For most of human history, architecture has responded to the necessity of what society deems normal. As a result, large groups of non-confirming, non-standard, marginalised groups have been disregarded and neglected in design decisions. One such marginalised group consists of neuro-divergent individuals, architecture addressing those in infancy. Since our built environment falls short of provision of care and safety for these individuals, there arises a need to design asylums, a controlled environment to house them. The architecture of insanity, thus, is the architecture of these sanctuaries built on the foundation of compassion, kindness, ethics, and innovation and on faith that the built environment can be an oasis for the mentally ill. 

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Slate Run Psychiatric Hospital in Venezuela_ ©Meridith Kohut

Walls of Confinement

Asylums, though built primarily with the hope to be a place of refuge, can often end up being a place of solitary confinement, a machine focusing not on the curing of these individuals but on protecting the ones beyond the walls as such, asylums are not very different from prisons in that they both emphasise confinement and social control within the built environment and act as a tool for controlling and managing individuals by means of surveillance and patrol. The growth of asylums over recent centuries in scale and complexity in machine-like forms optimised not with an aspiration to cure but in the language of economy and efficiency has led to the repeated failure of a claim that architecture could better, if not cure, insanity. And the corpse of this idea lays amidst the grave of thousands that it failed to save.

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An Abandoned Psychiatric Ward_ ©Matt Van der Velde

Design Dilemmas

To design for the mentally ill is to wrestle against arrays of design dilemmas stemming from the dual nature of the psychiatric treatment. While retention of an individual’s autonomy, dignity, and privacy remains imperative in psychiatric treatment, one is inevitably stripped of these very elements during their treatment. Likewise, privacy and isolation. remain, efficiency and spaciousness, structure and fluidity, medical and normal, domesticity and safety, stimulation and calm, communication and distraction, and care and disability. The crucial question in designing for insanity is where the balance lies between these contradicting elements and to create a consistent environment where these elements work together in the best possible scenario of healing architecture.

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Design Dilemma of Privacy and Isolation_ ©Natalia Batrakova

Designing for Insanity

The foundation of the design for insanity comes from considering the experiential quality that architecture offers. Indirect and diffused natural light in the interior, natural ventilation, and odour make up a suitable ambience. The balance between privacy and connection to the outside is to be paid heed to through proper fenestration, offering a view of nature, common areas, and landscape. The asylums need to provide an acoustically sound environment and ensure the absence of spaces that could lead to perceptual distortions and disorientation. It must ensure mobility and accessibility for all kinds of physical disabilities to evoke a sense of self-reliability in the patients. 

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Vejle Psychiatric Hospital_ ©MT Højgaard

In terms of interior, homelike furnishes and warm tones of colours are to be used in common areas. Sharp walls, furniture, and fixtures that could potentially injure the patients are to be avoided. Furniture is to be attractive yet durable, easy to repair, clean, and maintain since they are susceptible to abuse from the patients. Despite the need for functionality, efficiency, and safety, it must be ensured that the asylums do not feel like prisons or hospitals, since they serve as a residence for the patients who may otherwise feel like captives.

Blurring of Walls

Contemporary psychiatric theories advocate that asylums for the mentally ill shouldn’t be confined between the walls but spill out into the world and society within the realms of possibility. The asylum space should open to a landscape that offers rumination, exploration, and tranquility. It has been found that the patients are motivated to take up physical activities and exercises when they find themselves in a natural terrain and varied landscape, making it an exhilarating experience for them. In the realm of a safe landscape designed in the balancing point of structure and fluidity, insanity makes its baby steps toward sanity.

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Common Areas for Socialization in Mental Health Facility_ ©James Tensuan

As much as it is beneficial to locate the asylums in remote areas where they have access to a quiet retreat to heal away from the pressures of societal life, it can be detrimental to their long-term social life, along with prolonged separation from family. Thus bringing asylums closer to a community where they can open their gates occasionally for shared activities while maintaining safety within the premises can be an answer. Societal stigma related to mental illness can also be greatly reduced by bringing society in and letting them experience the normalcy that exists even within the realm of abnormality. However, in making the asylums more permeable and transparent for connectivity, care must be taken not to make the patients feel unsafe and like their insanity is on display.

Transforming the treatment

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Taube Pavilion, Mental Health Facility in Silicon Valley_ ©James Tensuan

Today the curing of mental illnesses consist of countless behavioural and occupational therapy. Insanity is approached with work and recreation, giving the patients back autonomy and dignity. The asylums allow voluntary physical activities through gardening and maintenance of the asylum, along with cooking, cleaning, washing, and sewing, which contribute to the functioning of the asylum itself. Along with work, asylums provide recreational activities like sports, writing, singing, dancing, and playing musical instruments. Income-generating work like tending to nurseries, basket making, crocheting, handicraft, etc., is also proven to be beneficial to the patients’ mental health. The built environment designed for insanity should, thus, incorporate these activities in the designing of the spaces.

Home Away from Home

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Domesticity and Safety_ ©Natalia Batrakova

The greatest despair and misfortune of insanity is banishment from home and society. The asylums become not just home but the world to the mentally ill. With provision for socialisation and serene retreat per necessity, asylums can help restore the balance in the patients deeply disturbed due to displacement from a former place of familiarity. With common rooms and parlours complete with pianos and T.V.s, couches and bookshelves that remove the feeling of institutionalisation, “normal” activities like reading, playing, listening to music, and watching shows together are to be facilitated. The doctors and caretakers act as guardians, helping the patients feel at ease, and more accepting of the help offered. 

Cemetery for the Living

Recreational Space in Vejle Psychiatric Hospital_ ©Niels Nygaard

Today, modern psychiatry recognises the wide spectrum of insanity, yet the stigma associated with madness remains. The asylums are metamorphosing into a cemetery for the living, where the mentally ill wait for their inevitable ending. The despair and hopelessness within these asylums are sometimes even more severe than lifelong incarceration. But to design for the insane is to hope for a future where they can return to their life and what they have known as normal within the realm of possibility. In the absence of coherence of space concept or space ambience or functionality to understand their surroundings, experience defines spatiality for the mentally insane. An architect thus must lose himself to insanity, even momentarily, since he cannot comprehend the spaces the same way otherwise.


Batrakova, Natalia (2019). Design dilemmas in mental hospital architecture [online] Available at: [Accessed March 4, 2023]

Re-thinking the Future (2023). Rethinking the architecture of Asylums [online] Available at: [Accessed March 4, 2023]

Eriş, Evin, & Basyazici, Burcin (2014). Architect’s Exam with Other Spaces: A Study on Mental Asylums [online] Available at:’s_Exam_with_Other_Spaces_A_Study_on_Mental_Asylums [Accessed March 4, 2023]

The Conversation (2019). Prisons and asylums prove architecture can build up or break down a person’s mental health [online] Available at: [Accessed March 4, 2023]

Yanni, Carla (2007). The Architecture of Madness: Insane Asylums in the United States (Architecture, Landscape and Amer Culture)


An architecture and art enthusiast, Rashmi Gautam, is an Architecture Student from Nepal in search of her own expression in forms of words and design. Finding solace in the company of literature, art and architecture, she can be found brooding in the nearest library or museum.