You’re opening your own private psychiatry practice and decided you want to see patients in person (at least part of the time). Maybe you'll be prescribing controlled substances that require an in-person visit.

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Maybe you offer TMS or ketamine treatments. Or, doing things face-to-face just works better for you and your patients. In any case, your practice space sets the setting for you and your patients.

In this guide, we’ll cover what you need to keep in mind to find and furnish your psychiatry office space:‍

• Find your office
• Negotiate your lease
• Get insurance for the space
• Furnish and decorate your space to create a warm and welcoming environment
  

Find Physical Office Space

If you’ve decided to see patients in person, you’ll need a professional space to see them. Your first instinct may be that you need your own space, but many psychiatrists rent space part-time. Others go in on renting a space with other professional staff to divide up office time and costs. If decide to buy a space, you may be able to sub-lease to other professionals looking for part-time space.

How to find part-time shared office space

Real estate agents can be great if you’re looking to rent a space that’s completely yours. But, if you’re looking to share a space, I recommend using local listservs or Facebook groups for mental health and wellness professionals.

You can Google “therapy rental spaces” in major metro cities. There you’ll find professional listservs with one day a week or even hourly rentals. There’s no equivalent of a national WeWork for therapy office space as far as I know,  but there are many smaller local businesses cropping up that do this. Lina.co is one example (in NY and FL only for now), and I know folks who’ve had positive experiences.

Also, check online marketplaces such as Craigslist. You can always reach out to local business owners who you suspect may not be using their space full-time. Or, pulse your professional network for interest in sharing a space.

Co-locating with complementary types of medical professionals is a good idea. Pediatrician’s office if you see kids, OB-GYN if doing women’s mental health, or even primary care if you want to work in a more collaborative model.

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Location, zoning, and security matters

Before you sign any office lease, you’ll want to think about location. Ask yourself these questions:
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Marketing/Discoverability considerations

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• Is the location in an area frequented by your target demographic?

• What is the concentration of other psychiatry practices in the area? You might find a location with fewer psychiatry practices around so your practice stands out.

• On the flip side, you might share a building with other mental health professionals to boost referrals. For example, my new office space is in a suite with massage therapists, acupuncturists, therapists, a ketamine psych NP, etc., and we plan to cross-refer.

Privacy and safety considerations

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• What is the access like on nights and weekends? If there is a doorman, do people need to sign in and if so, can they just do first name/last initial to preserve privacy?

• Does the location have a “storefront?” This may be less discrete. Is it on a higher floor? If yes, this can pose safety risks.

• Do you need to be close to public transportation or have easy parking?

• What is an acceptable commute time?

Landlord and zoning considerations

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• This is super important: Is the landlord comfortable with a medical/mental health practice being in the building/are there any zoning considerations? If you’re doing any procedures and blood draws, this can get complicated and not all spaces are able to allow this.

• Stigma against patients with mental health concerns exists. Make sure the landlord is aware and open to what your business does.

Create the perfect space for your practice

When it comes time to evaluate spaces, here are some questions to keep in mind:

• How does the rental/mortgage cost factor into your budget? What is the minimum number of hours you need to see patients monthly to make the space worth it?

• Is your space compliant with The Americans with Disabilities Act (ADA)?

• Is there a waiting room AND a place to see patients? If it’s a shared space, is there a receptionist? Is there space for one if you plan to have one?  

• If you plan to treat children, is the waiting room friendly to children?

• How does noise transfer?  

• Tips for soundproofing: Ask about any special sound insulation. You can consult with someone familiar with soundproofing therapy offices. You can for the builder to place sound-dampening filters in the ceiling during construction. These filters muffle voices.

• Note that soundproofing an already built-out space can be cost-prohibitive. But, you can use things like felt wallpaper and various sound-absorbing wall hangings. This is actually a HUGE issue for therapy spaces and most are not done well. Search for felt wallpaper for soundproofing and you should find something suitable.

• Where are the bathrooms? Is there a gender-neutral bathroom? Are they accessible to patients with disabilities? Do they offer changing stations for patients with young children?

• Will you and your patients feel safe in the space? If needed, are appropriate safety precautions put in place? (e.g., security guard, buzzers, locks)  

• Make sure there are locks in place that can be defeated if needed by you or your staff in the event of an emergency. For example, a deadbolt in a single bathroom that the patient can lock themselves in can be dangerous. I speak from experience here, unfortunately. I also recommend investing in a panic button/keychain for each room.

• Is it important to you to form a community with others who work in the space? Consider making fliers/brochures or postcards about your practice and ask if you can keep them in a common waiting area.

• Is it furnished? How will that affect your ability to pay for other up-front costs?  

• If unfurnished, consider getting a free business account with companies like Wayfair for more discounts. Wayfair and similar companies will also separate what furniture is “commercial grade.” If you plan to stay in a space for a long time, commercial grade is the way to go.

• Or, if you don’t mind replacing furniture every couple of years, cheaper is fine. Consider working with an interior designer who gets deep discounts on furnishings. That may offset the cost of the designer and save you a ton of time.

• Is it discreet for patients to enter/exit?  

• Consider what signage you'll need for your practice. Will individual offices need signs/numbers? A sign in the lobby? Does the landlord allow you to hang signs outside? If so, what are the restrictions?

• Does it have windows, natural sunlight, and/or nice views? Lighting can play a big role in changing the mood of a space. Encourage bringing in plants, fidget toys (yes, even for adults),

• Does it have central heat / AC?

Negotiate Your Lease Terms or Purchase

Once you find a space that works for you, you’ll want to make sure your lease clearly states what you get with the space. If a space or amenity isn't written into the lease, assume you don't have access to it!

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According to the American Psychiatric Association, a good lease should clearly state, but not be limited to the following terms:

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• Square footage of the office

• Storage space

• Parking

• Snow removal

• Utilities (Are they included? Are you charged based on your individual or total building usage?)

• Wifi

• Furniture

• Cleaning services

• Twenty-four-hour access to the office

• What insurance coverage is required

• Policies for remodeling and redecorating

• Sublet policies

• An escape clause for certain unforeseen incidents that require you to leave your practice

• Language giving you first rights to new space that becomes available, should you decide to expand.

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What is the lease term?  

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• For subleases and very part-time, month-to-month or annual terms are common.

• For a one-year lease or less, you don’t need to worry about consulting a commercial real estate attorney.

• For a real commercial lease, the terms are usually much longer: 3-10 years. If you’re embarking on a lease like that, consult with a commercial real estate attorney. Do not sign a multi-year lease without your attorney! I can’t stress this enough.

• With a real multi-year commercial lease, you can negotiate to bundle the costs of the buildout or renovations into the cost of the lease. An attorney can help with this. Many leases also will ask for a “personal guarantor” or “good guy guarantee” and a lawyer will help protect your interests there.

Additionally, you may want to think about:

• Building maintenance responsibility

• Elevator service

• Security services

• Snow/ice removal

Get the Proper Insurance for Your Physical Space

With a physical office space comes new insurance needs. There are a couple of different types of insurance policies you may consider.

General Liability Insurance

General liability insurance covers accidental third-party damage that arises in an in-person space, such as damage to patient property or even patient injuries. Often thought of as “slip and fall” coverage, general liability insurance can cover patient property damage, medical bills, and legal fees, among others. Note that general liability insurance does not cover damage to your own property.

Business Personal Property Insurance

Business personal property insurance protects your business equipment, like laptops, cell phones, and other durable equipment. If you work from home, it may cover some furniture too.

Commercial Property Insurance

Commercial property insurance protects your physical office space, whether rented or owned, plus tools, equipment, inventory, furniture, and personal property. If you work from home, it typically provides more comprehensive coverage than homeowners insurance. It usually protects against fire, a burst water pipe, storms, and some natural disasters.

Business Owner’s Policy‍

I recommend you consider a business owner’s policy as it’s the most robust type of insurance. It bundles a few types of insurance together, like commercial property insurance and general liability insurance.

The policy can also include things like medical equipment and “business interruption insurance” should something happen that renders the space unusable for a period of time.

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You’ll be covered for things like a power failure that causes medication stored in a fridge to spoil, a lot of cybersecurity stuff,  if an employee steals from the company, etc. A business owner’s policy is worth it rather than a super basic general liability policy—unless you’re super part-time and small-scale with no employees or space of your own.

Other Types of Insurance

The insurance policies listed above only protect your space, property, and injury to patients and their property. You’ll also want to look into comprehensive malpractice policy, as well as workers comp insurance, and cyber insurance (if not included in the BOP—which it often is).

Functional Essentials for your Practice

Medical Equipment

Before we talk decorations, let’s talk functional equipment. This may include:

• A pulse oximeter

• A scale that can also measure height if seeing children,

• A blood pressure cuff

• TMS equipment if you offer TMS

• Software for monitoring vitals if you offer ketamine or esketamine. Check if your EHR integrates with anything that tracks vitals. Osmind integrates directly with Caretaker software!
  

Office Technology

You’ll likely want to get standard office technology up and running as well. This includes:

• Strong internet

• A shredder

• A printer

• An efficient scanner for when patients bring in records (this one is a classic for clinicians and lawyers).

• A phone (if not just using your cell phone). Some services like Spruce Health allow the use of one’s cell phone as well as VoIP phones within the office.

• Voice over the internet protocol (VoIP) and electronic fax. Hardly anyone uses landlines these days for either phone or fax. I want to emphasize: you do NOT need a fax machine, just an electronic fax solution. No one needs to buy a physical fax machine again!

• A quality EHR that streamlines intake, measurement-based care, and payments/superbills.

• Fax machine

• A secure storage cabinet and/or fridge.  

• You’ll need a safe if storing medications and special medical fridges if storing any meds that require refrigeration—some of which also lock if it’s a controlled substance.

• A tablet/iPad for completing forms electronically and checking in. This is more portable and cost-effective than a kiosk and can be helpful if you don’t have a receptionist.

• A comfortable office desk chair—one with orthopedic support. This is a hot discussion on forums, but many people swear by the pricey Herman Miller Aeron chairs. Check for deals online through second-hand resellers to get them at a fraction of the full-price cost. There are also less expensive alternatives. Still, plan to spend several hundred dollars on a comfortable chair. Your back will thank you later!  

• Consider if you’ll be sitting in a different chair when meeting with patients than when working at your desk. If you like to use a laptop while in that non-desk chair, consider an “air desk” or other laptop stand for a laptop.

Telehealth tools

• If you plan to have hybrid meetings or sessions with multiple people in your office and others on video, consider purchasing a Meeting Owl. 360 camera views and audio makes a huge difference in meetings. It can also help record audio and video when paired with something like Zoom—which is helpful for supervision sessions.

• A ring light setup to light your face when conducting telehealth or virtual meetings and presentations from the office.

Designing and Furnishing Your Therapeutic Space

We all know the power of setting in any therapeutic context. The way you lay out your space sets the tone from the moment the patient walks in.

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When brainstorming office layouts, furniture, and artwork, a great place to start is by searching Pinterest boards. Search terms like “mental health office” and “therapist office” will likely also turn up more results than “psychiatry office.”

It can be daunting to furnish and decorate your space for the first time. Let’s cover the do’s and don’ts of psychiatry office decor.

The American Psychological Association recommends the following design practices:

• Calming colors: Keep the colors light and soothing. Soft, neutral colors such as light blue, beige, or pale green can help create a relaxing atmosphere in the office. Avoid using bright or bold colors, as these can be distracting.

• Create a cozy atmosphere: Use soft lighting, cozy blankets, and plush pillows to create a warm and inviting atmosphere in the office. This can help your clients feel more at ease and comfortable during their sessions.

• Try to bring in nature: whether that be plants, artwork, or window views. People often prefer natural-colored wood over glass and chrome. Choose low-maintenance plants that don't need a lot of sunlight, such as spider plants or succulents.  I recently discovered plants you only need to water once a month. They have a reservoir of water you add to monthly (e.g. EasyPlant).

• Incorporate positive distractions. For example, a fish tank or inviting artwork that can give patients a mini brain break. Provide fidget toys or Rubik’s cubes. Avoid anything that could be used to self-harm with or that could be a choking hazard for a child  

• Placement: You’ll want to hang artwork at eye-level. Keep in mind that you and your patient will be sitting down, so you’ll want to put the art lower than you would your home for instance.

• Keep your space neat and organized. When it comes to creating a healing space for your patients, less is more. Avoid clutter! (A cluttered space can create a cluttered mind).

• Display your credentials to establish early credibility.

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What NOT to do when decorating your psychiatry office:

• No cheesy inspirational artwork. This can come across as off-putting when people are in distress

• Avoid things like Buddha statutes and other “spiritual” items unless they’re central and essential to your work.

• Think carefully about any sort of family pictures that you include on your desk. It can be ok to include them but know that anything in your office is “grist for the therapeutic mill” and could be brought up by the patients.

• Think about what could get dirty easily—especially when there is bad weather—and choose fabrics and colors accordingly.

The layout of your furniture can make or break the feng-shui of your space. Dr. Liddicoat in the The Psychiatric Times offers tactical furniture and layout suggestions.

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• Arrange seating between a patient and you to be at a 45-degree angle, as sitting directly opposite can be seen as confrontational.

• Consider having a couch for a patient to sit on that empowers a patient to choose their distance from you. (We also like this because it’s inclusive of patients of all body sizes).

• Place a side table with a light, tissue box, and other decorative items next to each person.

• Place a clock on a table or shelf that’s at least visible to the psychiatrist—and ideally visible to both parties—to keep track of time during the session.

• Avoid placing furniture between your seat and the patient.

• Ideally, a patient will have full visibility to the exit door from where they’re sitting and an easier path to the door than you.

• Consider placing a positive distraction directly across from where the patient will sit, such as a window or artwork.

• Design your space with moveable furniture, so you can rearrange as needed.

Dr. Liddicoat also has 10 waiting area design strategies that may be helpful for your practice.

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Where to buy furniture and decorations for your psychiatry office:

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1) Online retailers: You can find a wide selection of decorations for your office on online retailers such as Amazon or Etsy. These websites offer a wide variety of options, from wall art to plants to throw pillows, so you can easily find what you're looking for.

2) Wayfair: You can get a free business account with companies like Wayfair for extra discounts. Wayfair and similar companies will also separate what furniture is “commercial grade.” If you plan to stay in a space for a long time, commercial grade is the way to go.

3) Home decor stores: Home decor stores such as Pottery Barn or West Elm may have a selection of decorations that are suitable for a psychiatry office. These stores have a range of options, from furniture to wall art to plants, so you can find everything you need in one place.

Conclusion:

There’s a lot that goes into finding, leasing, and furnishing your psychiatry office space. By following these suggestions, you’ll create a setting that’s warm and inviting for your patients.

If you’ve been following along in our “starting your practice series,” you’re so close to seeing patients! In future articles, we’ll talk about practice policies, marketing your practice, and cultivating a community for continuous learning.