Mental Health Moves Downtown

Several new or planned mental-health hospitals in city centers aim to do more than treat patients—spurring local business, providing work for those in treatment and using design to erode stigma

Wall Street Journal
By Laura Cooper
June 8, 2021

A pinkish building topped with a soaring glass atrium has long marked the skyline of Kansas City, Kan. The site, former offices for the Environmental Protection Agency, for years sat vacant across the street from a gas station known for drug deals in a stagnant residential area called Strawberry Hill.

More recently, the neighborhood has begun to change. More shops have opened up, including a grocery store. And the EPA offices were converted into a modern mental-health facility known as the University of Kansas Health System’s Strawberry Hill campus, bringing hundreds of workers to the neighborhood.

“It was an area where a lot of things were shuttering up and closing down,” says Gregory Nawalanic, a clinical director of psychology services at Strawberry Hill. “Now we’re seeing a little bit of a resurgence.”

Mental-health hospitals have long been isolated from city centers, often in places with a dearth of public transportation or sense of community, and confined to buildings that look more like prisons than treatment centers. The Strawberry Hill campus is one of several new or planned facilities across the country that aim to not only treat patients but also spur new business within communities, provide work for those in treatment, and use design and architecture to erode the stigma of residential programs.

The hospital system in Kansas City previously operated two small inpatient sites, including a dated, 15-bed unit with cinder block walls, says Christine Duncan, a medical director at Strawberry Hill. It was difficult for patients to find the building, she says, as it was hidden on a large campus a 15-minute drive south of downtown. “The biggest thing is we are now in the heart of Kansas City, Kansas,” she says.

The 47-bed, inpatient facility treats people with schizophrenia, bipolar disorder and major depressive disorder, among other diagnoses. The downtown location, which is near bus lines, has also allowed the facility to provide care to the city’s homeless population.

This shift in location and design comes at a time when Americans are struggling with mental illness, substance abuse and anxiety amid the Covid-19 pandemic. Four in 10 adults in the U.S. have reported symptoms of anxiety or depressive disorder during the pandemic, according to a January survey from the Kaiser Family Foundation.

Having more centrally located mental-health facilities could help more people in need of treatment find care, according to mental-healthcare providers. More people might seek help if treatment locations are accessible, familiar and welcoming parts of the community, they say.

Be Well OC opened its doors in Orange, Calif., a suburban area between Anaheim and Santa Ana, earlier this year. The 60,000-square-foot space, a collaboration between an insurer, the county healthcare agency and several local hospitals, has become a community hub, as well as an inpatient facility for people with mental-health and substance-abuse issues.

Last month, Be Well hosted a spirituality training for 50 deacons in its classroom space, says Marshall Moncrief, Be Well’s chief executive. The facility has a cathedral-like entrance space, a roof deck, an exercise facility, copious plants and hotel-style rooms. Patients and community members mingle under the same roof.

Building out space to invite in members of the community was important to destigmatize mental illness, Mr. Moncrief says. “It’s not a dark, cinder block, beige building,” he says. “You want to be here and host your event here.”

Be Well OC plans to open more centers across the county. For its next location, the nonprofit is considering including a cafe staffed by people in treatment as a way to provide them with jobs that involve interacting with community members, as well as to put a face and name behind mental illness, he says.

Orange embraced the opening of Be Well OC, according to Mr. Moncrief, but other mental-health facilities have faced resistance from local communities, some of which take a “not in my backyard” stance tied to stigma around mental illness. People in Strawberry Hill, for example, initially raised concerns that patients would wander the neighborhood, lost and mentally ill, Dr. Nawalanic says.

Strawberry Hill was renovated to welcome the community in, says Stephanie Vito, a mental and behavioral health architect at CannonDesign, the New York-based architecture, engineering and design firm behind the conversion. “This helps convey that mental-health hospitals are not places to be avoided,” she says, “but are valuable to the community.” The facility, ringed by extensive landscaping, blends into the surrounding buildings as if it is another commercial space. It has a cafe that serves its own coffee blend from a neighborhood roastery.

Elsewhere, facilities feature meeting space for local clubs, and gyms or pools for community use.

Some mental-health hospitals see a large number of homeless patients, many of whom don’t have access to care. One project in downtown Los Angeles aims to provide housing and care services in the same facility.

The Los Angeles County and University of Southern California Restorative Care Village is slated to provide both a residential treatment program and housing for people discharged from inpatient facilities. The village is located on county land that housed a hospital which has been out of use for more than a decade, says Jonathan Sherin, the director at the Los Angeles County Department of Mental Health.

Initial phases of the project are complete, and the campus is expected to be finished in the coming years. Local residents weighed in on everything from the murals to the builder to the layout of the buildings, Dr. Sherin says. Involvement from the local community is important because the campus is joining the neighborhood, he says.

In the future, Dr. Sherin says that he hopes the campus will bring in businesses like flower shops, cafes and a supermarket, whenever possible staffed by people living in the new housing.

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