The need for, and social acceptance of, mental health treatment has increased considerably in recent years, and commercial real estate has a role to play.
A combination of the pandemic, high profile mass shootings and the opioid crisis Has kept behavioral health in the headlines in recent years, creating a national consensus that something must be done.
“Covid has really brought mental health to the forefront,” Menninger Clinic President and CEO Armando Colombo said in a statement. great snow‘s Healthcare South, held on September 8 at the Houston Marriott Medical Center. “The challenge is providing access to care, the right level of care.”
That’s where CRE comes in.
Panelists at the event said the significant “infrastructure” of behavioral health services and an increased focus on spanning a broader continuum of care presents opportunities for new health care real estate.
Bisnow/Catie Dixon
Shawn Cloonan from McCord, Armando Colombo from Menninger, Joan Albert de Page, Michael Garcia from Houston Methodist, Stephen Glazier from UT Health and Jill Pearsall from Texas Children’s at Bisnow’s Houston Healthcare South event on September 8, 2022.
The global prevalence of anxiety and depression increased by 25% in the first year of the coronavirus pandemic, according to the World Health Organizationwhich said that a shortage of mental health services prevented people from accessing needed treatment.
“While the pandemic has raised interest and concern about mental health, it has also revealed a historic underinvestment in mental health services,” said Dévora Kestel, Director of the WHO Department of Mental Health and Substance Use. in a March release.
As an example, the Houston area has added five psychiatric hospitals in recent decades, but nearly all of them are full, according to UTHealth Harris County Psychiatric Center COO Stephen Glazier, who spoke at the event.
UTHealth opened a 264-bed Houston psychiatric hospital in February, the first new public psychiatric hospital built in Texas in about 30 years. Each morning starts with about 100 people knocking on doors to be added to a waiting list, he said.
“We are still significantly under the bed,” he said.
The increase in mental health problems nationally spans age groups and severity.
Mental health-related emergency room visits increased 24% for children ages 5 to 11 and 31% for those ages 12 to 17 during the pandemic, according to the American Psychological Association.
Meanwhile, the number of adults receiving mental health treatment of any kind has risen sharply: In 2019, 19.2% of adults surveyed said they had received medication or counseling for behavioral health issues in the previous 12 months, the Reports from the National Center for Health Statistics. As of early May, 26.8% of Americans reported having received mental health treatment of any kind in the last four weeks alone, according to the latest available NCHS data.
Tragedies like mass shootings in Uvalde, Texas, and the Fourth of July parade in Highland Park, a suburb of Chicago, have also shone a spotlight on the nation’s mental health shortcomings. Politicians have linked incidents like these, in particular, to a failure of mental health treatment. Although that link could be unfairhas sparked cries across the political spectrum for better funding for behavioral health.
“It’s the only bipartisan issue I’ve found in the legislature right now,” Glazier said.
Glazier said he’s been in the health industry for 45 years, but only in the last few have he seen real progress in reducing the stigma around mental health treatment.
That has corresponded to new federal support. In each of the last five legislative sessions, Congress added between $300 million and $900 million in new funding for mental health, some of which went toward infrastructure and renovation of aging facilities. In March, President Joe Biden funded the Substance Abuse and Mental Health Services Administration to the tune of $6.5Ban increase of $530 million over fiscal year 2021.
Congress is also debating the Restoring Hope for Mental Health and Wellness Act of 2022, which could funnel a great deal of money into mental health research and treatment nationwide. Glazier said the new bills being considered could have an impact on mental health similar to what Texas has seen at the Cancer Prevention and Research Institute of Texas. CPRIT has funneled $3 billion in grants to cancer research over the last 11 years and has another $3 billion in funding yet to be awarded.
Glazier said the investment spurred research and clinical advances in cancer treatment that helped remove the stigma surrounding the disease. The same could happen with mental health, he said: As science better understands it and finds ways to treat patients more effectively, society’s view of mental health and mental health treatments will change.
One of the focuses of the new investments will be to close gaps in care, Glazier said, and that is driving demand for new spaces. The greatest need is for beds that can serve people who need 60-90 day stays – safe therapeutic places where people can be discharged after completing a short-term acute hospital stay.
“If you don’t have a safe, supportive place to live, you’re not going to do well with your mental health issue, and that’s starting to get funded,” Glazier said. “This is really exciting.”
Bisnow/Catie Dixon
Fernando Rodrigues from HDR, Karim Zulfiqar from Walter P Moore and Joan Albert from Page
On Thursday, the Menninger Clinic cut the ribbon on a new 33K SF outpatient building in Houston that will help people transition from inpatient to outpatient services and bridge the continuum of care.
But in the future, Colombo said, the clinic is looking outside its campus for services like sobriety homes and substance use rehab. The biggest factor in making this kind of expansion successful is partnering with other organizations that can help expand the continuum of care, he said. Those facilities may be located in small assets, such as houses in communities, or in office spaces adapted for partial hospitalization or intensive outpatient procedures.
When the University of Texas was planning UTHealth’s new psychiatric hospital, it considered placing supportive housing within the hospital, according to Glazier.
“It took about 10 minutes and we came to our senses and asked ourselves: ‘Why would we put housing, which is really cheap to build, in the most expensive type of building we can build? That doesn’t make any sense,’” Glazier said.
Instead, UTHealth is working with a partner to expand post-crisis care “in appropriate housing buildings” so the hospital can focus on inpatient care.
A new focus on mental health also extends to facility design, including lighting. Glazier said a member of the architecture team for the new UTHealth hospital is also a neuroscientist who specializes in the effect of light on the brain, and that person delved into specific glazing of windows to let in a specific amount of light. light in the building.
However, the biggest design focus is to give the people inside these buildings a sense of control.
“Many of our patients are there unintentionally, they can’t leave until they are no longer a danger to themselves or others. They’re locked in there,” Glazier said. “But if you can design a building so that they feel like they have more control over their environment, they tend to relax, they do better, they get better faster.”
Most of this is subtle. UTHealth has built cubicles in its inpatient units where patients can lie down behind a partition and feel like they have some privacy, but open enough that nurses can monitor them and other patients can come say hello or help gradually wean them out. .
Monitoring is also important for staff, said Page’s health care director, Joan Albert. The mental health of doctors, nurses and technicians has also received attention, and the new facilities include breakout spaces for staff to have informal conversations and get away from the stress of work.
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