Addressing the stigma of mental illness was a key consideration in the design and construction of Nationwide Children's Hospital's new Big Lots Behavioral Health Pavilion in Columbus, Ohio. Even before the first brick was laid, that focus was evident in where the hospital chose to break ground.
"First and foremost, from a physical facilities perspective, we very intentionally put this large building on our campus so it wasn't tucked away-it's right downtown with the main hospital," says Patty McClimon, chief strategy officer, Nationwide Children's.
Pavilion includes expansive services and design features
Nationwide Children's commitment to pediatric behavioral health goes beyond its on-campus location. The nine-story, 386,000-square-foot building is the largest center dedicated exclusively to child and adolescent behavioral and mental health in the U.S., and it includes:
- Psychiatric Crisis Department. With nine assessment rooms, it provides a more appropriate environment for care providers to work with pediatric patients and families in a behavioral health crisis than a typical emergency room. A 10-bed extended observation suite allows the care team to evaluate patients for up to 48 hours to determine the proper course of care.
- Youth Crisis Stabilization. A 12-bed unit designed specifically for intensive mental health treatment for youth.
- Inpatient units. Neighborhood-themed inpatient units will house up to 48 beds and allow staff to maintain separate patient groups-patients who are more difficult to manage can have their own space without feeling secluded. Abundant lighting and outdoor access were important considerations during the design process to maximize outcomes while breaking stigmas. Other considerations included sourcing furniture and fixtures that were consistent with that mood while also protecting patients and staff.
"For a behavioral health or psychiatric facility, safety is an absolute key," says David Axelson, M.D., chief of psychiatry and medical director of Big Lots Behavioral Health Services at Nationwide Children's. "We've done that in a way that maintains our children's hospital's playful feel-it's open, colorful and engaging. It feels like the rest of our hospital, but it does have the extra safety features required for a behavioral health facility."
Growing need for behavioral health care drives community-based approach
The facility represents a larger commitment by Nationwide Children's to address youth behavioral health-a mission reflective of societal trends, according to Axelson.
"Public health figures drove our planning process. We are in a terrible crisis of youth suicide in this country-suicide is now the second-leading cause of death in children ages 10 to 19," Axelson says. "We see this as a major part of our public health mission; we take a population health approach to care for kids, and this is affecting a significant portion of our population."
Axelson says he considers the pavilion a hub for behavioral health services with spokes reaching out to all areas of the community; Nationwide Children's currently works with behavioral health providers and primary care practices to support existing programs.
He adds the hospital is looking to reach deeper into the community to provide additional early-intervention behavioral health services for youth, including increased school-based services and suicide prevention programs. The long-term goal, according to Axelson and McClimon, is to not only meet the growing need for behavioral health services for children but continue to erode the stigma of mental illness.
Optimism fuels flex-space design
The pavilion was built to be adaptable. Nationwide Children's officially launched its first unit in March 2020 and continues to open the facility in stages, with some areas of the building designed to allow flexibility for future use.
"We know it will evolve over time, and hopefully we can avoid the need for additional inpatient space," McClimon says. "As we continue breaking the stigmas and making people more aware, we're hopeful we'll be able to intervene with more kids earlier, so they don't get to the point where inpatient care is needed."
