The Systems Side of Behavioral Health:
MEP and Lighting Design for an Inpatient Facility
Mount Sinai Behavioral Health Center (MSBHC), a new inpatient facility at 45 Rivington Street on the Lower East Side of Manhattan, is a high-profile example of a successful conversion: Abandoned for nearly two decades, the 1898 building that started life as a school now houses a hospital that conveys a sense of welcome, calm, and care for the local community.
But adaptive reuse is only one notable facet of the project, which recently won several awards, including a 2025 Diamond Award for Engineering Excellence in building/technology systems from ACEC New York, the Association of Medical Facility Professionals NYC’s 2023 Project of the Year in the over $50-million category, and the 2024 Senior Housing News’s Architecture & Design award in the behavioral health category.
MEP and lighting systems contributed to the high standards of patient care and efficient operations that led to these awards. A Syska team, which provided MEP, fire protection, fire alarm, architectural lighting design, and building management systems services (BMS) for the 135,000-square-foot structure, offered some specifics:
Specialized Systems
The conversion involved the full replacement of all systems, a complex process for any project. But behavioral health facilities have extra requirements that add to the complexity. For example, nurses at behavioral health facilities must have control of the power in patient rooms.
Raj Mann, a senior electrical engineer at Syska, reports that the team met this requirement by equipping the nurses with a touch-screen control for every patient room, enabling them to turn on or off individual control receptacles and lights, and even to shut down power completely in a room if patients are trying to harm themselves.
To further enhance patient safety, the team also specified ligature-resistant and anti-barricade sinks, toilets, diffusers, shower heads, and doors. In some rooms Syska specified plumbing isolation valves to protect patients with polydipsia, a medical condition that causes them to drink compulsively.
“We didn’t want the sort of harsh lighting that has historically been found in many behavioral health facilities.”
Bill Kuchler, Senior Lighting Designer, Syska
“We strove to balance the safety and health requirements with our aesthetic goals and our focus on visual comfort.”
Bill Kuchler, Senior Lighting Designer, Syska
Lighting Considerations
The architectural lighting team, like the MEP team, had to accommodate safety requirements in its designs. According to Bill Kuchler, who served as Syska’s senior lighting designer on the project, these requirements create challenges in creating a “non-institutional environment” due to limitations on the types of lighting fixtures that can meet the criteria. Providing a comfortable residential illuminated environment that supports the healing process for the patients and their family members is an essential component of the success of this new facility. The goal is to achieve a combination of fixtures that offer visual comfort and provide the appropriate level of soft illumination to suggest an ambiance more typically associated with hospitality, while meeting safety criteria. Bill emphasizes: “We didn’t want the sort of harsh lighting that has historically been found in many behavioral health facilities.”
For example, the team specified large diameter fixtures with white lenses in the family waiting areas, rather than using only security-grade recessed two-by-four fixtures. The former “provide a little glow around the ceiling plane and make you feel like you’re sitting in a lobby or hotel waiting area,” Bill says. He adds that security-grade recessed two-by-four fixtures were not the only fixtures installed in patient areas, and that group dining areas were designed with recessed downlights. Furthermore, patient rooms feature recessed linear fixtures and sconces by the bedsides that patients can turn on and off by touch. There are no visible switches or other devices that can be damaged or broken off. This provides a more comfortable illuminated environment within the patient rooms without compromising safety.
Bill attributes the success of the lighting design to a great deal of research and extensive coordination with other project team members. “We strove to balance the safety and health requirements with our aesthetic goals and our focus on visual comfort,” he states. “With every project, we think about the end users and how the facility can be more appealing to them. Mt. Sinai Rivington is exactly the sort of outcome we envision.”
Unobtrusive Infrastructure
The building’s historic elements include terracotta slabs and cast-iron columns, which do not allow openings for conduit, ductwork, or other infrastructure. Consequently, the team worked closely with the builders and structural engineers to determine distinct solutions in various conditions.
Another consideration centered on the sense of calm instilled by the interior design. Syska did not want to interfere with the atmosphere by situating unattractive louvers or large pieces of equipment in areas visible to the public. Therefore, the team placed most equipment on the roof and used setbacks to hide it from view.
To facilitate coordination through this complicated process, Syska used a software called OpenSpace, which enables users to take 360-degree photos on site and share with team members, ensuring that every step of the construction would support the goal of unobtrusive infrastructure.
The building’s historic elements include terracotta slabs and cast-iron columns, which do not allow openings for conduit, ductwork, or other infrastructure.
The team also had to pay close attention to resiliency, which is essential in any hospital, but especially in a behavioral health facility.
Resiliency
The team also had to pay close attention to resiliency, which is essential in any hospital, but especially in a behavioral health facility. To ensure that MSBHC could maintain operation during a power outage or system failure, Syska reinforced the utility service supply and configured the generator to support occupancy of inpatient floors in concert with a roll-up generator and other roll-up utilities.
Results
Most adaptive reuse projects are complicated, but the special requirements for behavioral health facilities compound the challenges. That’s why the Syska team is so proud of its work on MSBHC. Another source of pride is the effect on the local community. “Having gone to the site many, many times, you get a good sense of the need,” says Alex Engelman, Syska project manager, who points to substance abuse and homelessness as problems that have plagued the local area.
Now that the project is completed, he and Raj are speaking regularly with staff to find out how the facility is operating and apply lessons learned to other projects. “We plan to collaborate with architects, planners, and others to design similar behavioral health facilities around the country,” says Alex. Raj adds: “We hope other engineers and architects will be able to use this project as an example of what is possible for adaptive reuse and reimagining healthcare facilities.”