Supporting Mental Health through Architectural Design

In this episode of Architecturally Speaking, host Ryan Schwartz sits down with Michele Cohen of B+H Architects to explore the fascinating intersection of architecture and mental health.

Drawing on more than 30 years of healthcare design experience, Michele explains that healing environments require much more than just clinical efficiency. She highlights how evidence-based design, natural daylight, and returning a sense of control to the user are replacing outdated institutional models.

Interested in how thoughtful, community-oriented design can move beyond basic function to genuinely improve human health? Take a listen!

Subscribe now to Architecturally Speaking on YouTube or wherever you get your podcasts.

Transcript

Architecturally Speaking

Episode 20: Supporting Mental Health through Architectural Design

Ryan Schwartz: 00:04 - 00:56

Hi there, welcome back to another episode of Architecturally Speaking. This podcast series is brought to you by the Ontario Association of Architects, and I'm your host, Ryan Schwartz. As always, the goal of the show is to pull back the curtain on the world of architecture by chatting with other architects and industry experts to give you a little peek behind the scenes. We've talked about housing, sustainability, accessibility, design competitions, adaptive reuse, and plenty of other interesting topics in the past. So I encourage you to go back and check out our earlier episodes if you haven't already. But today we'll be chatting about the connection between architecture and mental health, which should be interesting. We're joined by Michelle Cohen in Toronto. Michelle is an architect focused on healthcare with over 30 years of experience delivering health, medical science, and laboratory projects across North America. She's a principal at B plus H Architects and leads the office's healthcare practice. So Michelle, welcome to the show.

Michele Cohen: 00:58 - 01:00

Thank you for having me. It's a pleasure to be here.

Ryan Schwartz: 01:01 - 01:16

So your career has clearly focused a lot on a variety of healthcare buildings. And why is architecture important when we're talking about mental health? What's the connection there that's kind of interesting between architecture and mental health? What's the link?

Michele Cohen: 01:17 - 01:36

Well, as architects, we're not providing the care, but we're certainly creating the environments in which the care will be provided to the patient. And it doesn't just affect the patients. It affects everybody who experiences the building, which includes patients, their families, loved ones, and of course, the staff who work in the building.

Ryan Schwartz: 01:38 - 02:02

Yeah. And I think that's a really good point. Um, when you, you think about, you know, a hospital, that's obviously the patients are probably, you know, the, at the top of the food chain in terms of importance, but there's a lot of other people that work there that visit and what's, what are the challenges when you're, you're balancing, you know, maybe not even just a hospital, but any kind of a building in the healthcare space, like you're, you're balancing for a lot of different user groups and what's, what are the challenges there?

Michele Cohen: 02:03 - 04:32

It's always a challenge because you want to try and create, um, it's great spaces that are going to be supporting everybody. And it seems like they may be at odds with each other, like one group versus another. So you're trying to design and trying to make choices one over the other, but it's really not, um, selecting just the making it a safe environment for the patients. It really needs to be a system that works for everybody in the building. So it's not about choices one over the other. It's about how do we select a building that's going to be supportive of all inhabitants. And a lot of the same design features are supportive of all the people who inhabit the building. Let's say natural daylight. So natural daylight is a positive thing for anybody. It gives you a sense of hope. It affects your mood. It gives you a sense of time and day and diurnal processes of the body. So things like natural daylight, it's not competing for, uh, not better for one person or another. It just, how do we provide access to all of the inhabitants? or something like intuitive wayfinding, it's stressful for anybody to get lost. So even staff who are doing their day-to-day rounds of the building, it's frustrating for them to get lost. It's frustrating for them to be intuitive wayfinding. But if you're a new visitor to the building, it becomes even more stressful, especially as a patient when you're usually you know, arriving with some sort of sense of anxiety or foreboding because you're there for, let's say, an emergency or a treatment or you're uncomfortable with your own feelings. And then to be put into places confusing, you feel like youre entering a labyrinth. It's not good for any of the inhabitants. So it's how we address design that it's going to be good for everybody. So we don't want to make choices. It's not like we're going to make a good choice for the patient and then it's not going to be good for the staff. Because if you're building a building that is safe for the patients, it means that it's also a place where it's going to be safe for the staff to provide care. And if the staff are feeling safe, they have a place of respite, they have a place of safety observation of the patients, it's shown that they can provide better care and that patients have perceived that they receive better care in an environment like that. So it really has to support all the building occupants.

Ryan Schwartz: 04:32 - 05:03

Yeah, I love that. And that makes total sense. A better building is just going to be better for everyone that's in there. So that, that makes obvious sense. Um, as we're, I guess we're sort of shifting away from this institutional model, right? Is that, does that, is that fair? We're kind of shifting towards something that's less of the, like that asylum model that you would say maybe, um, from the past and, and introducing those things like daylight and that's not the way things used to be and why is that important? What's the reason for the shift there?

Michele Cohen: 05:05 - 07:19

I think that the last century, our approach to how we designed our buildings to support behavior health was very similar to how we view mental health as a society. So it became about building buildings that were, we wanted to kind of get rid of the problem or not have to deal with the problem on a day-to-day. So our buildings that were provided health were up the perimeter of the communities, like literally on the outskirts of the cities. They were a little bit foreboding. They were, if they were removed from the communities, the buildings were not very welcoming. Like when you approach a building that has bars on the window, it certainly sends a message to the community and to those people who are trying to receive treatment there, or if you even want to approach a building like that to receive treatment. So it's very encouraging to see that the way society is viewing mental health and how important it is for everybody is impacting how we're designing our buildings. So the push to have behavioral health buildings to have the exact same healing qualities as any other health care facility. And I think that's why there's a big push towards things like biophilia, use to nature and daylight within our mental health and behavioral health facilities. sometimes we design our behavior health facilities for the most acute and forensic patients, but there are so many different types of patients when you're trying to treat maybe a young adult that has suicidal ideation versus a middle-aged adult that may be dealing with early-onset dementia, or a senior who has full-on Alzheimer's or a brain-acquired injury, like there's a lot of different patients that we're trying to design for. It's not always the most forensic, the most forensic patient. So I think that our buildings are starting to reflect that. And it's so important that our buildings be welcoming and be open and create spaces that when you enter, you're going to be affecting change and that when they leave, that any inhabitants of the building, when they leave, will be feeling better than when they arrived.

Ryan Schwartz: 07:20 - 07:50

And you've touched on this a little bit, this, this idea of, you know, you picture like an old horror movie and there's the insane asylum on the hill and no one goes there. How do we start to weave these, these buildings into the fabric of the city? And you did touch on that cause it's, you know, a building that could be welcoming and it's, it's inviting for both the people in the building that are getting treatment and also just, you know, neighbors that are in the neighborhood. So yeah, what, what's the importance there or how do we start to, to weave the, those buildings into sort of the broader urban fabric of a city?

Michele Cohen: 07:51 - 09:17

So a lot of cities like Toronto have grown up to where their old asylums used to be, so they are now de facto within the city, and the walls that were surrounding them have to be integrated into the urban fabric. So it's very encouraging to see projects, let's say like CAMH in Toronto, they made the choice to take down the walls that surrounded the community. command surrounded the inside the asylum and opening up like physically open up landscape and open up the campus so that they create pathways so that the community can walk through the buildings walk past the building. So physically opening up these buildings taking off the bars and changing the design of the buildings to be more integrated with the cities and to have the to have buildings that are open, that are more transparent, that allow in daylight. The older asylums, it was all about control and durability, which are both very important, but just as important are elements of brightness and of joyfulness and color. and different sizes of spaces so that people can feel comfortable in a large space from a small space. So I think that our buildings are really trying to reflect how we're trying to treat people with NBAR.

Ryan Schwartz: 09:18 - 09:44

And how do we make buildings that actually change the way that people feel? Like you mentioned, they're bright, they're colorful. What other kinds of elements can architects introduce into these buildings that actually change the way that people feel? Because we're designing buildings, but we're also designing the experience of being in that building, right? So what does that look like? What can we change or update to affect people's moods and behavior?

Michele Cohen: 09:45 - 11:10

So I think we're moving away from some of the intimidating design elements like long, double-loaded corridors, lots of locked doors, or just only large spaces, and having spaces that you can't control the lighting, like a lot of harsh lighting or hard surfaces that are very loud and echoey. So trying to give back control to the inhabitants of the building, so creating spaces that, as I mentioned, are different scales. having a large community space is great, but if someone needs to deescalate and needs a little bit of quiet time, providing those quiet spaces just like we do in an education space. We have like large group working rooms, but we also have smaller quieter heads down space or like in a work area having a large boardroom and having a smaller head down space. So creating a variety of spaces is definitely important, and changing the sensory environment. It may seem simple, but giving someone control of their lighting, being able to dim a light in a certain area, it gives people back a sense of control. having the ability to have some more acoustic qualities that allow a more quieter, not as echoey feeling to the building. So when we look at the furnishings and finishes of the building, really paying attention to what those are so that when we look at the acoustics, that they can be a quieter, not as loud, softened space.

Ryan Schwartz: 11:11 - 11:35

I think that's really interesting, the idea of the acoustics and warm textures and things like that, because that can really, like you said, make a space feel more safe, more welcoming. And even if the inhabitants don't maybe consciously realize it, I think it maybe puts people at ease. Does that make sense? You might not realize that it's a space that feels better, but you feel better regardless. Does that make sense?

Michele Cohen: 11:36 - 11:53

I think it's very subconscious. I don't think, you know, we're architects, we talk about spaces all the time. I think then it's kind of innate when you walk into a space and you feel comfortable and you've had a good experience. People not, may not remember what the qualities of the building were, but they certainly remember how they feel when they left it.

Ryan Schwartz: 11:53 - 11:53

Right.

Michele Cohen: 11:54 - 12:29

So when you look at the church design and you look at buildings like, you know, St. Peter's or Hagia Sophia, and they were light-filled and bright and you felt a sense of awe. I mean people may not be able to express like because the dome size or the dimensions or the aisles but it's a very different feeling than when you talk about a building like Rochambeau where it's still light-filled but there's like an element of control and depth and it's a very different feeling. Both are very spiritual but in very different ways. So I think that's the same way we need to approach our buildings and how we can make the

Ryan Schwartz: 12:30 - 13:00

Yeah, that makes sense. You, you've, you realize afterwards like, Oh, I just enjoyed my time in this space, but you're not necessarily thinking about it at the time. So, and you mentioned, um, educational buildings and, and, and maybe a shift towards that from sort of this institutional as hospital feel with, you know, hard surfaces and it's equity and these long corridors and what kinds of elements do you take away from, from an educational building that you can apply to, to more of a healthcare style typology?

Michele Cohen: 13:01 - 14:43

I think the first thing you have to do is listen to the users of the building and really understand how they deliver their care and occupy the building. So we used to look more at the forensic architecture style. So hard materials with, you know, ligature points being the most important thing. I'm very encouraged to look at how we design edgy buildings. I feel like they're very similar. They're also built for durability, cleanability, but as well for education, we'd look more at like colors and playfulness and furniture that is flexible, that can allow the teacher to have flexible spaces, larger groups, smaller groups. I wanna see that our healthcare and behavioral health employees have those same capabilities, be able to have flexible spaces that can be used in different ways. So really looking at the furniture, you can have a weighted, cleanable, safe chair that is a molded plastic that just doesn't have the ability for someone to pick up and throw. But that's very similar to a comfortable rocking chair, one molded type of chair that can be used in an education facility. So I feel that if we can start looking and challenging the industry to build better products, build safer finishes that are more durable, I think it's great for a lot of different typologies. And one of them are any public buildings like museums, like education and behavior health. So I would really like to see those changes. And I'm so encouraged to see what is being done in education spaces and seeing how we can bring them into the health space.

Ryan Schwartz: 14:44 - 15:04

And yeah, you mentioned industry partners and working with, you know, maybe furniture manufacturers and materials manufacturers. Are they sort of helping drive this change or what this, the shift towards, um, you know, the more educational feel of a building is that based on research or what's kind of driving this?

Michele Cohen: 15:05 - 16:16

There has been a lot of research. There has been a lot of evidence-based design research, so I'm accredited. A lot of architects are becoming evidence-based design accredited these days, and it allows us to create actual research that we can refer to. There's a lot that's already been done that shows how these spaces when people can control them and, um, have a more, like more opportunity to interact those casual conversations, um, in an education environment, it may be a place for discovery and collaboration. And then in a behavior health and behavior health environment, it's shown that like, that's where a lot of the healing can occur. So having that control to be in a smaller space, when you need that heads down, um, on a centering space, but as well having the larger therapeutic areas, it's shown that a lot of therapy can happen in there as well. And having those two types of spaces is what creates that therapeutic environment, and it has been shown to create calmer areas and be more supportive of a therapeutic process.

Ryan Schwartz: 16:17 - 16:26

And you mentioned architects getting accredited. I think that's that's an interesting step. So what what does that look like? What does that what do you mean when you say that you're you're getting accredited to do research?

Michele Cohen: 16:28 - 17:36

Yeah, so the evidence-based design accreditation, it shows you how, well, first of all, it's encouraging architects to be part of creating actual research that is like peer-reviewed research that we can then use as evidence to affect change in architecture, that there's actual results that have been shown. So in the CSA, there's now a section that is towards postdoc evaluation. So if we start off our projects and come up with certain assumptions based on research that's already existing and why don't we take that opportunity and make our buildings like create change so we can come up with our of what we think the building may be able to affect change and then build it. And then the important part is actually doing the post office evaluation, doing the, whatever the interviews, whether it's a form, whatever it is, but the accreditation shows us, explains to us and trains us how to actually create the evidence in order to support the tech, not like support the change.

Ryan Schwartz: 17:38 - 18:00

I think that's such a great idea, because that's come up a few times on this podcast, is we're batting around all these great ideas, but then how do you actually test it at the end to show that it works? And I think that hasn't come up before. So the idea of accreditation, I think that's a fantastic way to actually test these ideas and see if they are truly working the way that we hope they are.

Michele Cohen: 18:01 - 20:08

Like we, I had mentioned, um, so there's like the empath model, which is the, um, it's a model to, uh, that they're testing out in, uh, emergency department. Where they've created spaces that are adjacent to the emergency department that are built specifically for behavior health patients. So if you arrive at the emergency department, which is not a great place for anyone, uh, in the sense that like it's stressful, it's full of anxiety. noises that are unusual and that are that are new, smells that you're not comfortable with, or you're definitely experiencing noises. So it's a lot of like stress, a lot of anxiety. It's not a conducive to behavioral health treatment or analysis. So they've created these spaces that they can immediately take the patients. So the idea is that they're in a more open space, a communal space that is a quieter area, and that they can really try and assess and treat the patients within 24 hours and get them into the right spot. So I think that making changes like that, and so the assumption is that it will get people better use of the emergency department so that we're not wasting our resources, and that these areas that we're building are going to get people through and get treatment faster, and the faster theyre treated, the more we're using dollars wisely. So, creating those spaces are great, but if we don't do the research and come up with a thesis of what we're trying to do at the beginning, it's very hard to say, okay, let's do this again, because then the owners and our government are going to say, like, is it really useful or not? So, it's so important for us to come up with a thesis before we build these spaces, so we can really show the evidence of, yes, it's working, yes, it's reducing wait time, and yes, it's getting patients throughput within 24 hours or whatever the goal is. So it's so important to make that assumption ahead of time and really try and create that evidence-based design so that we can know that it does make a change, it doesn't change and implement it in the future and kind of grow and create better spaces continually evolving.

Ryan Schwartz: 20:08 - 20:30

I love that because it can be difficult to get quantitative data I think sometimes out of these buildings because it really is, it's a qualitative experience a lot of the time. It's how do you feel, you know, how do you put that into numbers. So I like that idea of trying to write that down empirically ahead of time and then you have something to actually test it against.

Michele Cohen: 20:31 - 21:42

It is fascinating. I mean, it's fantastic when you go back to projects that's been built, like the mental health emergency service unit at St. Joe's Hospital in Toronto. And after we built it, we went back and talked to patients and families of patients who have been treated in the space. And it's the space that's on the perimeter of the building. We added lots of daylight, open spaces, a communal area to sit, areas that, simple things like patients can go and fill up their own water glass when they're thirsty, when they're still being assessed department and it's step for department, but we didn't do any actual research of the before and after. So it seems like we could say, well, of course natural daylight, but when you're talking to hospital administrators and making real questions about where are you spending your money, they really want to know what is that evidence. because every hospital administrator is hacking to be like, hey, we got people throughputs, the emergency department, we went from, you know, 24 hours down to 12 hours. Fantastic. But if we can prove it, then we're going to have the support from the administration to make those changes. And then it's good for the patients, it's better for staff, and it's better for the administration and ultimately our tax dollars and our community.

Ryan Schwartz: 21:42 - 22:31

Yep. No, it makes sense. And we're talking, you know, tens of millions of dollars in these cases, right? And it's, it's, it's big dollars that we're, that we're talking about. So it makes sense that they want to spend them wisely, but then if it is being shown to improve, you know, treatment times and overall outcomes and things, then that's a, it's good for everyone. So. Yeah, I like that. And you mentioned the idea of even just like filling up your own water glass. And before you'd also mentioned like giving back control. So I want to sort of touch on that and that idea of providing some autonomy back to people and giving them control back in an environment where they feel a little bit out of control, maybe in an emergency room or something. So yeah, can you expand on that a little bit and just that that sense of control that you can give back to people in these spaces?

Michele Cohen: 22:32 - 24:42

It's certainly different if you're talking about like a forensic behavioral health facility, if you're talking about a lower acute facility, whether you're talking about rooms that are double occupancy, single occupancy. So I'm not saying it's the solution for all typologies, but I do feel that trying to get people back a bit of control in their life does provide a sense of dignity, a sense of control. So small things, like I mentioned, being able to control the lighting in their rooms, being able to have places, you know, if they could have their own washrooms that they can feel like they have privacy. It does have to be balanced with staff being able to view the patients, make sure that they're safe. But if you don't have a space where they can gather as a group, then of course they won't be able to gather as a group. So we do need to build in these spaces that you can have larger groups, smaller groups, just the fact of having communal meal. We know how important it is for people to eat together or what a sense of sense of belonging and community that can provide. But unless we have those spaces, staff can't use them. So there is a balance, like, you know, it's not just all more bedrooms equals better care because you want to have those opportunities with maybe recliners instead of stretchers and single rooms, um, to give patients a sense, like they can go and sit in a group of four people. They can sit alone in a smaller, especially, uh, like providing human scaled spaces, like maybe a little all clover, someone to sit like a window seat, people always in residential. It's always, you need to have that little window seat by the window. It gives you a sense of like a cocoon, a little safety. So why not provide those sense of spaces for patients as well? So I think that's, it's, it's so important to give them a little bit of, of control and dignity. So like lighting, access to daylight and views. That's why, as I mentioned, biophilia is so, so important these days, like having the ability to be in a courtyard, having access to outdoor natural light and views of nature.

Ryan Schwartz: 24:43 - 25:17

I love that idea of control and not just about, you know, the temperature and the, you know, getting your, your glass of water, but also control over how social you want to be. If you're, if you're not feeling well and you want to be in a quieter space, but maybe near some people, you can do that. But then you have the control and the ability to maybe join a small group of people and chat if you're in a hospital for days or weeks or months or whatever it may be. And that just giving that little bit of self-determination back and saying, all right, like you can kind of have an impact on what your day looks like.

Michele Cohen: 25:18 - 25:36

If you can just step away from that group therapy and be like, you know what, I need a moment to deescalate. I need a moment to deal with my feelings to provide, if that space isn't there, it's very hard to step away in a room of 20. Like if you don't have that space to be really providing those, those variety of spaces.

Ryan Schwartz: 25:38 - 25:58

And I think that ties back also to what you mentioned about designing for not just the patients, but staff. And I think that that completely ties in with them, right? Cause you, you know, you're working in this place all day and you, maybe you want that a social lunchroom or something, or maybe you need a quiet space for yourself. It's been a stressful day and you need to be able to step away for a minute. So, um, I think that ties in perfectly.

Michele Cohen: 25:59 - 27:55

Exactly, just as important. So having staff feeling safe when they're on the floor, there's a big discussion of whether you have open nurse stations or enclosed nurse stations. If nurses are like behind glass, often it's very intimidating to the patients and it may make the staff feel safe or disconnected. But making sure that when they're off the floor, off the unit, that there are, exactly as you said, like there's staff lounges where you can have relaxing chairs, you can sit together as a group, you can have maybe a lounger that As well, they can talk, and talk freely, laugh, and joke. So, acoustic separation becomes really important. So, STC ratings is so important on different spaces. Like, if you're talking to a patient and you can hear other patients, then the staff may, the patients gives them anxiety. So, staff are aware of that. So, it just increases everybody's anxiety level. So having staff being able to talk freely in their staff room, knowing that they're not going to be overheard from the patients, and giving staff ability to go outside and have the same access to daylight and nature and get a little fresh air is a great benefit. great sense of work satisfaction. And it goes the same way for the families. Like families are so important for the recovery families and loved ones. And we want them to be included in the recovery. It's just as intimidating for them to be in the building, and they as well need an ability maybe to step out and to have a little bit of respite and heads down space while they're in with their loved ones. So it's also trying to, again, this balance, like creating for staff, for patients, for loved ones. but trying to create alternate spaces for the staff and you said the family that are visiting so that they can have that same ability to deescalate and participate in the community feel belonged in a sense of belonging in the building.

Ryan Schwartz: 27:55 - 28:22

Yep. No, I think that's important. If you're a family member visiting and a hospital or a, you know, a facility of some kind and you're, you know, you could be a long day, you could be there for several days and you might, you might really want some social connection while you're there. Maybe you're there by yourself or maybe it's a really difficult time. You're there with your family and you want some privacy and to be able to not be overheard by other folks. And, um, you know, to have that, that balance, I think is you're right. That's really, really important.

Michele Cohen: 28:23 - 29:17

Yeah, at the Newfoundland Adult Mental Health and Addictions Facility that B-Plus Aids built in Newfoundland, the building does have an actual 60 rooms where families can come and stay for a couple of days to help their loved ones who are in treatment. So looking at the space provided for those family members, and integrating spaces of community, not just with the community within the building, but the actual community, the neighborhood, because this is a building that's accessible from people that are coming for treatment as outpatients. So trying to balance those spaces as well, having a place to interact with the community. having, you know, a cup of coffee and sitting with a group or sitting down with a laptop and in a recessed corridor alcove. So just as important for the family who are actually like living in those spaces for, you know, two to three days while they're there.

Ryan Schwartz: 29:18 - 29:47

That's a great idea because everyone has, you know, slept in a hospital or know someone that's slept, stayed a night in a hospital in an uncomfortable chair and it's not great for your state of mind in a stressful situation to be sleeping upright in a chair. I think that's a really interesting addition to a hospital facility is, all right, we have rooms for people to actually stay and it becomes not a home necessarily, but at least a comfortable place for family to stay during a stressful time.

Michele Cohen: 29:48 - 30:39

Yeah, at least a home for maybe a couple of days, because our country is enormous, Canada. So a lot of times to receive the specialized care that you need, patients do have to travel quite a distance. So we want families to be involved in behavioral health care, just like any other care. So the ability for them to come and have somewhere to stay and to be near their loved ones is so important. and seeing your loved one at a sense of when they're in stress, like a broken leg, having a heart attack, having a mental health crisis. It's so just distraught, like it's so, you know, as a loved one, you're so distraught. So to create a space for them where they can see that their loved one is being cared for in a space that is as well-designed, that is full of natural daylight, it makes them, hopefully gives them a sense of peace of mind as well.

Ryan Schwartz: 30:40 - 31:00

And you mentioned daylight again, so let's dig into the details a little bit of these spaces, and I'm just picturing like the finishes and the fixtures and the furniture, you know, daylighting, control over lighting temperature, that kind of thing, materials, acoustics, what else? Or do you want to dig into any of those in particular, or what else is important in the design of these spaces?

Michele Cohen: 31:02 - 33:09

I mean, I don't want to get too technical, but, um, when, when you look at the, the, I mean, obviously like ligature issues, like trying to create spaces that are safe, that don't have, uh, finishes that can be weaponized, like. Picking off a finish and like, you know, creating, uh, a ligature or a weapon is very important. And then infection prevention control really has an impact on all the materials that we, that we select. because they have to be durable. So we want to have, you know, glass that's laminated and tempered so that if it does break, it doesn't create a safety risk. But at the same time, we don't want to have like plexiglass that if you're cleaning this beach, which a lot of these facilities do, they just yellow over time. So how do we create these spaces and how do we work with the industry partners to really look at the different materials we can use? But it does have a big impact. I am really encouraged to see the different materials that are out there today that we can use and sometimes simply a coat of, you know, colorful paint. or even having murals that we often use the same, very similar to like a bus wrap, like when you see like graphics on the bus and car. So they're easy to change, they're not expensive, and we can create large graphics that make a huge difference in space. So we may not be able to have a framed piece of artwork or a statue, but we can certainly create graphics on the wall that can give some visual interest. We've actually used, there's a, we have one of them again at the St. Joe's Hospital, and it's like this very large interaction iPad, but it's abuse resistant and safe. So it's installed in the patient space. So they can use it to gain information on their, diagnosis, they can use it for entertainment, they can use it for games, they can use it for all different things. So having those interactive facilities, like the digital facilities within the room is also one of the newer things.

Ryan Schwartz: 33:10 - 33:34

And that also gives a little bit of control back. Again, you can, you know, choose how you're spending your time, what you're doing, you can check the weather, you can play a game. Yeah, I like that idea. And you mentioned a couple of times that working with industry partners, so like manufacturers, is there any examples that come to mind from past projects or anything like that? Materials or fixtures?

Michele Cohen: 33:35 - 33:37

The actual supplier name or just...

Ryan Schwartz: 33:37 - 33:50

No, I like what, like, uh, I think you mentioned, um, before we hopped on, you'd mentioned like a particular sink or something, or just, you know, what, what are they, what are they doing? Like, what are they bringing to the table in terms of these, these designs and materials?

Michele Cohen: 33:51 - 36:13

We've had such great luck working with our industry partners, like when after SARS, we were looking for a good hand wash thing that had that met all the right criteria with the offset drain, making snack faucet and how it worked. And we presented that to the industry and they came back to us. Similarly, we still need those hand wash sinks in behavior health facilities, but you can't have a person sink that's going to break if someone smashes into it. So we've been challenging the industry. Like we don't want to have a, like a thing kind of sink that you would see in a jail, like a stainless steel. Things like powder coating and the shape and the design of them, especially with accessibility, these spaces have to meet accessibility. It's not just the physical accessibility, but visual, auditorial, all of accessibility. So putting that challenge to the industry and coming out with these products has been great. It's always disappointing, and I don't think the staff or patients or family, when you go in and see the toilet without a sink, I know it sounds like a simple thing, but just having a toilet with a sink, even if it's a powder-coated contrasting color and it's not actually a sink that can raise up and down, even though through research, I don't want to mislead, but I don't think it's ever been shown that it's an actual ligature point, but it's still seen in the industry like it could technically be a ligature point. even though I don't know if there's ever been a brickboard oven or burst event happening with a toilet seat, but just having those simple changes is so important. So having, like looking at the furniture, like instead of having like a weighted furniture that just, you know, looks like a hard and institutional chair, having these like molded recliners that are colorful and nice organic shapes It just makes the room feel so much different. And using different colors and the flooring opportunities that we have, that we have monolithic flooring, but you can have welded seams. So working with the industry to say, well, how can we create these spaces? What can we do? How can we meet infection prevention control? But at the same time, have materials that have contrasting colors or a fun pattern and things like that. So it's been so encouraging to see how the industry has met the challenges when we work together in collaboration.

Ryan Schwartz: 36:14 - 36:57

Yeah, it's nice to see things moving forward, especially together with other partners. I'm curious about the idea of, you mentioned wayfinding and, you know, these bright colors and things like that, and bringing these things to the forefront, like mental health as an issue, I think, like you mentioned, is becoming so much more talked about than it was, say, 20 years ago. And what are your thoughts on bringing these kind of design solutions forward in a visible way just so that it's not, it's not kind of subversive and we're not brushing it under the rug, but we're saying, we're putting at the forefront and saying, all right, here's an issue and we're dealing with it in this way and just making it really visible. And does that kind of help to destigmatize things a little bit, you think?

Michele Cohen: 36:58 - 38:19

I think that architects really make an impact. So if you have, like my biggest anxiety is going into an underground, large underground garage, parking garage, makes me uncomfortable, gives me anxiety. I don't know where I'm going. Everything looks the same. I find it very confusing. There's no daylight. So I really feel that in a hospital, that's where the architects can make the difference. Because you can put signage on, which is great, but really having integrated into the building, Really using daylight as a place maker is so important. So being able to create those spaces that have intuitive wayfinding is definitely the first thing I would love to do. But that being said, signage and wayfinding can make a huge impact because we live in a wonderful multicultural country that we're very lucky to live in, but we have to acknowledge that there are different languages, we can use different pictorials, we can use color, we can use images. So being able to integrate those wayfinding strategies into the building really helps with the staff, the patients, and reducing anxiety and anxiety. functionality of a building.

Ryan Schwartz: 38:19 - 38:37

And as architects, what other items can we, can we, you know, what are some other easy wins in terms of that kind of wayfinding, signage, colors, like other daylight? Is there anything, anything else that comes to mind that are just nice, easy wins that could be used in hospitals or even just in other buildings?

Michele Cohen: 38:38 - 39:44

I think just having a thoughtfulness of how we place spaces like the different sizes of spaces. A long hallway is very intimidating someone with mobility issues or just it's just intimidating overwhelming that day. So being able to create a small bench area a little small place of respite is it just makes a big difference. These are like really simple things but it really does make a difference to have you step out of the traffic and just have that spot, or even just if you want to people watch or something like that. So I think that those small little things, having those little alcoves, and when we look at buildings and creating, I always say, loose fit, long life. So looking at how we place rooms next to each other so that they can flex over time, so that you're not always facing a building that's having renovations. Looking at things like screens and how we can use different spaces and create different sizes and within the same footprint, creates a more flexible, useful space.

Ryan Schwartz: 39:45 - 39:56

I love it. As we start to wrap up here, we're getting a little short on time. Is there anything that you'd like to touch on or any closing thoughts, anything we didn't discuss that you'd like to mention?

Michele Cohen: 39:57 - 42:05

I think that when we talk about behavioral health design, what's good in a behavioral health building, I think it's good for any building in our society. So whether you're talking about public gardens, like everyone feels happier when they're like in daylight, when they can see where they're going, where there aren't corners that they think are hidden and they give them anxiety. So I just feel that there's so many lessons that we can apply to all types of buildings. all sorts of institutional buildings, city planning. I'm just so encouraged to see that the changes that we're implementing in those buildings, I really see how they can change all of the cities. So a sense of community, a sense of dignity. You see a lot of the condominium buildings that are providing the shared spaces, the communal spaces, because it's so important in cities where we're living in small spaces that are very isolating to go from work to a small condo space, especially in our long winters. So having those community spaces, just like in Gabriel, I think it's fantastic for any of the buildings. So I really like to just as I look at education typology to influence my behavior health design, I'd like to see other typologies looking and seeing how the good work that we're doing can be and really change our city. behavior health, it doesn't stop the minute you walk out of the building and it doesn't start the minute you come into the building. It needs to be something that's included in the way we look at our cities, the way we create places for opportunity for interaction, outdoor workout areas, how our parks are created, that they're accessible for all people of all abilities, you know, contrasting colors for people who may not have the greatest eyesight so that they can walk through public areas and be confident where they're going. So I'm just so encouraged to see the changes that are being made, and I'm really looking forward to seeing how those changes could now go back into planning and change the buildings that everybody

Ryan Schwartz: 42:06 - 42:35

I couldn't agree more. I think good design kind of transcends the user and it's good for everyone. Even if you're passing through a building for a minute or you work there every day for 20 years, it kind of impacts everyone that's affected in the immediate area. So couldn't agree more. That's a great answer. If people want to get in touch, I'm assuming they can probably find you at bharchitects.com. Is that a good place to reach out?

Michele Cohen: 42:35 - 42:35

Any time.

Ryan Schwartz: 42:36 - 43:24

Perfect. Well, thanks for joining today, Michelle. Thanks for sharing your time and expertise. That will wrap things up for today's episode. So thanks to you out there for listening. If you've been enjoying the podcast series, please leave us a quick review and share it with your friends and your colleagues. We'd really appreciate that. All of the episodes of Architecturally Speaking can be found wherever you get your podcasts and you can watch the full video version on the OAA's YouTube channel with some images of some of the projects and examples we were talking about. So be sure to check that out as well. And there is plenty more great information on the Ontario Association of Architects website. Just visit oaa.on.ca or search for the Ontario Association of Architects. So until next time, I'm Ryan Schwartz and this has been Architecturally Speaking. Bye for now.