Posted at 2:10 PM on May 17, 2012
by Bob Collins
(10 Comments)
Filed under: Health
For many people, this probably isn't a big deal. For anyone who's ever visited a family member in a mental health facility, it's a pretty big deal. Someday, it's going to be a window.
In attempting to end the mental health stigma, hospitals and mental health providers say all the right things, and then reinforce the notion that a mental health problem is different from a medical problem through something as simple as the unit's front door -- usually a windowless wall, behind a locked door, with an intercom to request permission to enter. When's the last time you had to go through that to visit your friend who just had her gallbladder out?
This window is the entrance to a typical floor on Regions Hospital's new mental health building, going up along I-94 in downtown Saint Paul. You'll be greeted at the nurses station, not by a voice on an intercom asking you what you're doing there.
This is a building being built with eliminating a stigma in mind. Like this, for example:
It'll be a porch allowing patients to get some fresh air in a secure setting. That's not possible now at the hospital's current mental health unit, which isn't unlike several others in the Twin Cities. Mental health patients, unlike other patients, don't get fresh air.
At Regions, they also don't get much privacy. There's two to a small room now. In the new building, each patient gets his/her own room (it'll be a coed facility, unlike the current unit). Each room has a private bathroom.
Each floor -- there'll be 20 patients on a floor -- will have its own kitchen and dining room. The kitchen will help the staff evaluate a person's ability to live independently.
There are few areas in the current unit for private meetings and group functions. That's changing, too.
Health professionals have learned a lot about treating people with mental illness since the last mental health facility was built in the Twin Cities. Plenty of light, the feeling of being in control, open spaces are part of that. They're patients, not prisoners.
One of the architects for the project brought his own perspective to the design. He has a family member with mental illness and experienced firsthand everything that's wrong with how facilities are designed.
The hospital, city officials, and mental health professionals have been designing and are implementing an anti-stigma campaign. The new facility is designed to help families and the community look at mental illness as what it is -- an illness.
The building officials hope will help do that opens in December.
"One of the architects for the project brought his own perspective to the design. He has a family member with mental illness and experienced firsthand everything that's wrong with how facilities are designed."
What a revolutionary idea: hiring a designer with practical experience in the function of the building to be designed. It's well past time, and I'm glad Regions made this commitment.
Having had my own visits with loved ones in mental health facilities, I always thought my own mental health took a hit from the surroundings. And I was just visiting those horrible, locked-down, claustrophobic wards. I can't properly imagine what my friends experienced while they were residing in them.
The new building has wider-than-normal hallways, higher than usual ceilings, lots of windows and light. A bit of a metaphor.
"They're patients, not prisoners." Except of course, when they are court ordered. Then they are something in between.
But I'm with you. This is fantastic. When Hennepin County did their smoking ban, they exempted patients in HCMC's mental health ward because they aren't allowed outside, let alone across the street, to smoke. Fresh air can do wonders for mental health, as can sunshine and respect. And I think this design shows respect to patients and their families. I bet the staff who will be working there is pretty happy with it too.
can a building end the stigma of mental illness?
Can Minnesota public radio end is as practice? It is a thought an idea, and if you cannot end your practice of directing it, I assure you no building can.
It is in essence an act of discrimination, coming from you, or elsewhere. We addressed it as an act of discmrination when it was directed at people who had survived sexual assault, and we fought a world war to end it in Europe.
How do we fight you?
"What goes around comes around."
I applaud Regions Hospital for this new MH building--which looks like an excellent, humane facility. But in 1968, a very similar facility opened in Minneapolis at Metropolitan Medical Center, linking the old St. Barnabas and Swedish Hospitals.
The MMC mental health unit had everything described for Regions, including carpets, decorator designed wall coverings, and even a swimming pool--shared with a rehab facility. This was a time when ample funds were available for MH treatment programs.
By the late 1970s and since--funds became increasingly limited, and MH patients have had additional stigma added by discrimination in insurance coverage, and generally poor reimbursement for inpatient and outpatient treatment. The result has been the struggling treatment programs we now see in our community.
Mr. Maio, I know you patrol the Internet and post this same message at many sites, so you probably won't be back to read this, but from what I understand from your postings elsewhere, your focus on language. For example, referring to "the mentally ill" in the same way Jews in Europe were referred to as "the Jews."
You will note the phrase "the mentally ill" was not used. So it's unclear what exactly your point is here.
I'd like to hear more about your organization, Florida Self Directed Care, and more about your work analyzing ethics and language ( I found this article of yours to be interesting).
A positive discussion and conversation would be more informative and useful and meaningful. It's what we do here.
Dr. Deane Manolis is right on...the old MMC (Metropolitan Medical Center) Building (now part of HCMC) had many of the same features of the new Regions Building....ahead of its time....
it also had a group of forward thinking psychiatrists....Thank you!
The Building is awesome at Regions. Let's hope that the providers are a similar group of progressive psychiatric providers with a strong sense of professional identity...Let them embrace their field and their core population--persons with neurobiological brain illnesses. Let them partner with NAMI and with families....
Let them humbly treat our most vulnerable citizens with grace, care, and the best that medicine has to offer....
A building is just a building, no more and no less. Only in our mental health system is the nature of the structure considered evidence that stigma is being addressed or that effective treatment is being afforded.
Would we judge any medical unit principally on the nature of the structure? Wouldn't we ask what outcomes the services in the structure foster?
A building can actually say a lot about the dignity with which patients are treated as well as how staff are supported in a safe and efficient environment. A warm environment has positive effects on both the physical and mental well being of the building's occupants. Put a unit in a basement with no windows, narrow hallways, harsh fluorescent lighting and an institutional atmosphere and people -- both patients and staff -- will find it uninviting and not therapeutic.
In fact, the elements being incorporated in Regions' new mental health hospital are strategies hospitals have been employed vastly in other health units. See Maple Grove Hospital, Woodwinds Health Campus, Children's Hospitals and Clinics remodeled NICU units, Park Nicollet's Frauenshuh Cancer Center, and St. Joseph's de Paul Tower and remodeled emergency department. They all incorporated design strategies to reduce stress, create comfort, elevate patient choice, and support the staff -- all the elements necessary to improve outcomes. You are exactly right that we must measure the quality of the services by outcomes -- design of the right environment is a significant factor that will improve those outcomes as much as hiring the right staff, providing the right training, and aquiring the right equipment.
Can an mentally healthy person ever recover from the stigma of being labeled MENTALLY ILL? As a past president of an LC-MS church in Edina, I am now facing a civil commitment process (27-MH-PR-12-316) for exposing the people behind the cover-up of church embezzlement and the 2010 vandalism of 7 churches in Edina.
It is ironic that David Frauenshuh, a commercial developer that specializes in building clinics and hospitals, is the person using his money, influence and adult children to have me put away. David was on the Youth Board at the church when the Director of Christian Education for the youth program was found to be inappropriately handling church money. I resigned rather than participate in a cover-up.
Killing me would raise too many question. So Plan B is to discredit someone by having corrupt examiners produce fraudulent reports that opine a person is mentally ill AND a threat to others. If the individuals denies they are mentally ill - well let's just say they are the hardest of all to help. Those individuals need longterm commitment at St. Peters or elsewhere. They don't get the benefit of window view.
Mr. Collins, investigate the complaint by Matthew Frauenshuh, and the Restraining Order using an Affidavit by David Frauenshuh. Then seek me out (I will likely be incarcerated) for a positive discussion and conversation that will be more informative and useful and meaningful. It's what we NEED TO do here.
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