Warm welcome: What to consider when designing a modern mental health space
October 14, 2020
Lessons learned from working on a transformative mental health project for the Centre for Addiction and Mental Health (CAMH)
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For those of us who have chosen to focus our careers on healthcare design, we’re inspired and touched by the positive experiences of the patients, families, and caregivers who use the facilities we design. It’s heart-warming to have that kind of positive impact on people during their most traumatic or joyful life moments. But every once in a while, as a designer, you’re given the opportunity to work on a truly transformational project—providing an experience that lingers long after opening day. I recently had the opportunity to work with the Centre for Addiction and Mental Health (CAMH) on just such a project.
CAMH is Canada's largest mental health teaching hospital and one of the world's leading research centres in its field. Headquartered in Toronto’s Queen West neighborhood, CAMH offers clinical care to more than 34,000 patients each year. Stantec has been working with CAMH since 2008, first on phase 1B which opened in 2012, and now on phase 1C of its long-term redevelopment project. The latest phase—which helps the hospital achieve its vision of inclusive and recovery-oriented mental health care—features the addition of two new buildings on Queen Street West: The eight-storey McCain Complex Care & Recovery Building and the seven-storey Crisis & Critical Care Building.
My team's interactions with CAMH, and with our partners on the Plenary Health team, PCL Constructors Canada, we talked a lot about how to design a modern, purpose-built mental health space in the heart of downtown. Early on, we considered several questions: How can you keep spaces feeling as “normal” as possible to help break the stigma surrounding mental health issues? How do you create spaces that are well integrated into the community? How can you accomplish both of those goals while establishing a safe environment for patients, caregivers, and visitors?
When designing a new mental health facility, you’re afforded the opportunity to create a fully tailored environment that responds to the unique needs for safety, privacy, and dignity of the facility’s caregivers and patients. Here are a few points to keep in mind.
The exterior of CAMH’s new McCain Complex Care & Recovery Building, located at Queen Street West and Ossington Avenue in Toronto.
Establish a friendly atmosphere
A sense of openness and visual interest in lobbies, the inclusion of intriguing artwork, and interactive elements can help to create a friendly and inviting atmosphere. As one young former client said during a design consultation, perhaps a mental health facility could feel more like a university campus space or a modern library. Keep safety features unobtrusive so the experience feels less institutional.
For example, at CAMH, visitors are still buzzed into certain spaces for safety and security. But, the environment feels welcoming with care desks positioned in a way to blur the lines between caregivers and patients, creating opportunities for interaction and dialogue. The more private spaces at CAMH, like the inpatient floors, also feel comforting with great city views, fully integrated interactive art pieces, and uplifting accent colors that aid in intuitive wayfinding.
The large lobby of CAMH’s new Crisis & Critical Care Building will make patients, care teams, and visitors feel welcome.
Make mental health accessible to the public
Making mental health accessible to the public is not just about location. When a facility is located right within a downtown neighborhood, how do you further encourage passers-by to visit and seek treatment?
CAMH’s new buildings, located in the bustling Queen West neighborhood and next to vibrant green spaces, are universally accessible by the broader community during times of crisis and for every day mental wellness. The entrance for the dedicated mental health emergency department—the only one of its kind in the city—is tucked just south of Queen Street with clear, visible signage, and is accessible by foot, public transit, or car. The new 300-seat auditorium will be used for community events (with enough space to keep people physically distanced, if needed). CAMH’s new library, offering information on research and treatment, is highly visible and publicly accessible from Queen Street. A teaching kitchen located on the ground level offers patients a place to learn life skills. Former patients are included in many art and theater projects, in treatment as peer support workers, or in on campus food operations. Creating and fostering employment opportunities is an important part of CAMH’s vision for client recovery.
The exterior of CAMH’s new Crisis & Critical Care Building, which faces onto Queen Street West in Toronto.
Select safe materials that feel non-institutional
When selecting materials for your mental health space, the detailing, safety features, and performance must be considered along with the look and feel. It’s vital to normalize the space through furniture, fixtures, or other materials so it looks and feels non-institutional. A sophisticated and biophilic palette inspires well-being and makes spaces feel modern and connected to nature. At CAMH, we used a combination of real wood, wood-look materials, stone, porcelain, terrazzo, and linoleum—all in timeless neutrals you might find in your own home—to serve as a backdrop to the accent colors and integrated artwork program.
Sound absorption is critical in creating a comfortable and less disruptive interior environment. Achieving acoustic control while maintaining safety and cleanability of materials can be a challenge. Fortunately, there are now more options on the market that are sound absorbing, easy to clean, and secure.
Infection control is important in any hospital, but especially in the age of the COVID-19 pandemic. So, we used materials that are easy to wipe down and non-porous, but the infection control qualities are not necessarily obvious to the eye. In some areas at CAMH, we’re using a plastic laminate that looks like wood, but it has an additional coating that makes it even more durable. The upholstery materials on the built-in benches and furniture are resistant to hospital grade disinfectants, which is important given the frequency of cleaning and sanitizing required. It means the upholstery won’t get damaged easily by disinfectants.
When selecting materials, the detailing, safety features, and performance must be considered along with the look and feel.
Design open areas to avoid congestion and promote physical distancing
When it comes to mental health spaces, overcrowding and congestion can cause agitation. Large exterior spaces, like courtyards or terraces, provide people with places to heal outdoors and enjoy fresh air. Inside, wide corridors with built-in benches and open concept dining areas and lounges allow easier access and more personal space choices. Well-planned open areas help to alleviate overcrowding and lend themselves to appropriate social distancing.
A rendering for the CAMH Phase 1C project. When designing mental health spaces, how can you help establish an environment that feels as “normal” as possible?
Integrate artwork that creates a welcoming space
Recognizing the value art has on a space, CAMH offers a therapeutic art program in addition to artistic base building elements proposed by the design team. CAMH’s Therapeutic Art Project is a donor-funded art competition featuring pieces by people with lived experience, including former patients and local artists. This creates a nice link to the art galleries and artistic culture of the neighborhood. Art in a mental health center can engage, act as positive distraction, aid in wayfinding and landmarking, and tell uplifting stories.
Artwork is not always part of a project’s budget. Even so, there are ways that artistic elements can be integrated into the base building design. Pattern and imagery can be incorporated as part of wall protection, image walls and privacy film, glazed divider panels in waiting areas, and even through sculptural lighting elements. These elements should be well integrated in the design, and not appear to be an afterthought.
It’s great when art can be integrated into the base building design—such as this limestone carving installation by artist Simon Shimout that is featured above a fireplace in one of CAMH’s new lobbies. CAMH’s Therapeutic Art Project is a donor-funded art competition featuring pieces by people with lived experience.
An inspiring vision
The experience of creating a space for healing and support for CAMH will remain with me. It’s been a pleasure collaborating with our project partners, and we’re grateful for the involvement of Infrastructure Ontario and for the important work by KPMB and Montgomery Sisam Architects as the Planning, Design, and Compliance team. Design can encourage community integration and help destigmatize mental health care. By operating under the recovery model of care, and by blurring the lines between public and treatment space so patients can thrive in their community, CAMH has inspired me with their vision.