Open, Closed or In-between? Nurse/Care Station Design in America

Synopsis

Historically, care desks in mental healthcare facilities have gravitated toward fully enclosed fortresses with the explicit purpose of protecting care givers. In reality, the stigma surrounding those experiencing mental illness and older, purely palliative care models were drivers as much as staff safety. The underlying “Us vs Them” mental construct led to clear and hard divisions between staff and patient spaces. Even today, this model is favored among many caregivers and often assumed to be the only viable solution. Indeed, staff safety is an important consideration, especially given the current shortage of mental health caregivers, however, research and project-based evidence suggest the enclosed care desk may not always be the most effective approach, not only for recovery, but also for the safety and wellbeing of service users and staff.

This presentation will explore drivers and solutions for various care desk typologies, and will look to research on the topic, including perspectives from service users and clinicians, for evaluating the effectiveness of each in the context of a recovery-based model of care. Specific project examples will demonstrate important lessons learned about the designs, but more importantly about the design process and operational policies established in service. It is evident there is no single solution for all projects, but this presentation aims to provide a better understanding of both the important and essential aspects of care desk design.