Comfort in treating co-occurring disorders

June 25, 2012
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Main Lounge on Unit. High ceilings and large window panes allow natural light to enter the buildings. Courtyard. Walking paths run throughout the campus, complete with covered “gathering spots” where patients can sit and talk. Double room. Semi-private rooms enable patients to walk into the room in either direction and remain in their own space. Private bathrooms: Patients trigger wireless motion detectors that triggers water to start flowing from a spout on the mirror.
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In May, the Menninger Clinic opened its new facility in Houston. Named the “Epicenter,” the 120-bed psychiatric hospital offers psychiatric assessment and stabilization as well as services for substance abuse, eating disorders, adolescents, young adults, and professionals in crisis.

The layout of the new facility is designed to treat patients with a variety of co-occurring disorders, including those involving addiction. In fact, two-thirds of Menninger’s patients receive treatment for co-existing psychiatric and addictive disorders.

The new facility features a number of amenities, including an onsite pharmacy, an interfaith chapel and a wellness center with a weight room, aerobics room, gymnasium, outdoor therapeutic saltwater swimming pool and sand volleyball court.

But even when plans for the grounds were first envisioned, Larry Denoyer, Menninger’s vice president of facilities and property management, says one of management’s primary goals was to develop a sense of flow that would allow patients to feel as comfortable as they would in their own home.

“The vision we had was for a campus-style facility, a setting that felt warm and welcoming,” explains Denoyer, who oversaw daily construction, was a member of the leadership team for facility planning, and now serves as safety director. “We didn’t want an institutional look. We wanted there to be a residential feel, as well as a ‘park-like’ atmosphere.”

To create that atmosphere, Menninger took a sprawling 47.5-acre property and carved out a 25-acre campus. According to Denoyer, the facility had a $1.3 million landscaping budget, which afforded the opportunity to transform a flat, bare piece of land by transplanting 650 trees and incorporating several large berms.

With inspiration from the work of the late Frank Lloyd Wright, the campus design elements reflect a harmony with humanity and the environment, set off by several courtyards, a sculpture garden, outdoor terrace and a “meditation labyrinth.” Walking paths run throughout the campus, complete with covered “gathering spots” where patients can sit on a bench and talk.

 

Common areas

Even when patients are situated indoors, there is a “natural” quality to the atmosphere due to the high ceilings and large window panes that allow natural light to enter the buildings.

For the common areas, Denoyer says furniture was selected in the “Arts-and-Crafts” style, with most pieces manufactured by L. & J.G. Stickley (www.stickley.com). “The furniture is heavy and you can push it around, but it’s not something you’re going to pick up,” he explains.

Furniture is upholstered with custom fabrics, which were selected to be “pleasing to the eye” but that also had a high “rub factor” (a measurement that indicates a fabric’s resistance to abrasion).

“We chose fabrics that would be durable and last a long time,” explained Denoyer. “And the furniture itself is timeless, which means that in 20 years most pieces could still be in use and not appear institutional. It will just be a matter of making repairs and reupholstering as needed.”

A similar approach was taken with the floor covering throughout the facility. Essentially all of the floors in Menninger’s five buildings are covered by carpet, but carpet tiles were chosen to provide the ability to simply replace them as needed.

 

Bedrooms

During their stay at the Menninger Clinic, patients reside in semi-private rooms in order to encourage social interaction, according to Denoyer. But while the rooms aren’t exactly “private,” they are designed in a way that each patient does have their own space.

“The rooms are set up so that when you walk in, it’s almost like there are two separate rooms,” he says. “If you walk through the doorway, you can see each bed on either side [of a wall]. As you walk into the space in either direction, you’re essentially in your own space.”

The furniture in each bedroom, which includes a wardrobe, a dresser, and an oak desk, was “built in place” by the contractor, which means each piece is fixed to the room and thus immovable. Inside the wardrobe, the rods used for hanging clothes were designed to prevent them from being used as ligature points.

Full-sized windows with breakaway draperies allow patients to determine how well-lighted their rooms are during the day. At night rooms are lighted by ceiling fixtures, while additional lights are found near the bed for reading, and near the desk for patients to perform various other tasks at any time.

In addition, while many treatment facilities use twin beds in their patient rooms, Menninger elected to purchase full-size mattresses. “We went with full-size beds instead of the twin because we thought it would help make the patients’ stay a little more comfortable,” notes Denoyer.

Each patient also has a private bathroom, in which the shower fixtures operate with push buttons rather than handles, and the showerhead is installed flush with the wall. While the toilets selected are residential in appearance, Denoyer explains that they also feature a lockable tank to address issues with stashing contraband.

“They are locked so clients can’t get to them,” he says. “In addition, the toilet paper rolls are in a slot in the wall to prevent them from being used as ligature points.”

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