The Psychology of Architecture and Design

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    Changes in the Architecture of Mental Facilities

    By dennisleigh
    Jul 3, '17 12:57 PM EST

    My first blog post will be rather about the psychiatry of architecture and design.

    I have recently become interested in the history of antipsychotic drug development. While reading, I have caught myself thinking that not only the treatment methods have changed, but also the vision of how mental facilities should look like.

    By the way, I can also say that pharmacology and architecture may be mutually connected, and it is science that indirectly affected the architecture of mental facilities. I do not like it when connections are made out if sin air, however, I think this is a situation when looking for connections is legitimate. 

    If psychiatric drugs were not invented, people wouldn’t probably change their attitude towards the mentally ill. New medication allows patients to live relatively normal lives, so they are not necessarily considered the margins of society. While there is still a stigma, the situation is gradually changing for the better.

    Now we take it for granted that mentally ill people need good treatment and must be provided with good living conditions. Not that long ago it was not the case. Mental facilities looked like prisons, which definitely did not contribute to improving patients’ mental health. We can even notice the resemblance with the architecture of the Third Reich with their threatening massiveness, lack of sunlight and atmosphere of isolation.

    Pilgrim State Hospital, Brentwood, NY, 1938 – Source

    Up to the middle of the 20th century, there were no prerequisites for architects to take care about creating an atmosphere of home-like atmosphere in mental facilities they built. Moreover, fire safety was often neglected, huge rooms were designed for a large number of people, where they could not , bare walls in , no room for personal belongings. (You can read how a standard room looked like in the end of 19th in Nellie Bly’s Ten Days In a Mad-House).

    In fact, the first architectural and engineering specifications for mental facilities have been developed not long time ago. However, finally people consider the importance of exterior and interior design for the efficient treatment and follow patient-centered principles.  

    For instance, the Mental Health Facilities Design Guide says:

    “In new construction projects, whether an addition or a stand alone facility, the exterior architecture serves as the first introduction to the facility for patients, their families and other visitors. As such, it helps to create initial expectations about the facility and the care provided therein. Accordingly, the exterior design should embody a warm, familiar, and home-like design.”

    “The primary objective of the interior design of any of the various Mental Health units and facilities is to provide a residential, therapeutic environment. Finishes, fixtures and furnishings that maintain the safety and security of the facility need to be integrated into the interior design without detracting from this primary objective. A warm, welcoming, and familiar environment can help calm patients and promote their participation in treatment and their rehabilitation and recovery. A warm, therapeutic environment has also been shown to be preferred by staff”.

    Such guides reflect a significant shift in our approach towards the design of mental health facilities. Today we finally understand that the environment also affects the efficiency of treatment and that the interior design impacts the patients' perceptions they have about themselves and about the staff.


    • citizen

      For a very good history of the evolution of health-related architecture and development, see Medicine Moves to the Mall, by David Sloane.

      Jul 3, 17 4:51 pm  · 

      Thank you so much , intrigued to read it.

      Jul 18, 17 3:00 am  · 

      Have you looked at Kirkbride hospital forms? 

      Jul 5, 17 10:09 pm  · 

      Donna, thank you for mentioning it) Actually, I haven't delved into this topic yet, since his design was later ignored. Seems like cruel irony that Henry Cotton with his disgusting methods worked at the first Kirkbride mental hospital, doesn't it?

      Jul 18, 17 3:53 am  · 


      Jul 13, 17 12:45 am  · 

      Haven't read that post yet. Thanks, Nam

      Jul 18, 17 7:51 am  · 


      Jul 18, 17 7:50 am  · 

      Further, this article is perhaps less related, or at least a different take on your title...A History of Healing aka Homes Built (originally) for Healing

      Jul 24, 17 12:30 am  · 

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About this Blog

This blog is about the interdependence of our state of mind and the built environment. Different life experiences can be turned into metaphors and then, transformed into shapes and colors that affect how we live our lives.

Authored by:

  • dennisleigh

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