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New University of Washington behavioral health facility will expand workforce, access to inpatient psychiatric beds in Seattle

Seattle Times - 10/16/2021

Oct. 16—Patients of the Behavioral Health Teaching Facility on the University of Washington Medical Center-Northwest campus will get fresh air on sun-drenched terraces and decks (at least in the sunny months), sleep in secured private bedrooms, and spend afternoons in a therapeutic sensory space.

They'll meet with resident physicians and other medical trainees and staff in spacious treatment areas designed with teaching in mind — many of the state's next generation of mental health providers will train here.

The new state-backed mental health teaching facility is among several others nationwide ushering in a new era of inpatient mental health treatment — one that uses intentional design to support the therapeutic needs of those in long-term care. Many psychiatric hospitals were retrofitted from buildings never intended to serve psychiatric patients; the tall, brick-walled Western State Hospital, for instance, is on the site of a historic military fort. The hospital lost its federal certification in 2018 and has been plagued by health and safety violations.

The new facility is now under construction near Northgate Mall. Friday marked the building's ceremonial groundbreaking. Funded through $234 million in state appropriations, it will be operated by UW Medical Center-Northwest and is expected to open to residents in December 2023.

"When you walk in, it doesn't feel like a behavioral health facility," said Charity Holmes, assistant administrator of behavioral health services at UW Medical Center. "It is going to be an open and welcoming environment."

Unlike many other modern builds, the new facility will serve the dual purpose of expanding bed capacity and the mental health workforce, which is facing serious shortages across the state. Washington's inpatient psychiatric bed capacity has ranked almost last nationwide, with many forced to experience long wait times in emergency departments or never receive a bed at all. And only 12% of Washington residents live in an area where they can expect their mental health needs to be met.

The approximately 184,000-square-foot building will be situated on a small footprint adjacent to the main hospital wing.

It's expected to tower six stories, with patients residing on the upper floors. The facility will accommodate 150 beds, many of which will be dedicated to people experiencing mental health conditions who are civilly committed, older adults and those seeking voluntary treatment. The rest will be designated as medical/surgical beds for those with mental health conditions who also require physical health treatment.

Large-scale terra-cotta tiles will flank the building's outer structure, offering a more contemporary look and feel that complements the medical campus's existing brick buildings. Sage, soft yellow and other colors mirroring the Pacific Northwest's natural landscape will create a calming environment in patients' common spaces, said Carl Hampson, the project's lead designer and a design principal for the firm SRG Partnership. Outdoor benches will be fabricated from reclaimed trees; the reception desk will be made to look like a felled tree trunk.

On the first floor, visitors and UW students and staff will eat together in a public dining hall. Massive commissioned art in public and patient spaces by visual artist Hernan Paganini will, as he describes it, serve as a "second skin" on the building's interior walls.

In Paganini's initial concept art, as residents and visitors walk the corridors they'll be able to touch giant faces and abstract shapes cast in white relief. Throughout the day, sunlight and shadow will transform the look of Paganini's artwork, which draws inspiration from ancient Egyptian relief sculpture.

"The work itself is going to produce (in) you some kind of emotional reaction," said Paganini, who lives in Bremerton. "My general idea is to try to bring to these people the experience (of being) alive. And in a small way, these people can reconnect, little by little, to their body."

Patient safety was one of the highest priorities during the planning process, Hampson said. In patient areas, for example, the toilets, sinks, blinds and other fixtures were designed to prevent patients from hurting themselves.

The facility is expected to be outfitted with a neuromodulation suite, where staff can treat patients using brain stimulation therapies. Consultation rooms will offer space for psychiatrists to do telehealth consults with health providers across the state; rural areas, in particular, face a significant shortage in mental health professionals.

Retaining and building the mental health workforce is a challenge: Pay is low, training programs are lengthy and the mental health system has a long history of mismanagement and underfunding. Washington psychiatrists earn tens of thousands of dollars less than certain medical specialties, Bureau of Labor Statistics show; bus and transit workers earn more than several other behavioral health professions, including mental health counselors and social workers.

Creating conditions — both the physical environment, and the clinical standards — that motivate people to enter the mental health workforce is one way to improve retention and recruitment, said Dr. Jürgen Unützer, a professor and chair of the Department of Psychiatry and Behavioral Sciences at UW School of Medicine, who has been involved in the facility's planning since its inception. Those involved in designing the new facility's clinical services and training programs say it will set a high standard for interdisciplinary medical and behavioral health care.

A majority of UW's 85 psychiatry residents will rotate through the facility over the course of their residency, said Dr. Anna Ratzliff, director of UW's Psychiatry Residency Training Program. Other trainees, including those set to become nurses, occupational therapists and social workers, will also have an opportunity to work shoulder to shoulder and collaborate on patient care and safety planning, she said.

The goal, she said, is to "teach residents and other trainees around what high-quality care should look like, so they really have that idea in their head as they go out into, hopefully Washington state, and sometimes beyond, to practice."

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