For millions of people, mental health care has become an optimal course of action as they anticipate restorative outcomes. Not so long ago, mental health institutions were referred to in derogatory term and many residents would reside in these secure institutional facilities indefinitely due to the inability to obtain approval for release.

Challenging the Status Quo

Stigma had been attached to the abusive mental health practices until 1967, when the Lanterman-Petris-Short Act of 1967 ended the practice of institutionalizing patients against their will. As asylums closed across the U.S.  between 1967 and 1994, the justice system began to inherit portions of the population with mental health or behavioral health needs. Due to an inability to find proper placement or treatment facilities, detention centers were slowly becoming the largest mental health institutions. Today, the healthcare and justice continuum of care, in partnership with the design community, has been working to create the path forward for individuals struggling with mental or behavioral health illness.

In order to challenge the status quo, reviewing and changing terminology is necessary to bringing dignity, health, and wellness to patient care, to remove barriers from access to care, and to give better understanding to evidence-based practice and treatment. " Brooke Martin and Cassey Franco

Updated facility language doesn’t only exist to remove derogatory connotations, but it also aligns with modern best practice approaches for mental or behavioral healthcare that emphasize providing patients with the self-confidence and an active role in their treatment towards recovery and stability. By starting with the foundation of correct terminology, many things grow out of it, including improved treatment description, room names, wayfinding that eases stress, and facility names that are inviting versus anxiety inducing. These improvements allow a much healthier and normative environment. Cumulatively, there is one goal in mind: the successful treatment of the patient or client and to destigmatize and decriminalize mental health and behavioral health.

Person-First Versus Identity-First Language

Language updates also apply to how we refer to individuals with mental or behavioral health needs. Our industry is shifting to focus on using person-first language, which is a linguistic approach that puts a person before a diagnosis, versus identity-first language, which describes a person in the context of a disability, medical condition, or cognitive difference. In the past, an identity-first language example would be calling a person “a schizophrenic,” whereas in the push for change to de-stigmatizing person-first language, today this person would be described as an “individual who lives with schizophrenia.” These simple, but important updates to the language allow us to avoid identifying or defining the patient in need by their condition. Each patient is valued and should be spoken to with dignity.

Identity-First Examples:

• Disabled person
• Autistic person 
• Intellectually disabled person
• Addict

Person-First Examples:

• Person with a disability
• Person with autism/person on the autism spectrum
• Person with an intellectual disability
• A person with a substance use disorder

Examples are taken from thesaurus.com.

Designing a Welcoming Patient/Client Experience

To coincide with updates in healthcare language, architecture and interior design professionals have updated the way they design mental health or behavioral health facilities. Our firm works with healthcare providers and justice systems to fill in the mental or behavioral healthcare facility gaps within the continuum-of-care by designing crisis centers and outpatient facilities so that this population is not admitted directly to a hospital, placed in a detention center, or placed back into their homes before they have had time to stabilize. One great example of a leading crisis center our firm has the opportunity to design is the New Psychiatric Hospital in Tulsa, Oklahoma.  The Oklahoma Department of Mental Health and Substance Abuse Services is embracing a design approach that reduces the stigma surrounding mental health. This facility is being designed for spaces to feel warm and welcoming for their patients. As a patient becomes more comfortable and trusting in their environment, they will open up more fully to their treatment plan and actions.

Rethinking the Way We Think and Communicate About Healthcare

The U.S. mental or behavioral healthcare system is slowly adapting to the modern world, but there is still much to be done. Changing the way we look at mental and behavioral health patients, updating our language and terminology, and improving our design strategies will have a profound impact on both the patient and client experience and their recovery process. When we speak with dignity for others, we give them respect, value, and support our vulnerable populations. Our firm is proud to work with community healthcare and justice systems to positively impact mental and behavioral healthcare and justice approaches. We partner with our clients to implement transformative design for restorative outcomes.