Access to the outdoors is fundamental to the human experience. We encounter sunlight, rain, wind, views and vistas on a constant basis. We play outside, we exercise, we work. We have also long known the benefit of this access and exposure for clinical environments, and yet frequently within secure mental and behavioral health spaces it is not the priority.
The existing inpatient behavioral health unit at Dayton Children’s Hospital lacked any physical access to outdoor space for patient therapy and recreation, so in 2022 when they embarked upon creating a new facility with expanded capacity and services, outdoor space was not only a high priority – it became a focal point of the design.
Frequently, inpatient behavioral health units are physically centered around a staff zone that prioritizes visibility and observation. While this design approach has certain benefits, outdoor space is often pushed to the periphery in this model, and sometimes far enough away that it becomes operationally challenging to utilize. At the new Mathile Center, an outdoor courtyard is intentionally located smack in the middle of each unit, becoming the figurative heart and literal organizing presence for the space.
The result of this approach yields several tangible benefits that are positively impacting care within the new facility, including:
* Natural daylight penetrates further into the building, touching over 95% of patient spaces and corridors, and amplifying experience. No matter where you are, you have a connection to the exterior perimeter or one of the central outdoor spaces.
* Circulation is designed as a continuous loop that envelops the courtyards, fostering ambulation path opportunities. This also avoids dead-end bedroom wings often attributed to traditional designs, where kids and staff may feel trapped or unsafe.
* Outdoor space becomes easier to access and operationally manage, resulting in higher utilization and an effective extension of therapeutic offerings on the unit. Outdoor spaces can truly become additional group therapy rooms or recreation space.
* Staff are able to observe and monitor the outdoor space with more confidence and awareness, given it is always in proximity to other internal activity spaces.
* Repetitive clinical tasks such as nighttime bedroom checks can be accomplished in less “steps”, taking advantage of continuous circulation rather than “out and back” patterns seen with hub-and-spoke or radial layouts.
Completed in 2025 and now open for roughly 6 months, the new Mathile Center is proving that these benefits are making a difference in the care that Dayton Children’s offers to kids, both in terms of the spatial environment but also the extension of programming and therapy that staff now have at their disposal. Access to outdoor space matters, and when it’s prioritized it can open tremendous opportunity.
