is flexible and can serve multiple needs. Our job is to bridge that gap. To find a way to design spaces that can be used by any age group or gender, while still tuning each space, as much as possible to the needs of its programmed population.
My final thought isn’t so much a rule as an important reminder. It is a devastating experience to be the parent of a child in psychiatric crisis. No parent wants to watch their child suffer, but for a parent to fear for their child’s safety while at home, or worse to be in fear of their child is more than many parents can bear. So many parents are both physically and mentally exhausted by the time they reach the point of admitting their child to an inpatient facility. The design of the building and spaces, needs to give them hope for their child, for themselves and for their future.
