The Pueblo Behavioral Health Center was designed to contribute to public safety and positive healthcare outcomes. | Photo Credit: Treanor
By Jeff Lane, Treanor
Across the country, healthcare systems are increasingly called upon to respond to behavioral health crises manifesting within correctional environments. Jails and detention centers, often ill-equipped to address the needs of individuals with untreated mental illness or substance use disorders, are seeing growing demand for solutions that blend treatment with security. Counties are turning to healthcare-informed facilities that deliver services to justice-involved individuals with dignity and rigor. The key to their success lies in pre-planning — establishing a healthcare-first mindset from the outset to determine whether facilities support healing, enable licensure and deliver measurable outcomes for patients and communities alike.
Defining the Care Model Early
One of the biggest challenges in pre-planning is defining what the project should be. At the Pueblo Behavioral Health Center in Pueblo, Colo., leaders initially envisioned a hybrid of opportunities and spaces. As the concept design evolved and expenses mounted, they removed the detox and substance abuse wings to focus solely on behavioral and medical health. Because the facility was tied to the jail, intake areas also became part of the program.
The decision to operate under a healthcare license or as a diversion/detention program dramatically impacts reimbursement models, staffing and design codes. A detention-based program may be faster to establish and eligible for more grant money, but it lacks access to federal or state reimbursements. In contrast, licensed healthcare facilities require more stringent design and operational standards but open the door to long-term funding. Architects and planners must therefore design spaces flexible enough to evolve, ensuring hospital-level requirements such as room sizes and corridor widths are met from the start.
Workshops play a critical role in guiding stakeholders toward clarity. In Kansas City, a one-day workshop with Department of Corrections representatives helped define the facility’s function. Through open-ended questions — such as, “What is the end goal?” and “How do we measure success?” — the team aligned around outcomes like reducing violent incidents and supporting de-escalation.
This illustrates how deliberate engagement at the planning stage can transform vague ambitions into measurable objectives. Early clarity sets the stage for tackling one of the most complex tensions: balancing security with therapeutic care.
Navigating the Tension Between Safety and Care
Facilities that straddle behavioral health and justice must balance two imperatives: public safety and healthcare outcomes. Stakeholders — law enforcement, clinicians and state or county leaders — often bring dynamic priorities. Law enforcement may emphasize security, while clinicians prioritize therapeutic care. Early alignment around shared goals, such as reducing recidivism or improving continuity of care, helps bridge the divide.
At Pueblo, the program targeted low-risk offenders with severe mental illness. Participants entered a 45- to 60-day program where their medications were monitored, preparing them for release with community support systems. This model highlights how facilities can meet both security and clinical needs — supporting rehabilitation rather than containment.
The challenge is not just aligning these goals, but embedding them into the architecture itself. Design choices can reinforce safety while creating dignity-driven environments that support recovery. Pre-planning enables decision-makers to set a course where public safety and clinical outcomes are not opposing forces but complementary objectives. Striking this balance naturally leads to the next consideration: designing environments that not only secure but also heal.
Designing Environments for Clinical Care in Nontraditional Settings
Correctional facilities have historically been built with punitive rather than therapeutic environments. Yet surroundings profoundly affect behavior, safety and recovery. Interviews with inmates at Pueblo revealed a desire for spaces that did not resemble a traditional correctional atmosphere. In response, the facility incorporated softer design elements — wood ceilings, aluminum frames, glass and open staff workstations without barriers. Though the exterior perimeter remained secure, the interior projected dignity and normalcy.
For facilities that may one day seek healthcare licensure, embedding clinical design standards is essential. Elements like corridor widths, air quality, lighting and material selections not only enhance comfort but also ensure regulatory compliance. These choices make it possible for a facility to evolve into a hospital-level setting without costly renovations. In practice, this means designing for healthcare even in environments not yet licensed — ensuring flexibility for the future.
Rather than reinforcing punitive environments, facilities are embracing therapeutic design as a clinical tool. By creating normalized, human-centered settings, architects can reduce stress, support treatment and improve outcomes for patients and staff alike. Designing for care within carceral walls also enables another critical function: capturing the data needed to prove these approaches work.
Stay tuned for Part II of this article, which will focus on incorporating data collection, facility growth and program evolution into facility pre-planning.
Jeff Lane, AIA, is a principal with Treanor’s Justice Design studio.