In late july, Tribeca Twelve, a new five-floor residential building in New York City, began leasing to young adults ages 18 to 29. The project’s tenants, who are required to be enrolled or plan to enroll in an area college, are expected to shell out a minimum of $5,000 per month for rent. They also need to be qualified candidates for Hazelden and Columbia University’s Department of Psychiatry’s new alcohol- and drug-free housing for students in recovery.
The project, which borrows heavily from conventional luxury residential projects, sets a new standard for collegiate recovery residences. The 2,200-square-foot, furnished, semiprivate or shared units feature a full kitchen, dining room, living room with fireplace, flat-screen television, study, and two full bathrooms, with Wi-Fi and in-unit laundry facilities. Decorative items were sourced from Etsy and local antique shops, and no two units are identical. These amenities don’t come cheap, though Hazelden does label itself “insurance friendly.”
Though experts say that the basic tenets of treatment design—group spaces, private spaces, family spaces, and so on—are a constant, designers are employing evidence-based design strategies and adapting facilities to specific populations.
Tenants at Tribeca Twelve, for example, will get more than high design for their money; the facility will serve as a supportive, independent-living environment for young adults in school and for those who have had to leave school to obtain substance-abuse treatment while reintegrating back into campus life. Ann Bray, general counsel and vice president of strategic initiatives for Hazelden, a national nonprofit organization based in Center City, Minn., explains that the project was intentionally designed to feel much more residential than a typical hospital environment. “When you walk in [to a Tribeca Twelve unit], it doesn’t jump out as a treatment area; it looks like a living room,” she says.
Hazelden tailors facilities to its patients’ level of acuity, Bray says. While centers serving more acute patients, such as Hazelden’s main campus in Center City or its Springbrook facility in Newberg, Ore., are designed to support a range of clinical services, patient-residents at Tribeca Twelve enjoy kitchens in what are essentially condominiums.
“The trend in design is to deliver healthcare. We like to turn that upside down and think about the patient experience,” Bray says.
Many healthcare facilities are now adopting a design-for-home philosophy, HGA senior interior designer Christine Guzzo Vickery says. This trend is particularly relevant when patients will be residing in a facility for an extended period of time. “Creating a home-like environment [at an inpatient substance abuse facility] really matters,” Vickery says. “People are living there; they need to feel comfortable.”
To reduce stress and anxiety in a recovery setting, designers are tasked with providing abundant natural light, optimizing views of nature, addressing safety with discreet design solutions, and selecting therapeutic artwork, among other requirements. “It’s about treating a person as a whole, not just dealing with the substance abuse,” she says.
These design elements not only create a calm environment for patients; they can mitigate what Rick G. Wessling, AIA, managing principal of TSP Architects and Engineers in Minnetonka, Minn., calls the “rearview-mirror factor”—how families of patients view the facility. “Often, people dropping loved ones off are torn up and want to know it’s OK,” he says. Design can help ease some of these concerns.
Though recovery is the goal at many facilities, other centers exist to ensure that people who are coping with substance abuse are safe. Lehrer Architects principal Michael B. Lehrer, FAIA, has completed two wellness centers for Homeless Health Care Los Angeles (HHCLA), an organization for which he now serves as board president. The facilities vary from traditional substance-abuse treatment settings by offering “harm-reduction” services, such as a needle exchange, in addition to conventional services and referrals.
In his work with HHCLA, as well as two other projects serving low-income and indigent people in Los Angeles, Lehrer has found that providing a welcoming atmosphere can help clients overcome any initial pathologies they might have regarding integration and rehabilitation.
“Design matters a lot in all of these projects. They are calibrated very much in terms openness and protection,” Lehrer says. “This is not fear-based design.”
Bray says the same considerations go into designing Hazelden admissions areas, which she describes as intimately scaled, not voluminous or intimidating. These spaces “feel private and confidential. The flow is very important, warm and intimate, not commercial,” she says.
According to Vickery, even subtle design enhancements can turn a potentially off-putting but ultimately necessary building feature into a welcoming design asset. With security glass, for example, she says, “You can etch a pattern on it.”
In contrast to other behavioral health environments, Francis Murdock Pitts, FAIA, a principal at Troy, N.Y.–based Architecture+, says inpatient treatment facilities typically feature shared bedrooms and areas designated for group therapy.
In treatment, “success depends on an environment that supports groups and [a patient’s] ability to take a role within that group,” Pitts says. “It’s a question of the individual and society and what architecture does as a mediator.”
Joseph Lomonaco, AIA, principal of Architecture+, likens the group dynamic to a “bootcamp arrangement.” “Once they [patients] have been through detox, people live in a world built around a little community. They eat there, live there, sleep there, receive group treatment there,” he says.