Behavioral and mental health facilities should be planned around the care delivered, the people served, clinical risks, and the requirements adopted by the local authority—not around a single idea of what a “safe” facility looks like. Good construction planning has to support safety and dignity together, with observation, sensory regulation, stabilization, treatment, and privacy considered in context.
Start with the care setting and the locally adopted requirements
The applicable Facility Guidelines Institute (FGI) resource depends on whether a project is a hospital, an outpatient or crisis setting, or a residential care and support setting. Before design decisions are made, the owner and project team should confirm the facility type, the authority having jurisdiction, and the edition of the requirements that authority has adopted. Publication of a new FGI edition does not, by itself, establish which edition applies to a particular project.
FGI released its 2026 Codes and Handbooks on August 31, 2026. FGI describes the Codes as baseline, consensus-based minimum requirements for planning, design, and construction. The companion Handbooks provide explanatory information, technical guidance, and best practices to help professionals understand and apply the requirements. Handbook advice is supporting guidance; it should not be represented as a binding code provision unless an applicable authority has made it one.
| Project setting | FGI resource to check | Planning distinction |
|---|---|---|
| Hospital, including behavioral and mental health hospitals | 2026 Hospital Code, subject to the edition adopted locally | FGI’s 2026 hospital resource includes provisions for medical psychiatry patient care units and staff personal alarm systems. |
| Outpatient behavioral health or crisis care | 2026 Outpatient Code, subject to the edition adopted locally | FGI’s crisis-setting summary distinguishes community facilities from centers embedded in freestanding emergency departments. |
| Residential behavioral and mental health treatment | 2026 Residential Code, subject to the edition adopted locally | The residential code expressly covers residential behavioral and mental health treatment facilities. |
FGI says its Guidelines documents are updated every four years. That is the organization’s stated revision cycle, not a guarantee that every jurisdiction adopts each edition on the same schedule. The adopted code, applicable local requirements, and project-specific decisions must be confirmed for each job.
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Translate clinical needs into a safety-and-dignity brief
Behavioral health construction is not a matter of adding the same safety features to every room. The planning brief should identify who will receive care, what services will be delivered, what clinical risks the environment must address, and how staff will observe and support people without undermining privacy or therapeutic use of space. FGI’s Behavioral Health Design Guide offers supplemental detail for adult inpatient behavioral health units, but it does not cover every population or care need.
- Population: Define the age groups and patient needs the facility is intended to serve. The adult inpatient guide does not cover children and adolescents, geriatric patients, or some people with medical needs or specific diagnoses.
- Care model and acuity: Clarify whether the project is for inpatient treatment, crisis assessment and stabilization, outpatient care, residential treatment, or care that combines behavioral and active medical treatment.
- Observation: Decide where continuous or other observation is clinically needed and how it can coexist with privacy, dignity, and appropriate staff workflows.
- Sensory and stabilization needs: Consider whether dedicated calming or stabilization spaces are appropriate to the service model and how they will be used.
- Staff and patient safety: Identify the risks and operational needs that safety measures are meant to address rather than assuming a particular product or detail is universally suitable.
This brief gives the design and construction teams a basis for evaluating choices with clinical, facilities, and code professionals. It also helps prevent a feature intended for one population or setting from being treated as a universal solution.
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Plan crisis settings for observation, regulation, and stabilization
FGI’s current description of behavioral health crisis settings emphasizes balancing safety with dignity. It highlights continuous observation zones, sensory-regulation calming rooms, and spaces intended to support stabilization. These are planning priorities, not a substitute for checking the adopted code or determining project-specific requirements.
For a crisis center, the team should establish how assessment, observation, calming, and stabilization will work in the actual care model. FGI distinguishes community crisis facilities from centers embedded in freestanding emergency departments, so the project should not assume that the same layout or operational arrangement fits both. FGI’s 2022 paper on behavioral health crisis units provides additional design context beyond the minimum requirements in the 2022 Guidelines; for current project decisions, the adopted 2026 requirements and local rules need to be checked.
Account for medical complexity in psychiatry units
A medical psychiatry patient care unit serves people who need behavioral health support alongside active medical treatment. That combination changes what the design must accommodate: therapeutic and family support, observation and risk controls, as well as safe access to medical equipment and treatment.
FGI’s 2026 hospital resource identifies family-centered support areas, ligature-resistant strategies suited to medically complex patients, safe access to medical equipment, and dedicated social or group therapy spaces. These priorities should be coordinated rather than treated as separate checkboxes: the design needs to support clinical care and staff access while responding to behavioral health risks and preserving a usable, respectful environment.
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Use risk-informed design guidance without treating it as a guarantee
FGI’s Behavioral Health Design Guide addresses adult inpatient behavioral health units and provides more detailed discussion of built-environment choices and products considered safer in that context than baseline requirements alone. FGI cautions that no product is entirely without risk. The guide is supplemental design guidance, not a replacement for regulations or a legal standard of care.
Accordingly, evaluate proposed safety features against the people served, clinical services, and specific risks being addressed. A product or detail should not be described as risk-free, universally appropriate, or sufficient on its own. The reviewed FGI material does not establish that any particular product or design feature independently causes better recovery outcomes.
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Coordinate code review and design decisions through the project
FGI’s Codes establish minimum requirements; they are not a complete substitute for project-specific judgment. For a facility project, that means code review and clinical planning need to inform the same decisions, from the initial brief through design coordination and construction. The team should record which requirements are mandatory under the locally adopted edition and which choices are supplemental recommendations or responses to the project’s clinical model.
- Identify the facility and authority: Confirm the care setting, jurisdiction, authority having jurisdiction, and adopted code edition.
- Define the service and population: Document who the facility serves, the care delivered, medical complexity, observation needs, and anticipated use of calming or stabilization spaces.
- Review applicable minimums: Use the relevant FGI Code and local requirements to identify enforceable requirements. Use the Handbook and design guidance as explanatory or advisory material, not as a substitute for the adopted requirements.
- Assess risks and operational fit: Have qualified clinical and design professionals evaluate whether proposed spaces, features, and products address the identified risks while supporting dignity and care.
- Coordinate implementation: Resolve conflicts among code requirements, clinical workflows, equipment access, staff needs, and therapeutic use of the facility with the project team and applicable authorities.
FGI does not provide a ranked comparison of architectural options or their cost-effectiveness in the sources cited here. Nor do those sources establish local adoption across jurisdictions, project costs or schedules, or universal safety for a particular product. A project-specific determination therefore belongs with the qualified design and clinical professionals and the relevant authority.
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