To serve the members of the Eastern Band of Cherokee Indians (EBCI) in need of mental, emotional or behavioral health or substance abuse services, the Cherokee Indian Hospital Authority (CIHA) sought to replace the existing Cherokee Indian Hospital in 2015. Following that move, the CIHA then built Kanvwotiyi, a 20-bed residential treatment center in Graham County, North Carolina.
But a void still remained. What was needed was a secure, safe environment where patients could be stabilized before being transferred from hospital to residential care. This would alleviate the prolonged use of ED beds and provide a designated space for mental health care services.
“It was decided that if we really wanted to help and provide treatment for this community, we needed an entire continuum of services,” says Casey Cooper, CEO of CIHA.
The only thing that stood in the way of the addition was the former hospital, still partially occupied for use as an administrative and storage space. With full demolition deemed too expensive, the team of McMillan Pazdan Smith Architecture and Robins & Morton ultimately opted to tear down part of the building. The decision then left 34,000-square-feet to be salvaged and renovated, with an additional 43,000-square-feet available to create an outpatient clinic and crisis unit attached to the main hospital.
Filling in the Missing Piece
The first floor of the addition houses a behavioral health outpatient clinic with 13 counseling rooms, an exam room, small and large group rooms, and two large classrooms. Meanwhile, the second-floor crisis stabilization unit comprises 18 inpatient rooms for behavioral health patients, four acute-care patient rooms that are equipped to support someone in a health crisis, and two large group therapy rooms. A two-story atrium serves as the spine of the hospital and ties into the outpatient behavioral health clinic.
A committee met regularly with tribal members and elders to ensure that the design properly reflected the EBCI culture and community.
“Exterior cultural symbols, materials, and elements match the Cherokee Indian Hospital seamlessly to convey the message that the programs contained inside are equally important to the mission and vision of the facility,” says Christie Adams, healthcare segment leader and project manager at McMillan Pazdan Smith Architecture.
For example, the design of the terrazzo flooring in the entry area and main corridor at the hospital illustrates a local legend—a detail that’s carried into the new addition with the legend of a magic lake represented in the flooring. On the exterior, a unique motif depicting the symbol for wind matches the new hospital’s exterior.
A version of this article previously appeared on Healthcare Design.