A middle-school student in Ohio was worried about her friend's mental health, so she told her teacher.
The school is part of Columbus-based Nationwide Children's Hospital suicide prevention screening network, where Nationwide clinicians provide on-site mental health screening, trained teachers lead discussions on the topic, and students fill out questionnaires and can suggest friends who they believe need assistance.
The school and Nationwide facilitated an emergency assessment for the girl, which revealed that she felt guilty she couldn't have done more for a different friend who committed suicide the prior year.
Overarching hopelessness led her to map out a plan to take her own life. But with the help of her friend, the school and Nationwide, she improved. “If we just gave the schools a packet or tried to do it all ourselves, it isn't sustainable,” said Dr. David Axelson, chief of psychiatry and medical director of behavioral health at Nationwide. “We need schools to buy in and teachers to do it on an ongoing basis.”
Having a clinician on site, which Nationwide bears the cost of, and going to where the kids are help break through barriers created by the stigma of mental illness, Axelson said. “We may have saved a life or a suicide attempt that would've resulted in hospitalization and ongoing problems,” he said. “It makes sense from a clinical and overall systems perspective to invest in this upfront.”
The focus on behavioral health is surfacing in pediatric facility design. As this traditionally underserved area of healthcare grows, providers are boosting their mental health services by hiring more specialists, building more private rooms, integrating more play areas, and weaving more soothing, nature-related elements into the design.
“We realized we needed to think about children's health differently,” said Patty McClimon, Nationwide's senior vice president of strategic and facilities planning.
Nationwide already has one of the largest behavioral-health programs in the U.S., logging nearly 209,000 visits for more than 33,100 patients last year, but it doesn't have adequate acute-based services. Pediatric patients often showed up in the costly and ill-equipped emergency department because they had no other place to go.
So Nationwide started planning its $158 million, nine-story free-standing psychiatric facility in 2014. The 386,000-square-foot Big Lots Behavioral Health Pavilion will include 18 acute-care beds, conference space that could be used for mental health specialist training, a gym, a rooftop play area and outdoor courtyards. The building is expected to open in 2020.
“So much of mental health has been marginalized and stigmatized,” said Ryan Hullinger, a partner at architecture firm NBBJ, which helped design the Nationwide behavioral-health project. “Nationwide has made it the marker of their campus. The de-stigmatization of mental health is something we're seeing now—how we need to address it as a society rather than push it under the rug.”