© Murphy Philipps 2025
The architecture of mental health care has undergone a quiet but profound revolution. For much of the 20th century, the prevailing image was the asylum: a vast, sterile institution designed for containment, often located in remote areas, away from society. Today, the picture is radically different; one of therapeutic sanctuaries designed not just to house, but to heal. This essay explores the philosophical and practical shifts in mental health design. An evolution from control to compassion that is reshaping the landscape of care.
The most significant development in mental health architecture has been the move away from designing for patients to designing with them. For decades, the primary design considerations were surveillance and control, resulting in environments that felt more punitive than therapeutic. This old paradigm has been replaced by a collaborative process known as coproduction, which treats individuals with Lived and Living Experience (LLE) as essential and equal partners in the design process. This approach ensures that spaces are shaped by genuine understanding and empathy, moving beyond clinical assumptions. By integrating the insights of those who have experienced the mental health system, architects can create environments collaboratively, that foster dignity, reduce anxiety, stigma and actively support recovery.
Additionally, by incorporating shared resources with other departments, such as social spaces like a café or restaurant, meeting rooms or bookable spaces Mental Health facilities become better integrated with the wider context, resulting in patients and staff feeling valued and included.
Another core principle in modern mental health architecture is biophilic design, which is founded on the idea of the need for people to connect with nature. This concept goes far beyond placing a few potted plants; it involves the integration of natural elements into the built environment. Spaces designed to maximize natural light, provide direct views of nature, and utilize organic materials, patterns, and textures that mimic the natural world. Exposure to biophilic elements has been shown to significantly reduce stress, lower blood pressure, and decrease feelings of anxiety and aggression, making it a powerful therapeutic tool. Outside spaces are effectively additional rooms with which to offer therapeutic activities, be they physical or passive, such as picnics, or light gardening. I have experienced first-hand the joy that patients feel when discovering herbs like chives and mint within a courtyard garden at Hellesdon Rivers Centre, as they enjoy the aroma and taste.
Anti-ligature design remains essential for patient safety, but its evolution lies in discreet, non-institutional features. Cold, prison-like fixtures of the past, which often exacerbated feelings of hopelessness and confinement, have given way to homely modern, ligature-resistant fittings. Elements such as taps, handles, and lighting can now provide a warm, residential aesthetic. This approach preserves safety while fostering comfort and normalcy, reinforcing the therapeutic value of the environment itself.
The journey from imposing institutions to collaborative sanctuaries shows in our understanding of mental wellness. Mental Health is discussed much more openly now than ever before. It reflects a move towards a more humane and intelligent model of care. The future of mental health support is inextricably linked to the compassion and evidence-based wisdom we invest in the spaces we design for it.
