HEALING ADOLESCENT ENVIRONMENTS (HAVEN): A TRAUMA-INFORMED FRAMEWORK AND TOOL FOR DESIGNING ADOLESCENT MENTAL AND BEHAVIORAL HEALTH FACILITIES
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The adolescent mental and behavioral health (A-MBH) crisis is increasingly recognized as one of the most pressing public health challenges facing the United States today. Sharp increases in the prevalence and acuity of A-MBH conditions have prompted recent efforts to address the crisis, including improving access to timely, evidence-based prevention and treatment services. However, the physical contexts in which these programs are implemented have received far less consideration, despite mounting evidence that the design of these environments can meaningfully shape therapeutic experiences and outcomes. This doctoral research employed a multi-phased, mixed-methods approach to address this gap. Study 1 synthesized existing evidence and insights from expert interviews (N = 15) to identify critical considerations for designing A-MBH facilities and to establish a framework linking the developmental and therapeutic needs of adolescents to specific environmental features. In Study 2, this framework was operationalized into the Healing Adolescent Environments (HAVEN) tool for evaluating A-MBH facilities, which was refined through expert review (N = 22) and underwent preliminary validation through a national staff survey (N = 139). A youth-adapted version of the tool was also developed to support adolescent involvement in future applications. Finally, the complete staff survey was analyzed in Study 3 to identify design priorities and implementation gaps in existing A-MBH facility design, demonstrating the practical utility of the HAVEN tool and informing a set of design guidelines to support future research, policy, and design practice. Together, these studies advanced a trauma-informed, evidence-supported approach for aligning A-MBH treatment environments with adolescents’ developmental and therapeutic needs to foster long-term healing and recovery.