Blog Post

An Oregon sheriff's office used 'design thinking' to dramatically improve behavioral health outcomes. If they can do it, you can too.

March 29, 2018

    Providers face similar challenges to sheriff's offices: high volumes, unpredictable patients, and inappropriate spaces to treat them. And many arrested inmates also need high-acuity health care services. So the Multnomah County Sheriff's Office in Portland, Oregon, started an innovative initiative to use simple design tweaks to address these challenges. If sheriff's offices can use design thinking to drive throughput and effective management, health care providers can apply the same thinking to emergency departments, inpatient psychiatric units, and outpatient clinics.

    Design thinking starts with a focus on desired outcomes

    Nationally, one in five inmates is likely to have a mental illness. However, the traditional detention environment is stressful, uncomfortable, and can exacerbate behavioral health conditions. Inmates who are not properly treated for mental illnesses have an increased risk of recidivism, as high as 68% for inmates with co-occurring mental illness and substance abuse. This cycle of illness and arrest is not unlike the cycle of behavioral health patients through the ED again and again.

    Inspired by how four health systems came together to create the nearby Unity Center for Behavioral Health, Sgt. Amie Banta at the Sheriff's Office spearheaded the detention center's renovation to meet often overlooked behavioral health needs.

    Taking cues from Unity's calm, relaxing environment, the Sheriff's Office incorporated two significant design elements that providers can easily replicate:

    1. A calming color palette and access to nature to reduce anxiety. Simple fixes such as painting waiting or exam rooms in shades of light blue or green, hanging nature murals on the walls, or, if possible, incorporating windows into the environment can go a long way towards stabilizing an inmate or patient in crisis.

    2. Spaces for artistic expression to allow for positive distraction and creativity. Large squares of chalkboard paint allow inmates to express themselves constructively. This easy, safe modification has helped reduce inmate stress and deter violent or agitated behaviors.

    The Sheriff's Office has seen a reduction in violence, agitation, and destructive behaviors since the renovation. The environment is now much more relaxing, and it has made handling inmates much easier by reducing the need for use of force. Using design thinking to make a few simple changes can have dramatic results for inmates and law enforcement—and potentially for providers' patients and staff, as well.

    Scroll down to see pictures of the facility


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