Infrastructure.

Our nation's infrastructure is aging. The tragic bridge collapse in Minneapolis last month was a stark reminder of the billions, if not trillions, of dollars needed to maintain, monitor, and update our transportation network, utilities, and other "background" features that keep 21st-century America running.

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Healthcare facilities are part of this critical infrastructure, and I'm not talking about just acute-care hospitals. Outpatient, residential, and inpatient behavioral health facilities are vital elements of our nation's core infrastructure, at which people often shunned by society receive treatment and learn how to become more productive citizens. While we usually are preoccupied with the state of behavioral health services, the state of the facilities in which they take place cannot be ignored.

For example, more welcoming treatment environments might help to reduce the stigma associated with mental health and substance use disorders. Eschewing drab offices and institutional patient areas, modern behavioral health settings include more windows, brighter colors, and roomier spaces. These friendlier, more welcoming environments might help draw in more people suffering with behavioral health disorders but not receiving treatment. Such environments might lead to better outcomes too (there's plenty of evidence for this in physical healthcare particularly).

But this is about more than just aesthetics. Older buildings usually weren't constructed with energy efficiency in mind. With electricity and natural gas prices marching upward, and funding stagnant at best, behavioral health organizations would be wise to find ways to minimize operating costs, especially in renovated or new facilities. Some behavioral health agencies are even embracing "green" design, using recycled materials and energy-efficient mechanical systems in their buildings. The renovated Southeast Regional Treatment Center in Indiana has gone green (see page 30), and others are in the process of doing so (see the June issue, page 38).

Yet like many aspects of our nation's infrastructure, many behavioral health organizations often can't do much more than maintain the buildings they have. But even little changes can make a big difference. If you are repainting a waiting area, choose bright yellow instead of "medical office beige" (I wonder if you could find that on a paint swatch). Take down those crusty drapes and let the sunlight in (HGTV watchers--put your skills to the test!). If you are replacing your HVAC system, consider a more energy-efficient model. And if you have the dollars for new construction or renovation, look into the U.S. Green Building Council's LEED rating system (www.usgbc.org/DisplayPage.aspx?CategoryID=19).

Your buildings might not be your top priority as you juggle your daily demands. But I suspect that making your treatment center more welcoming, reducing your operating costs, and being a more visible anchor in your community are among your organization's strategic goals.

Douglas J. Edwards

Editor-in-Chief

dedwards@vendomegrp.com