ANN ARBOR, Mich. - Even on a gray winter day, the space is bright and welcoming, the furniture elegantly accented with leaves and flowing designs. When you first walk in, you might think you had entered a boutique clinic rather than the University of Michigan Health System's facility for psychiatric patients during their most severe periods of illness.

But if you look beyond the warm wood trim and open, airy design, you start to notice the carefully thought-out improvements that make the newly remodeled inpatient unit simultaneously more functional and safer for U-M patients and staff.

The large glass windows fronting the rooms off the main corridors let in more natural light, but they also create better sightlines for staff. No longer behind a wall of glass, the clerks' desks look as elegant as anything you'd find at an upscale hotel - but an extra 10 inches of depth provides an invisible buffer.

"It really brings us into the 21st century," says Michael Casher, M.D., the medical director of the unit on University Hospital's 9th floor. "In addition to the safety features, this brings the atmosphere of the facility up to the high standard of the medical, psychiatric and nursing care that we provide."

The final touches are just being put on the $3.8 million remodel approved by the University's Board of Regents in September 2008. Other changes include the flexibility to turn a section of the unit into a secure intensive care unit. Upgrades also include a new library, Internet terminals for patients to use and updated fixtures in bathrooms and patient rooms specially designed for patient safety. Books for the library and other enhancements were donated by grateful patients and supportive community members.

Generous donations also allowed the wall outside of each patient's room to display a colorful tile from Ann Arbor's Motawi Tileworks. 

"They might not remember their room number, but they might remember they're in the room with the boat or the castle or the knight," says Michael Kraft, R.N., B.S.N., M.P.H., the unit's nurse manager.

Nowhere are the nuances of the overhaul more evident than in the intensive care unit, which offers special facilities to treat disruptive patients while at the same time separating them from others.

Unfortunately, even on the very best units, the potential exists for patient self-harm. Accordingly, aspects of the remodel were designed to minimize that risk. For example, mirrors and light fixtures are virtually unbreakable and many surfaces are designed so nothing can be wrapped around them.

Other improvements to the unit include:

• a new activity therapy room,
• a dining room accessible to patients all day,
• a large tub room for bathing patients,
• improved patient access to exercise facilities,
• exercise equipment on the unit as a result of a gift,
• and upgraded waiting and post-treatment areas for outpatient electroconvulsive therapy.

The remodel also creates the potential to add three more beds to the 22-bed unit in the future.

Along with the physical changes, over the last several years, U-M has emphasized a "hospitalist" approach to care, which centers on a team of psychiatrists who specialize in providing care in a hospital setting.

"The patients who are hospitalized have a major mental illness," Casher says. "It might be schizophrenia, severe depression, bipolar disorder or a personality disorder. We routinely take care of these patients when their illnesses are at their most acute, and as a result, our psychiatrists are adept at working with people who are in crisis. We understand their needs.

"As an academic psychiatric center, our program also offers the latest innovative treatments, therapies and programs."

The inpatient program is broken into three sub-specialties - mood disorders, thought disorders and geriatric psychiatry - and each focus area includes a dedicated team of psychiatrists, nurses, social workers and activity therapists.

The unit also links closely with U-M's Psychiatric Emergency Services, located at University Hospital, which is one of only two 24-hour emergency rooms in southeast Michigan for people in mental health crisis.

"This simultaneous overhaul of our physical space and our treatment programs allows us to provide a seamless continuum of high-quality care, from emergency to inpatient to outpatient," says David Knesper, M.D.,director of U-M's Hospital Psychiatry Section.

Gregory Dalack, M.D., chair of the Department of Psychiatry, agrees.

"The project represents a major commitment on the part of the U-M Health System to caring for the mental health needs of our community, and continuing our mission of improving care and safety for patients," Dalack says.

For more information about U-M's psychiatric care, visit the Department of Psychiatry's website at www.psych.med.umich.edu.

You can take a photographic tour of the unit at http://bit.ly/UMHSphotos. (Note: No actual patients appear in the photos; those pictured are either staff members or models.)