Revisions to the 2014 Guidelines for Psychiatric Hospitals

Several changes to the 2014 FGI Guidelines affect the physical space for behavior health spaces in stand-alone centers and in-hospital behavioral health units.

Section 2.5–2.2 General Psychiatric Units was altered this year to add the requirement for a sally port in a locked unit at the primary entrance. The FGI guidelines define “sally port” in the in the appendix as “the space between two lock doors that must be traverse to enter the unit.” The doors must be unlocked in sequence to reduce the risk of flight. When renovating existing space with varied existing condition, this requirement may be more difficult. When overlaying the requirements for handicapped accessibility, a sally port becomes quite large. 

To reduce the risk of climbing and increase patient safety, Section 2.5-2.2.3 gives further definition and requirements to outdoor areas. Most of the added requirements are common sense for those experienced in behavioral health design. 

Verbiage has been added throughout the guidelines in order bring patient safety to the forefront when designing a behavioral health unit.

One change that stands out – and really alters the possibilities for planning a behavioral health unit – is the requirement that toilet rooms no longer need to be accessible directly from a patient room. As long as it is within the nursing unit and no more than 150 feet from the bedroom, it can be accessed from the corridor outside a patient room. This change opens the possibility for bathrooms and showers to be located in a central area for better monitoring by staff, and possibly reducing the occurrence of incidents in patient bathrooms within the bedroom.

While I am not advocating the use of gang showers or toilet rooms, having the ability to group single-use toilet and shower rooms cannot only increase staff’s ability to monitor access to these rooms, but also reduces the cost of plumbing by reducing the length of piping runs to individual bathrooms in a construction project.

Another change to the 2014 Guidelines is the introduction of requirements for Electroconvulsive Therapy. This section lays out the physical size and location of procedure rooms for the first time. ECT has been defined in the guidelines for both inpatient and outpatient settings.

Many of the changes to this year’s guidelines delete specific requirements in the psychiatric hospital and unit sections, and refer back to corresponding sections in General Hospitals. These are simply administrative revisions to make the guidelines more compact and easy to edit.

Overall, the edits to the 2014 Guidelines are to promote safety and welfare of psychiatric patients and staff, making safer environments for everyone.