From a spacious lobby to calming color schemes, the way a healthcare space is built can support substance abuse treatment and retention.
Contributed by: Elinor Slomba, MPPA
Slomba is a Community Engagement Specialist who conducted a site visit to the West Haven program on June 27, 2023
You kinda gotta know it’s there. That’s how it seemed to me visiting APT’s West Haven clinic and, according to the staff, that’s how it should be. Lack of prominent outdoor signage and a main entrance which faces the rear of the building maintain privacy and discretion for clients and visitors. In addition to an ample parking lot, the convenient Front Street location is near a bus line.
When APT purchased its first ‘owned’ space in 2014 in North Haven, the existing building underwent a ‘gut’ renovation in an effort to maximize privacy, patient comfort and ease of receiving treatment services from reducing waiting time to providing coffee, water, snacks and a space for gardening. What was learned in North Haven was enhanced and applied to the West Haven program that was built in 2016.
The Lobby
Upon entry, signs establish the clinic as a weapon-free zone, while asserting All Are Welcome. Wide aisles, cheerful and attentive staff at the reception station, lush green potted plants, a wide, flat-screen television, and hot and cold beverage station not only provide clients with practical comfort but signal that their ease and wellbeing are valued.
The lobby also offers a range of informational resources, from fliers on suicide prevention to steps to obtaining a criminal pardon. Group schedules include drop-in Open Houses and various workshops, on goal-setting or poetry, for instance. For clients, attendance beyond one time per month is optional and clients are encouraged to attend as many groups as they need as they develop their own menu of services. All of the available groups and complement the clinic’s Intensive Outpatient (IOP) program, a level of care that requires attendance of at least 9 hours/ week that clients can utilize when they need extra support. The most popular group offering right now is Acupuncture, which clients appreciate as a spa-like service that offers an immediate benefit; many report it reduces their anxiety.
Client-Centered Design
As a clinic, West Haven stands out. Potwardowski explains, “This is the first building that APT built, so we had an opportunity to design it from the ground up. Open Access is more than a theory, it’s a mindset of making choices with our clients’ needs and interests in mind. When you create a whole environment that supports APT’s commitment to providing respectful, individualized, and confidential care, that has a profound impact not only on our clients but also on all their loved ones as well.”
Spending time in the resulting environment can be a therapeutic experience, reinforcing other substance use and mental health treatments. The calming green color scheme, for instance, is based on research into trauma-sensitivity and visual cues. A set of small rooms where clients receive their prescribed doses of methadone have closing doors, so confidential conversations with nurses can take place.
The entire clinic occupies a single, ground floor. An open floor plan makes navigation simple, featuring one hallway for group and individual therapy rooms laid out in one loop that begins and ends in the lobby. Restrooms are single, accessible, and gender neutral. The restroom doors face away from the lobby, taking some of the friction out of collecting urine specimens. This floorplan not only improves security but reinforces the message APT intends to send: that people are safe and welcome with all of their personal characteristics or circumstances.
A baby-changing area and toys in the waiting area indicate that APT recognizes the roles clients play as parents and caregivers. Computer stations enable clients to check email or submit job applications. At a display table set up for ongoing mental health awareness, clients can pick up swag and seasonal items such as towels or chapstick.
Staff Space
Staff have a well-appointed break room as well as individual cubicles behind a soundproof, glass partition where they can focus but still see what’s going on. A centrally-placed document shredder signifies the importance of protecting clients’ private health information and other confidential data.
Future Spaces
APT Foundation hopes to build a brand new Access Center in New Haven, adjacent to its present Long Wharf location at some point in the future – it will be a chance to reinforce and refine these and other successful design choices. An entirely new location along the shoreline is also in the works, along with a mobile treatment program.
Upcoming Related Research
Patient Perspectives on an Open Access Model for Methadone Treatment – the foundational paper that provides a base of evidence for this approach.
Special thanks to Diane Potwardowski, Program Director at APT’s West Haven Clinic, and Lynn Madden, PhD, MPA, for hosting the site visit. This article is cross-posted on the blog for Red Rock Branding.