Changing perceptions around mental health through design and construction

Nearly 47 million Americans—one in five adults—experience mental illness in a given year. Yet, there is still a stigma that surrounds mental health, specifically the notion that behavioral treatment facilities are cold, sterile places reserved for only the most extreme cases. In an effort to normalize psychiatric care, healthcare providers have moved towards purpose-built behavioral health facilities with the help of healthcare designers and builders, like Skanska.

1 / 2 The new $105 million, 60,000 square-foot campus consists of four, single-story mental health recovery centers, each accommodating 16 occupants, as well as a three-story co-housing building for 57 residents.
2 / 2 The new $105 million, 60,000 square-foot campus consists of four, single-story mental health recovery centers, each accommodating 16 occupants, as well as a three-story co-housing building for 57 residents.

Our team is currently working with San Mateo County and CannonDesign, one of the country’s leading architectural companies for behavioral health facilities, on the Cordilleras Mental Health Center Replacement project (Cordilleras) in Redwood City, California. After seeing research that shows patients are more likely to recover in smaller, more intimate environments, the County decided to rebuild the Cordilleras facility with patient recovery in mind. Originally, the center was constructed as a tuberculosis hospital in 1952 and adapted for behavioral health in 1978.

The new $105 million, 60,000 square-foot campus will consist of four, single-story mental health recovery centers, each accommodating 16 clients, and a three-story co-housing building for 57 residents. The buildings are formed around a central open space with sheltered outdoor seating, community gardens and recreation courts.

Once our team was awarded the project in July 2018, we came prepared to tackle the various obstacles that define behavioral healthcare construction and achieve the objectives of this facility.

Incorporating biophilic design elements and preserving the site’s natural environment

Early research detailed that bringing patients closer to nature helps with healing. The site is located in a valley and surrounded by open space and trails—it’s very peaceful. The campus design also provides patients with pleasant outdoor views. Instead of building traditional blocks of rooms, our team will construct corridors configured into a V-shape, which will give every room a view into the courtyards. And no detail is too small—the team is also focused on the finishes, colors and textures used within the facility to ensure they reflect natural elements. For example, the interior will feature exposed wood, which will add to the residential feel.

Maintaining a healing environment while building a replacement campus

The replacement campus we’re building is just 15 feet from the existing facility, so sound attenuation measures will be implemented during construction to maintain a healing environment. We are prefabricating a system that will attach to each patient’s existing window to provide them a sound insulation layer. The sound insulation layers will be customizable, so we can display different images on the vertical surfaces—from making them dark or see-through to putting pictures on them. By doing this, we’ll be able to customize every patient’s window to their needs and preferences. Many feel as though their lives are not within their control, so giving patients something that they have ownership over is important to us.

Meeting security and anti-ligature requirements

To create a secure yet home-like treatment facility, we are taking into account every detail, from corridor site lines to finishing screws; this will ensure patients are as safe and comfortable as possible. To bolster the design team’s efforts, Skanska provided research on manufacturers that are designing for anti-ligature, or anti-suicide, installations and offered multiple pricing options for different products.

Receiving support from the community

To change perceptions of behavioral healthcare over the course of construction, we first needed community support. We attended meetings with the facility’s Board of Supervisors to discuss the project. The community was very supportive. Not only do the Board of Supervisors currently view it as the most critical project for San Mateo County, but the members of the community also see value in the facility and want this project to come to fruition.

Preserving the budget while building on unique terrain

The campus is in a “V” shaped valley, surrounded by very steep slopes. To create a larger valley floor for the buildings, we will construct 60-foot-tall soil nail retaining walls, which will use a disproportional amount of the budget in the site work. Some of the budget was also designated to installing an additional large water tank next to their existing tank. The municipal water supply doesn’t have the pressure necessary to support the building’s requirements. The installation of this tank will be challenging because there is only one steep dirt road that leads to the water tank and no flat ground around it. Getting equipment to the site and creating the necessary space for construction will be a very unique challenge of this project. With such challenges, remaining within budget hasn’t been easy, but value engineering exercises and constant communication with the design team and client has kept us on track.

Making sustainability a priority

Incorporating renewable power, this project will be the first net-zero mental health campus in California. There will be solar panels on every roof, including the on the shade structures over the site parking. The facility will have natural ventilation in shared areas and an air-to-water heat recovery system to allow for pre-heating of the domestic hot water system. Patients will be able to independently moderate their own spaces to meet their comfort needs—an improvement over their current facility, which doesn’t have air conditioning. Currently, the project is targeting LEED® Silver certification.

Building for a better society

At Skanska, we build for a better society and there are few projects that better encompass our values and mission. Cordilleras will hopefully change individuals’ perceptions on behavioral health facilities. Construction will begin in early 2021 and when work is complete in late 2023, we will be leaving behind an inviting, comfortable and sustainable space for individuals to heal.

Last updated: 12/3/2020