Feel Safe Enough? How Psychiatric Units Design Can Support Psychological Safety?

Sara Bayramzadeh (Kent State University)

Psychiatric units actively prioritize patient safety due to patients' vulnerability to risks such as suicide, self-harm, or violence in extreme conditions. However, it is often overlooked how safe such safety measures make patients feel. The predisposition of psychiatric patients to risks also impacts their feeling about being present in a psychiatric unit. Therefore, to holistically respond to the psychiatric patient safety, the psychological safety should be addressed in addition to physical safety. From known factors involved in improving feeling of safety among patients, the design of the physical environment is not studied as well. This study aims to address the gap in the literature regarding the role of the environmental design in providing psychological safety for patients in psychiatric units.

Using a mixed method approach, this study utilized a web-based survey and two focus groups to explore staffs' perception of patients' attitudes towards psychological safety and how it might relate to the physical environment. A total of 78 Staff members participated in the survey. Two one-hour long focus groups with 9 participants were held.

Findings revealed that the physical environment can influence psychological safety in various ways. For example, smaller units and decentralized staff stations can promote a feeling of safety among patients because of the increased accessibility to staff. Moreover, providing a quiet room for agitated patients and increasing flexibility in regards to furniture arrangement and space to group patients with similar conditions and compatibility can improve psychological safety.

Conclusions: Findings supported the notion that the physical environment can influence psychological safety of patients in psychiatric units. Based on findings, some design implications are introduced, which can help designers to create spaces for psychiatric patients that not only provide them with physical safety but also promote the feeling of being safe in such spaces.