By Stephen Parker, AIA, NCARB, LEED AP
Editor’s note: This article contains a personal account of a family’s experience of psychiatric hospitalization and electroconvulsive therapy (ECT). We recognize that these experiences can be difficult to read about and that experiences of mental health care and treatment vary from person to person.
Every line we draw can define the life of another.
For architect Stephen Parker, that idea is anything but abstract. Years spent designing mental and behavioral health environments had taught him to think carefully about safety, dignity, choice and the human consequences of design decisions.
Then mental health care became deeply personal.
What followed changed not only how Stephen saw the environments he helped create, but how he thought about family, belonging, sensory experience and the responsibility carried by every line on a drawing.
A Birth, a Diagnosis, a Different Perspective
The same week Stephen and his wife welcomed their first child, Jack, into the world, Stephen’s father was admitted to his local emergency department and placed on a 72-hour psychiatric hold.
One of life’s greatest moments of joy arrived alongside a profound sense of loss.
As an architect dedicated to designing mental and behavioral health environments, it was a deeply personal reality check. Stephen had spent years shaping spaces intended to support healing and recovery, but he came to see those environments in an entirely different light when the person relying on them was someone he loved.
Suddenly, decisions about bedrooms, corridors, social spaces, privacy, storage, acoustics and visiting arrangements were no longer professional considerations alone. They were shaping his father’s daily experience, and his family’s ability to remain connected to him.
[Image: Stephen’s sketch of the long corridors and door-lined social spaces within the recently renovated behavioral health unit where his father received care.]
This was not his father’s first experience of severe mental ill-health. Years earlier, a complex interaction of prescribed medications had coincided with profound paranoia. An inpatient stay and a revised medication regimen had eventually enabled him to return to everyday life.
Stephen already had some understanding of the environments his father might encounter. His architectural thesis had explored traumatic brain injury (TBI) and post-traumatic stress injuries (PTSI), informed by the experiences of friends returning from military service. He was also working on the U.S. Department of Veterans Affairs’ new Inpatient Mental Health and Residential Rehabilitation Treatment Program Design Guide.
Professionally, he knew the challenges.
Personally, nothing prepared him for them.
When the Environment Becomes Part of the Experience
Two weeks later, amid the haze of midnight feedings and diaper changes, FaceTime calls with family eight hours away painted a difficult picture.
Stephen’s father was staying in a recently renovated behavioral health unit at his local hospital. He shared a bedroom with another person, an arrangement the family felt intensified his distress, paranoia and confusion.
The room itself offered little respite.
[Image: Stephen’s sketch of the dual-occupancy patient bedroom, including its locked stainless-steel headwall.]
Newly furnished but stark, the dual-occupancy room was dominated by a locked stainless-steel headwall. Personalization, color and other points of visual interest were limited.
For Stephen, the experience raised a question that would recur throughout the months ahead:
When someone is experiencing profound distress, what is the environment communicating to them?
Is it communicating safety and care? Or containment?
Does it provide privacy, choice and a sense of normality? Or does every feature reinforce that the person has entered an institution?
These questions are rarely answered by a single design feature. Mental health environments have to balance complex clinical, operational and safety requirements. But those requirements do not make the human experience of the environment any less important.
Fifteen Minutes With Someone You Love
With a newborn at home, Stephen initially could not travel to see his father or be physically present with his mother and brothers. His family navigated those first weeks without him, something he describes as one of the greatest regrets of his life.
Months later, his father was transferred to another facility several hours from his hometown. A course of electroconvulsive therapy (ECT) followed.
Family visits were limited to 15 minutes per day, for no more than two family members.
For Stephen’s family, that meant a five-hour round trip for a quarter of an hour together.
[Image: Stephen’s sketch of the combined dining, activity and visiting space, where several families could be visiting at the same time.]
Those few minutes often took place in a shared group or dining room alongside other families trying to reconnect with their own loved ones.
Privacy was minimal.
Conversations overlapped. Families witnessed one another’s distress. Just as a meaningful conversation began, the visit could be over.
Fifteen minutes is short in any circumstance. It can feel impossibly short when the person you love is experiencing a reality profoundly different from your own.
Even finding the unit added another layer of stress. Visitors navigated complex hospital corridors before arriving at nondescript double doors, uncertain about how to enter and what belongings, food or clothing they would be permitted to bring inside.
The experience prompted another question:
If family relationships can be an important part of care and recovery, what would it mean to design spaces that genuinely support those relationships?
The Sensory Experience of Treatment
On ECT treatment days, the family’s 15-minute visit could sometimes extend to around an hour and a half.
That additional time was precious, but the setting mattered.
Before treatment, visits took place in a pre-operative bay separated by thin curtains, offering little acoustic or visual privacy. After treatment, the family could stay a little longer, offering food, reassurance and company during recovery.
Stephen became increasingly conscious of the entire sensory experience surrounding care: sound, privacy, lighting, unfamiliar equipment, materials, movement and the ability, or inability, to control what was happening around you.
The lesson extended beyond any individual room.
Care does not happen separately from the environment. It happens within it.
Finding Belonging in the Smallest Details
During a tour of his father’s room, Stephen noticed personal belongings spread across almost every available horizontal surface.
The visual clutter reflected a simple problem: there was nowhere obvious for those belongings to go.
For someone temporarily living in an unfamiliar environment, personal possessions can carry meaning well beyond their practical use. They can provide familiarity, identity and a connection to life outside the unit.
Stephen found himself asking:
If our belongings do not have a place, how can we belong in this space?
That observation eventually helped inspire a collaboration to develop the Clark Compartment, a modular, open storage concept designed to make use of the often-underused floor space created by chamfered corners in mental health environments.
[Image: Clark Compartment, a recessed psych-safe storage concept designed to provide useful personal storage while integrating into the room.]
It was a relatively small intervention born from a much larger principle: dignity and belonging are often communicated through everyday details.
Designing for the Whole Person
After ten rounds of ECT, Stephen’s father returned home.
What followed was more than a year of difficult care involving his mother, relatives, friends and a daytime caregiver, alongside an ongoing search for a setting able to meet his complex needs.
Finding appropriate care for an older person experiencing psychiatric symptoms alongside medical frailty proved particularly difficult. He could fall between conventional service models: too clinically complex for some settings, while not meeting the criteria for others.
That experience sharpened Stephen’s interest in environments capable of supporting people with combined medical and psychiatric needs.
It contributed to his participation in the Sextant Foundation’s Med-Psych Workshop during the Association of Medicine and Psychiatry meeting in Milwaukee, at a time when the Facility Guidelines Institute’s proposed Complex Medical Units were open for public comment. Later, he worked with a modular manufacturer to develop a new med-psych patient room prototype.
Having worked on hundreds of med-psych beds across the United States and Canada, Stephen saw an opportunity to ask a broader question: Can environments meet demanding safety and medical requirements without unnecessarily stripping away dignity, familiarity and sensory comfort?
From Barriers to Boundaries
Too often, he had encountered patient spaces where amenities had been removed in the name of risk management.
In some settings, garage-style doors had been installed to close off headwalls and sinks. While intended to address operational and safety requirements, their visual and acoustic presence could also make an already unfamiliar environment feel more institutional.
For Stephen, the issue was not whether safety mattered. It was whether safety and humanity had to be treated as competing objectives.
[Image: Sensory-Enabled Architecture (SEA), exploring immersive and neuroinclusive approaches to environmental experience.]
The challenge became one of designing boundaries rather than simply building barriers.
How might safety features be integrated more thoughtfully? How could an environment support clinical care while also considering sound, touch, light, familiarity and choice? And how might sensory experience become part of the design brief rather than an afterthought?
What Does a Mental Health Environment Communicate?
Eventually, after several placements had proved unsuitable, Stephen’s father found a secure unit able to accept him.
Across the different facilities the family encountered, Stephen noticed recurring patterns: long corridors, limited daylight and views, social spaces surrounded by doors and environments that could be difficult for visitors and people receiving care to navigate.
The cumulative effect mattered.
Having to constantly read an unfamiliar environment, searching for the correct door, watching who can enter where, working out where you are permitted to sit or move, can add to the cognitive and emotional load of an already difficult experience.
We can design better. We should design better. And we have a better chance of doing so together.
For Stephen, that meant thinking much more seriously about how families are integrated into care and how their experience connects with the expertise of people who have themselves received mental health care.
Drawing Out a Better Visiting Experience
That exploration led to DrawnOut!, a series of mental health sketch workshops combining drawing with listening.
Working with friends and fellow designers Emily Schnicker and lived experience expert Shahad Sadeq, Stephen began asking designers, clinicians and others to reconsider one of the few spaces most members of the public ever encounter inside a secure behavioral health facility: the visiting space.
[Image: DrawnOut! Mental Health Sketch Workshop.]
The workshops have since taken place internationally, generating hundreds of sketches and conversations about what visiting environments could become.
At their heart is a deceptively simple idea: family presence should not be treated as an inconvenience to accommodate after the clinical environment has been designed.
Where family involvement is appropriate to a person’s care, the environment should be capable of supporting it with dignity.
The workshops also became Stephen’s introduction to the Design in Mental Health Network and, later, his election to the DiMHN Board as an Associate, becoming one of the Network’s American representatives.
For Stephen, drawing had come full circle.
Each line really could define the life of another.
What Happens When Community Has Ownership?
Stephen saw another expression of this principle through his work on the Aqqusariaq Nunavut Recovery Centre in the Canadian Arctic.
Aqqusariaq means “”a trail you go through to reach your destination,”” in Inuktitut. The project takes a “Made in Nunavut” approach, shaped around the needs, culture and experiences of Inuit communities.
Rather than focusing only on an individual’s recovery and then returning that person to an unchanged home environment, the model recognizes the importance of kinship and community, including opportunities for family units to participate in care.
A Cultural and Lived Experience Advisory Council (CLEAC) helped shape the project from the beginning. The voices of elders, youth, families and lived experience individuals are all
That distinction matters.
Lived experience should not simply have a seat at the table after the important decisions have been made. Meaningful collaboration means sharing influence over the questions being asked, the priorities being established and the environments ultimately created.
[Image: Aqqusariaq Nunavut Recovery Centre, winner of Project of the Year – Future Design (International) at the 2026 DiMHN Awards.]
The project reinforced another lesson for Stephen: every design decision represents a choice about what, and whom, we value.
Where Do We Choose to Spend the Design Dollar?
Walking through newly completed facilities, Stephen often finds himself following the money.
Investment is visible in dramatic entrances, large lobbies and architectural gestures designed to make an immediate impression.
But what happens deeper inside the building?
Could some of that investment create a better patient bedroom rather than one designed to the minimum requirement?
Could it give someone greater independence in using a bathroom?
Could it provide better visiting spaces, quieter environments, useful storage, access to daylight or a meaningful choice about where to spend time?
This is not an argument against architecture with ambition or beauty.
It is an argument for asking where design investment can create the greatest human value.
What would change if the success of a mental health project were judged not only by its opening-day photographs, but by the everyday experiences of the people who live, visit and work there?
From a Courtyard to the Bench
On another project, Stephen toured a decommissioned facility on a beautiful tropical island.
Beyond its walls was lush vegetation. Inside the courtyard were concrete, steel and limited seating.
Yet the people who had used the space had tried to transform it themselves. Flowers and blossoms had been painted across walls and concrete benches, bringing color and personality into an otherwise hard environment.
Stephen also noticed younger people using furniture in ways designers might not have anticipated, lounging, climbing, stretching and repositioning themselves as they socialized or self-regulated.
Those observations stayed with him on the flight home.
A few rapid sketches became the beginnings of the new, biophilic-inspired bench concept.
Its curved form was intended to support different ways of sitting and gathering. Arranged together for group use, the benches form the petals of a flower.
[Image: Seating prototype of the Blossom Bench, inspired by a tropical site visit and observations of how people use furniture to self-regulate, socialize and recover in ways that work for them.]
The concept was only possible through collaboration: people willing to share their experiences candidly, a care provider with a real challenge to address, a designer prepared to listen and a manufacturing partner willing to explore a different response.
Those are precisely the kinds of connections the Design in Mental Health Network’s North American community seeks to strengthen.
Every Line Defines a Life
Mental health environments are not simply containers for care.
They are places where people may experience some of the most difficult and vulnerable moments of their lives. They are workplaces. They are places families wait, worry, reconnect and hope. And, for a period of time, they may become someone’s home.
Design cannot solve every challenge within mental health care. It cannot replace compassionate relationships, appropriate treatment, adequate staffing or well-designed systems of care.
But design is not neutral either.
A door, a bedroom, a chair, a window, a visiting room or somewhere to keep your belongings can influence whether an environment feels understandable or confusing, dignified or institutional, connecting or isolating.
For Stephen, that responsibility is now impossible to separate from his family’s experience.
Every line on a drawing represents a decision.
And every decision is an opportunity to ask a better question:
How will this affect the person who eventually lives, works, visits or receives care here?
As the Design in Mental Health Network grows its North American community, our aim is to create more opportunities for those questions to be explored together, bringing lived experience experts, families, clinicians, caregivers, facility owners, architects, designers, researchers, manufacturers and other partners into the same conversation.
Because better mental health environments will not come from one discipline having all the answers.
They will come from listening, learning, sharing influence, and designing with people in mind.
Join the Design in Mental Health Network – North America
Better mental health environments are created when we bring different perspectives together. Design in Mental Health Network – North America is building a community of people with lived experience, families, clinicians, caregivers, designers, architects, researchers, facility leaders, manufacturers and others who share an ambition to improve the places where mental health care and support happen.
Join the Network and help us turn shared experience, evidence and ideas into better mental health environments across North America.
About Stephen Parker
Stephen Parker, AIA, NCARB, LEED AP, is a licensed architect and internationally recognized specialist in mental and behavioral health facility design. Elected as an Associate to the Board of the UK-based Design in Mental Health Network, Stephen is also founding member and advisor of the DiMHN North America Chapter.
With more than 15 years of experience designing health care environments, Stephen co-led the Mental + Behavioral Health practice at international architecture and engineering firm Stantec from 2021 and now serves as Chief Design Officer at Sage Collaborative, an independent design consultancy.
His work spans the Arctic to Australasia and includes sensory spaces for students, autism centers for children and behavioral health facilities serving a wide range of populations. His clients have included Cleveland Clinic and Kaiser Permanente.
Stephen’s professional recognition includes Healthcare Design magazine’s Healthcare Architect of the Year, Engineering News-Record’s National Top Young Professional, RIBA Rising Star and Behavioral Health Business Future Leader. He was also named to Healthcare Design’s Best Under 40 list by the AIA Academy of Architecture for Health.
He was the youngest architect elected to the AIA Strategic Council, where he championed its Mental Health and Architecture Incubator during the pandemic. He also co-authored the U.S. Department of Veterans Affairs’ Inpatient Mental Health Design Guide and has contributed to design standards for health systems across North America.
Stephen serves on Johns Hopkins University’s Arts + Minds Lab Intentional Spaces Initiative, supporting greater research rigor in neurospatial, neuroarchitecture and neuroaesthetic design. His published research includes work on adolescent crisis environments, Sensory-Enabled Architecture (SEA) and other mental health environments in the United States and United Kingdom.
He has lectured at Harvard University, Texas A&M University, the University of Kansas, Clemson University and Kent State University, and has presented to conferences and organizations internationally.
Stephen was appointed by the AIA President to the International Union of Architects’ Public Health Group.
He is also a founding member of The Center for Health Design’s Behavioral and Mental Health Environment Network, a member of the Academy of Neuroscience for Architecture (ANFA) and the American Association for Emergency Psychiatry (AAEP), a Pathfinder Fellow with the Centre for Conscious Design and a practitioner with the Trauma-Informed Design Society.
