Process improvement for behavioral health

Offer a Safe, Private, and Clean Physical Environment


Clients do not feel safe and private in your facility.


Provide an inviting and cheerful physical environment that allows for privacy.

Featured Stories

Perinatal Treatment Services in Seattle, Washington commissioned a mural of baby animals with their mothers to make their reception area less institutional and more inviting to pregnant women and mothers. They also started doing assessments in a separate room so that clients would have more privacy when answering sensitive questions. They offered clients refreshments during the admission process. For more information, see the case study.

Central New York Services in Syracuse, New York added soothing music, plants, and posters to create a more welcoming environment. They also provided beverages and reading materials for clients waiting for an appointment. For more information, see the case study.

Lessons Learned

  • Provide clear directions about how to find the agency to prospective clients, particularly if signs are not prominent in order to protect confidentiality about where clients are going.
  • Reassign room designations to ensure privacy.
  • Provide refreshments to clients waiting for assessment and treatment.
  • Provide books, magazines, and newspapers in the waiting area.
  • Display client-contributed works of art.

Tracking Measures

Due to the nature of this promising practice, it’s better to just make the changes and get informal feedback about whether the changes are improvements. Just do it.



  • 1. In addition to what you learned in your walk-through, solicit feedback from your staff and clients about the physical environment of your reception area.


  • 2. Make simple changes that will improve the attractiveness of your reception area and ensure privacy.


  • 3. Check the fidelity of the change. Was the change implemented as planned?
  • 4. Evaluate the change:
    • Do clients report that they were able to find the agency easily?
    • Do returning clients find your agency more attractive and inviting?
    • Do your staff members find their work environment more attractive?


  • 5. Adjust the changes that you have made or continue to make additional changes to the physical environment and re-evaluate this promising practice for an additional two weeks.

Repeat this series of steps until you have made all of the desired and feasible changes to the physical environment.

More Stories

CAB Health and Recovery Services in Peabody, Massachusetts, in direct response to a client survey, added a separate, private space for clients to answer confidential questions. They renovated the outpatient services space to increase the amount of private counseling and work space. They created a warmer and more welcoming environment with new paint, new carpeting, client artwork, and magazines. For more information, see the case study.

Mid-Columbia Center for Living in The Dalles and Hood River, Oregon made their waiting room more inviting by bringing in plants, by using floor lamps instead of overhead fluorescent lighting, and by changing their window treatments. For more information, see the case study.

Palladia, Inc. in New York City, New York worked with their Continuing Care Treatment clients to get ideas about how to upgrade the physical environment of their agency so it would be more welcoming. For more information, see the case study.

Catalyst Behavioral Health in Oklahoma City, Oklahoma moved the intake counselor’s office from the back of the building to the front, right next to the waiting area where new clients fill out intake paperwork. This alleviated clients’ anxiety about walking down a long unfamiliar hallway to get to the intake counselor’s and also staff’s discomfort about having unknown people walking by their offices.