HCS 446 Week 2 Facility Selection and Research Example

Three Sites, One Bus Line and Nineteen Hours of Boarding: Selecting and Researching the Facility Type and Location for a Behavioral Health Crisis Center

[Student Name]

University of Phoenix

HCS/446: Facility Planning

Week 2 Assignment

[Instructor Name]

[Date]

The county, the candidate sites and the demand figures are composites written for a model paper; guidance and research come from the sources listed.

Last week's paper described the design process for a composite county's first behavioral health crisis receiving center. Before any floor plan is drawn, the planning team had to confirm that a crisis center is the right facility and decide where it should stand. This section presents that research: the facility type and its alternatives, the users it will serve, the estimated demand and the scoring of three candidate sites.

The Problem

County emergency departments recorded about 6,900 visits last year by adults in psychiatric or substance use crisis. Adults who needed further care waited a median of 19 hours in the emergency department before transfer or discharge. Nordstrom et al. (2019), in a resource document from the American Psychiatric Association, described emergency department boarding of patients with mental illness as widespread and harmful, noting that emergency departments are often loud, crowded and poorly suited to people in crisis and that boarding delays treatment.

The Facility Chosen

A crisis receiving and stabilization center accepts adults in crisis at any hour, whether they walk in, are brought by family or arrive with police or a mobile crisis team. Staff assess and treat each person, most go home within 23 hours with a plan and some stay several days in a short-term unit. The 2025 federal crisis care guidelines (Substance Abuse and Mental Health Services Administration, 2025) describe such facilities as the somewhere-to-go element of a crisis system and recommends that they accept all referrals, including police drop-offs, without turning people away. The earlier federal toolkit had already listed round-the-clock staffing and acceptance of walk-ins and first responder drop-offs among the essential features of such facilities (Substance Abuse and Mental Health Services Administration, 2020).

Alternatives Considered

The team compared three alternatives. More inpatient psychiatric beds would help people needing hospital care but would not help the majority whose crises resolve in a day. A psychiatric emergency unit inside a hospital emergency department would improve care for patients already there but would not give police an alternative to jail. A mental health urgent care clinic open limited hours would serve walk-ins but not overnight crises or police transports. The crisis center was the only option that addressed all three gaps.

Demand Estimate

Planners combined three sources. Of the 6,900 emergency visits, clinical staff estimated that 60%, about 4,100, could have been served at a crisis center. Police records showed about 2,300 transports a year for mental health reasons to emergency departments or jail, about 1,700 of which could go to the center. Crisis line data suggested 2,700 callers a year who needed a place to go but had none, of whom about a quarter would come. Allowing for overlap, the first-year estimate is about 8,500 visits, roughly 23 a day, with a peak between 6 p.m. and 2 a.m.

Users and How They Arrive

The building must serve several groups arriving in different ways. Walk-ins and families arrive by car or bus, often upset. Police arrive in patrol cars and need to hand over a person within ten minutes, the county's target, so officers return to duty. Mobile crisis teams and ambulances bring people who may be medically unwell. Staff work 12-hour shifts around the clock. Peer specialists, security staff and visiting family complete the picture. A crisis center has two front doors because its users do not arrive the same way or in the same state.

Site Criteria

Before scoring sites, the steering committee set seven criteria with weights totaling 100: transit access, 20; police drive time from the county's patrol districts, 20; proximity to a hospital emergency department for medical transfers, 15; zoning that allows the use, 15; neighborhood acceptance, 10; size and room for parking and a secure vehicle entrance, 10; cost, 10.

Site A: A Former Urgent Care Building

A vacant one-story building of 18,000 square feet on a bus line, two miles from the county's largest hospital, zoned for medical offices. It needs an addition of about 6,000 square feet. Weighted score: 84.

Site B: County Land Beside the Jail

Free land and short police drive times, but no bus service, 11 miles from the nearest hospital and a strong risk that people will see the center as part of the jail. Weighted score: 58.

Site C: A Downtown Warehouse

Excellent bus access and central location, but industrial zoning requiring a variance, a large renovation and objections already raised by a business association. Weighted score: 66.

Community Engagement

Neighborhood acceptance carried only 10 points, but the committee treated it as a potential veto. Before scoring, the project director met with the neighborhood association near each site. Residents near Site A asked about loitering, parking and whether people would be released onto the street at night. The provider agreed to arrange rides home or to shelters for anyone discharged after dark, to keep parking on its own lot and to create a neighborhood advisory group that meets quarterly for the first two years. The association's letter of support became part of the zoning file, and the same commitments were written into the functional program so that the floor plan would provide a covered pickup area.

Recommendation

Site A scored highest. It is reachable by bus, within 15 minutes of most patrol districts, close to the hospital for medical transfers and already zoned for health care. Its main drawback, the need for an addition, is manageable, and its location away from the jail supports the center's aim to be seen as care rather than custody.

Questions for the Floor Plan

The site raises design questions for next week: where to place the separate police entrance on a corner lot, how the addition will connect to the existing building and how to keep the walk-in entrance welcoming while meeting safety needs.

Conclusion

The research confirmed that a crisis receiving and stabilization center is the facility the county needs, because it alone serves walk-ins, police drop-offs and overnight crises. First-year demand is estimated at about 8,500 visits. Scoring three sites against weighted criteria points clearly to the former urgent care building, which gives the floor plan a defined space to work within.

References

Nordstrom, K., Berlin, J., Nash, S., Shah, S., Schmelzer, N., & Worley, L. (2019). Boarding of mentally ill patients in emergency departments: American Psychiatric Association resource document. Western Journal of Emergency Medicine, 20(5), 690-695. https://doi.org/10.5811/westjem.2019.6.42422

Substance Abuse and Mental Health Services Administration. (2020). National guidelines for behavioral health crisis care: Best practice toolkit. https://www.samhsa.gov/sites/default/files/national-guidelines-for-behavioral-health-crisis-care-02242020.pdf

Substance Abuse and Mental Health Services Administration. (2025). 2025 national guidelines for a behavioral health coordinated system of crisis care (PEP24-01-037). https://library.samhsa.gov/sites/default/files/national-guidelines-crisis-care-pep24-01-037.pdf