Speakers from a variety of backgrounds, including architecture, lighting engineering, and nursing, discussed how to support behavioral health care through facility design and lighting at the HDC Virtual session “Advancing Care In Behavioral Health Through Lighting.”
Specifically, the speakers, including Meredith Banasiak, director of research at Boulder Associates Architects; Andrea Wilkerson, lighting research engineer at Pacific Northwest National Laboratory; Jill Eriksen, director of nursing at Boulder Community Health; and Carolyn Schilling, senior associate at Boulder Associates Architects, discussed how to use tunable lighting, which mimics the natural progression of sunlight throughout the day, changing in spectral content and intensity from an increase in short wavelength (blue) morning light to a warm long wavelength (red) energy at the end of the day. “Because light is a synchronizing agent for the circadian system, tunable lighting may potentially benefit persons vulnerable to circadian rhythm disorders such as nightshift workers who may experience chronic circadian misalignment and patients experiencing sleep-wake disruptions caused by medication, substance use, depression, or mental illness,” said Banasiak.
Furthermore, compared to a traditional static lighting system, a dynamic light experience provided by a tunable lighting system can also offer a surrogate connection to the outdoors and nature by simulating the passage of time over the course of a day. “This is important for patients who remain largely inside the unit for about a week on average where it’s easy to lose a sense of time and a connection to the external world,” Banasiak said.
Additional benefits to patients may go beyond circadian impacts, as well. “This behavioral cuing supports patient autonomy in guiding their behaviors rather than needing to be directed by a staff person,” Schilling added.
Boulder Associates designed and integrated a tunable system for a newly constructed inpatient behavioral health facility for Boulder Community Health in Boulder, Colo. The experience provided further insight into tunable lighting, including some challenges, which the speakers shared during their presentation. For example, Banasiak said substantial additional work and coordination was required to ensure a fully integrated solution before and after occupancy. “About a month after occupancy, it was discovered that lights were running at different color temperatures, and the system had control and driver issues interfering with transitions between program settings,” she said.
Another issue is the lack of tunable behavioral health lighting fixture options, compared to static lighting fixture options. However, during the Boulder Community Health project, the project team was able to program for competing user needs such as the need for darkness for patients during nighttime hours, but alertness for staff during that same time. “Individual users require different light levels for different purposes and different personal exposure,” Schilling said. “Tunable lighting affords us the ability to program for those variations.”
In closing, the speakers noted the need for more research to bridge the gap between benchtop and bedside. “We need greater confidence that the spectral content and intensity which we are programming for is indeed what people are experiencing,” Banasiak said.
Tracey Walker is managing editor of Healthcare Design. She can be reached at firstname.lastname@example.org.