Caption: With the complexities of designing for safety at every level of a behavioral health facility, such as Southwood Psychiatric Inpatient Hospital, some subcontractors may require extra guidance to navigate the nuances of these projects. Photo Credit: Warfel Construction
Author: Rusty Hoffman, Project Executive, Warfel Construction
The demand for behavioral healthcare services remains high in the United States. According to the “2024 State of Mental Health in America,” 23% of American adults have experienced mental illness in the past year and 18% of adults report having a substance abuse disorder. Of those reporting substance abuse, 77% did not receive any form of treatment.
To ensure more people get the help they need, it’s important for stakeholders like local communities, legislatures and insurance companies to support expanding mental health programs and constructing new and renovated facilities. By understanding the unique challenges and following some best practices, building, design and construction teams can collaborate effectively to ensure their next BH facility construction projects get completed successfully and benefit the whole community.
Best Practices for BH Facility Construction
In Part 1 of this article, we discussed best practices for gaining community support for new BH facility construction and the exceptional level of safety detail needed to protect patients, staff and visitors to these facilities.
In Part 2, we explore best practices for successful working relationships with trade partners and vendors during BH facility construction projects, as well as useful tips for navigating regulatory approvals.
Increase Support for Trade Partners and Vendors
With the complexities of designing for safety at every level of a behavioral health facility, some subcontractors may require extra guidance to navigate the nuances of these projects. Experienced contractors take the time to engage trade partners and vendors thoroughly. This ensures BH facility construction is sequenced more deliberately so construction doesn’t inadvertently introduce elements that could put patients, staff or visitors at risk. Light fixtures are one example. For both safety and stability, these fixtures need to be hung by four pieces of all-thread rod from the structure above. If there are floor-to-ceiling constraints in a particular area, it will be more difficult to install other elements—mechanical, plumbing, electrical—if the engineering has not allowed for things like ductwork to go around the fixture, rather than over top of it.
Ideally, contractors will work with facility teams and trade partners to prepare them on the complexities of the project early in the process. This often includes in-depth interviews, portfolio reviews and detailed prequalification checklists.
Vendor relationships can also have a significant impact on the quality and success of a project. Many key products—such as ligature-resistant hardware or psychiatric-grade windows—are produced by only a few manufacturers with potentially long lead times. It can be helpful to work with a construction management partner that has well-established relationships with key vendors and understands the procurement timelines. This allows teams to identify opportunities for early release products, get what they need on time and keep projects running smoothly.
Prioritize Inspection Readiness
Inspection delays can stall occupancy and push critical services out for weeks or months. For BH facilities, contractors need to be prepared for multiple, rigorous inspections. This includes separate inspections for local building codes, state Department of Health regulations and highly detailed multi-day inspections from The Joint Commission.
To mitigate this risk, building and construction teams must prioritize documentation and inspection preparedness from day one. This means maintaining comprehensive submittal records, flame-spread certificates, UL labeling for fire and smoke barriers, and life safety punch lists.
To ensure readiness, an experienced construction partner will schedule interim walkthroughs with inspectors at 75% project completion. These visits offer an opportunity to identify and resolve issues before final inspections, while also demonstrating transparency and collaboration.
It’s also important to proactively reach out to local officials to inform them on the unique aspects of a BH project prior to the inspection. In some locations, they may not be as familiar with exceptions to the building code that allow for specific functions at the facility. For example, a local fire chief could question fail safe versus fail secure for egress in the event of emergencies. Understanding the difference, and which one is in use, can be a key factor in the speed of an emergency response. Notifying officials of features like this prior to inspection helps reduce confusion and ensure a smooth process overall.
Collaboration Builds Community
Behavioral healthcare facility construction is a highly specialized discipline that calls for unique technical expertise, regulatory awareness and willingness to engage communities. For owners and operators embarking on these projects, partnering with experienced contractors who understand the nuances of BH design and construction provides a strong foundation for success.
Collaboration is key. Owners, designers, contractors, inspectors and community members all play critical roles in delivering a facility that is safe, functional and responsive to the needs of patients and staff alike. Applying these best practices and educating all stakeholders in the importance of following these approaches can help keep projects on track. When done right, behavioral health facilities can be a source of healing and support for patients and their communities.
Rusty Hoffman is a project executive Warfel Construction.
