The Architecture of Hope: Brian Giebink Leads HDR’s Vision for Better Behavioral Health Spaces

In behavioral health facilities across America, a quiet revolution is taking place.

While safety concerns and institutional traditions have long shaped these spaces, innovative thinkers are reimagining what’s possible. Among them is Brian Giebink, who sees beyond conventional limitations to envision something different: POSSIBILITY.

As Mental Health Practice Leader at HDR and host of the “Listen: Mental Health Matters” podcast, Giebink is helping to reshape how we think about spaces for mental health treatment. While safety remains the absolute priority, he challenges the notion that therapeutic environments must be stark and institutional to provide that safety.

That vision has made Giebink a thought leader in behavioral health design. His approach goes beyond architecture, extending into education, advocacy, and a deeper mission to transform how we think about mental health in all spaces.

Breaking Down Barriers

Achieving this vision means first dismantling long-held assumptions about behavioral health facilities. When Giebink looks at them, he sees possibilities, while others see limitations.

“You might hear people say we can’t have a foosball table or a ping pong table or a treadmill because it’s unsafe, and patients will misuse them,” Giebink explains. “Well, maybe some patients might, but that’s why you put them in controlled spaces.” The key, he emphasizes, is creating the proper operational framework—having staff monitor usage, establishing clear protocols for access, and understanding that not every patient may be ready for every activity.

“We often say we’re designing for the 1%,” he notes, referring to the tendency to restrict all patients’ opportunities based on the highest-risk cases. “But should we really be designing for that 1% or for the 99% who really need these things because they are therapeutic and beneficial to healing?” This questioning of conventional wisdom, combined with rigorous attention to safety protocols, has become central to his approach.

This measured approach to innovation becomes particularly striking when Giebink discusses international comparisons. “Look at Scandinavian countries,” he says. “Their maximum security prison has a six-foot high fence around the perimeter with no razor wire. They’re preparing meals with the same utensils and tools you and I would use.” While American healthcare systems operate in a different legal and cultural context, these examples challenge assumptions about what’s possible.

The impact of these assumptions runs deep. When facilities are designed with an overwhelming focus on control and restriction, it affects both patients and staff. “Patients feel like they’ve lost freedoms,” Giebink observes. “They have no opportunities to express themselves, so they start acting out. Staff feel that because the place is so confining and controlled, they need to be fearful.” This cycle can undermine the very therapeutic goals the facility is meant to achieve.

Breaking this cycle requires leadership buy-in and cultural change. Giebink has seen this transformation happen in facilities nationwide, where thoughtful operational strategies unlock new possibilities for therapeutic spaces. “When facility leadership is on board, when operations is on board, you can start to provide opportunities that wouldn’t traditionally work in a hardened mental health facility,” he explains.

This success often comes down to understanding that safety isn’t just about physical barriers—it’s about creating environments that support every aspect of healing and recovery.

Education & Healing

One topic that has not come up on all our interviews over the past several years is classroom space in behavioral health facilities. However, it came up on Giebink’s podcast, so we asked him to tell us more about that. He explained that education is a crucial part of recovery for many patients, especially young ones. “If kids are there for a month or two or three, they have to receive education,” Giebink explains. “Otherwise, they get incredibly far behind, fail classes, or cannot graduate on time.” These academic setbacks can exacerbate the mental health challenges these young patients are already facing, creating a damaging cycle that makes recovery even more difficult.

This reality has shaped Giebink’s approach to designing behavioral health spaces, particularly in partial hospitalization programs (PHP). “Kids are spending all day there,” Giebink notes, “so it needs to fill the therapeutic need, the academic need, and the social need.”

The design considerations for these educational spaces extend well beyond merely adding a classroom. Giebink has observed that historically, these spaces were often designed too small, utilizing the same spatial metrics as therapy rooms. “In an inpatient setting, a 300 square foot group room is quite large,” he explains. “However, a typical school classroom ranges from 800 to 1,200 square feet.” This insight has resulted in more appropriately sized spaces that can support both learning and therapeutic intervention.

Integration is essential for these designs. Social workers’ offices are strategically located to ensure easy access from classrooms, facilitating seamless support when necessary. “If a child with behavioral issues is acting out in class, sometimes the teacher may not be trained to manage certain situations. That’s where a social worker steps in to engage in more therapeutic conversations with the student,” Giebink explains. This approach helps destigmatize mental health support by making it a natural aspect of the educational environment.

The spaces must also include what Giebink calls “breakout areas”—smaller spaces where students can step away briefly without being fully removed from the learning environment. These thoughtful design elements help maintain the delicate balance between education and therapeutic support, ensuring that students can continue their academic progress while receiving the mental healthcare they need. These innovations didn’t come from theoretical design principles but from listening to the people who would use these spaces.

The Power of Listening

This emphasis on listening runs deep in Giebink’s work—it’s not just a design philosophy; it’s the core of his approach. The word “listen” appears frequently in Giebink’s work—it’s the title of his firm’s behavioral health brochure and his podcast, “Listen: Mental Health Matters.” But this isn’t just clever branding. “If you say, ‘we listen’ in the wrong tone of voice or context, it just comes out as kind of cliche or cheesy,” he acknowledges. “Of course you listen, right? That’s what you’re supposed to do.” But for Giebink, listening goes far deeper than simply hearing what clients say they want.

Take, for example, a seemingly simple comment from a patient: “I like to sit and look out the window.” A conventional response might be to add more window seating. But Giebink sees beyond the surface request. “It’s about that connection to nature, that connection that humans have with nature,” he explains. “It’s about feeling connected, feeling the warmth of the sun, being able to look out the window and be distracted by all the beauty in the world and not have to think about other challenging aspects of life.”

This deeper understanding comes from years of engaging with patients, staff, providers, family members, and people with lived experience. One particularly impactful conversation came from young patients at a pediatric health system where Giebink was designing the organization’s first behavioral health inpatient unit. During user engagement sessions, one girl said that everything being provided looked great—beautiful, actually—but what they really needed was a place to run around and move. That sometimes the kids at these facilities have so much energy, and they just want to move.

That feedback led directly to design changes—a larger recreation space on the floor plan and direct access to outdoor areas. “We can all understand that therapeutic nature,” Giebink reflects. “We can imagine how it would feel to be cooped up for so long and just need to be able to move.”

The insights gained from listening have shaped individual projects and Giebink’s approach to behavioral health design. His team’s approach continues to resonate with healthcare providers and designers because it captures authentic needs and experiences rather than architectural theories.

But listening is only the first step. The real challenge lies in turning these insights into actual change.

Creating Change

For behavioral health design to evolve, change needs to happen from the top down. Giebink has seen this play out repeatedly in his practice: As concerns about safety and logistics arise, initial excitement about innovative design elements understandably require dialogue about risk associated with doing something new, which can make traditional approaches a more appealing option. “Clients like fresh ideas; however, they’re always keeping patient safety, and therefore, risk aversion, top of mind,” he observes. This is where the architect’s role becomes crucial as a designer and an advocate for better therapeutic environments.

“I think it is the architect’s responsibility if it’s not being brought up by others, to be the one to have the conversation,” Giebink says. “These conversations can be challenging and uncomfortable for some because change is hard, but it needs to happen. That’s the only way we’re going to make progress in this area and really move the needle.”

This commitment to creating change extends beyond his professional practice. Giebink has found himself increasingly connected with universities across the country, mentoring students who reach out with interest in behavioral health design. “I really find a sense of fulfillment in helping the next generation,” he says. This mentorship is crucial given the persistent stigma around behavioral healthcare and behavioral health design.

Even the most accomplished architects can approach behavioral health facilities with misconceptions. “Historically, media and movies portraying behavioral healthcare have distorted some perceptions about behavioral health, which could give anyone almost a backwards or upside-down perception of what these spaces should really be like,” Giebink explains.

Recently, Giebink returned to his alma mater, the University of Kansas, to moderate a panel on mindful design and mental health design. He says it was a great opportunity to help shape the future of the field by engaging with emerging architects, eliminating the stigma, breaking down barriers, and getting people excited about the possibilities in behavioral healthcare.

Looking Forward

When Giebink looks to the future of behavioral health design, he sees momentum building that goes far beyond specialized facilities. “I believe we’re right on the cusp of mental health being as important of a consideration as physical health, with mental health design discussions at the forefront of every building typology—not just healthcare,” he says with evident enthusiasm. “I don’t know if mental healthcare becomes a curriculum in school, but we’re right on the brink of something extraordinary with thinking about mental and physical health all working together.”

This integration is already happening in his current projects. At Intermountain Health in Utah, where his team is designing a new pediatric facility, a simple basketball court has become a powerful example of thoughtful design enhancing therapeutic relationships.

A provider in the user group highlighted the half-court as one of the facility’s most beneficial features. He said that patients engage more freely, have deeper conversations, and form stronger connections with their providers while simply shooting baskets.

“When you’re moving around, your endorphins are flowing, you become more comfortable,” Giebink notes. “Now you’re shooting hoops with your provider, and you’re on a different relationship level. The conversations go deeper than they ever would sitting in a consultation room inside.”

The evolution Giebink envisions isn’t just about new mental health facilities—it’s about fundamentally changing how we think about mental health in all spaces. “Right now, I’m the mental health practice leader,” he reflects, “but I hope eventually everybody is a mental health practice leader. I want everyone to design with mental health in mind, regardless of the facility type.”

This vision of universal mental health design marks a significant shift from the era when behavioral health facilities focused mainly on restriction and control. However, Giebink observes the industry is already progressing in this direction, with greater openness from regulatory authorities and healthcare leaders to question outdated assumptions. “If we build a case for why we want to do things differently and demonstrate that it will improve outcomes, we’re rarely told no,” he says.

As behavioral health continues to gain broader recognition and understanding, Giebink remains optimistic about the future. Year after year, the snowball of change keeps building momentum. Through his design work, his podcast, and his mentorship of the next generation of architects, he’s helping to ensure that the future will be one where mental health is considered in every space we create.

It’s a future where architecture itself becomes a source of hope—not just in specialized facilities but everywhere. “We’re right on the cusp of something,” he says, “and I think it’s just around the corner.”