Illustration by Calvin Sprague

When it comes to designing for mental well-being, the architecture profession has been more than a little remiss. For all their obsession with health and cleanliness, only a few of the 20th century’s most influential designers ever ventured into creating spaces for psychological healing, and then only within the prescribed boundaries of the era. Take Otto Wagner’s 1907 Steinhof Psychiatric Hospital in Vienna: While the mental health facility was remarkable for its time—a village-like compound of 60 pavilions surrounded by green spaces, with a striking, Art Nouveau church at its center—it was still an old-fashioned asylum, a typology now long obsolete.

For today’s architects, the relative silence of their forebears has left a void in need of filling, while radical changes in the field have given designers that much more catching up to do.

Most people see mental illness and they see only the roles of patient, doctor, and nurse. They fail to see the people.

“Not enough people have addressed this in the built environment,” Erin Peavey, AIA, says. With an academic background in both psychology and architecture, Peavey, now a design researcher at the Dallas-based firm HKS, focuses on the thin and sometimes fuzzy line where space and the subconscious interact, a still-emerging science that is more prescient now than ever before, especially in light of the pandemic's global effect on mental health

“So many more of us are now working from home,” Peavey says. “This is not having a great impact on our mental health.”

Spero Academy by HDR
Dan Schwalm Spero Academy by HDR
Spero Academy by HDR
Dan Schwalm Spero Academy by HDR
Spero Academy by HDR
Dan Schwalm Spero Academy by HDR
As studies have shown, sudden changes in noise, lighting, and other external stimuli can be distressing to autistic children, and so the Spero Academy features carefully calibrated transitions between different aural and visual zones.

Statistics bear out her point: In the early stages of the COVID-19 outbreak, the CDC released a study demonstrating that at least 40% of Americans had experienced adverse psychological effects as a result of the pandemic and its fallout. In response, experts like Peavey and her colleagues have been endeavoring to create projects that “really resonate with us biologically,” as Peavey puts it—projects like HKS’s Floral Farms, an upcoming public space in Dallas that includes secluded bowers, community programming, and plenty of lush greenery, all calculated to soothe, stimulate, and restore the frayed nerves of cooped-up locals.

Spero Academy by HDR
Dan Schwalm Spero Academy by HDR
Spero Academy by HDR
Dan Schwalm Spero Academy by HDR

That kind of holistic thinking shows how much mental health design is moving beyond the clinical space, touching every corner of architectural practice. There’s a reason for that: As noted by Francis Pitts, FAIA, founder of the Troy, N.Y.–based Architecture+, both everyday and treatment-focused environments involve “the same sensibility—you’re designing for a human being, first and foremost.”

Over the course of the last 30 years, Architecture+ has made a specialty of mental health facilities, having designed more than 150 of them across the country. And yet Pitts says that the motivating principles behind such projects are no different from those behind any other typology. “Most people see mental illness and they see only the roles of patient, doctor, and nurse,” Pitts says. “They fail to see the people.”

In two recent mental hospitals, the Vermont Psychiatric Care Hospital and the Wyoming State Hospital, the Architecture+ team looked to cater to basic human needs for privacy and convenience, eschewing the alienating double-loaded corridor model in favor of more intimate, suite-based patient rooms, and then filling each domicile with built-in furniture, cozy niches, and more.

Vermont Psychiatric Care Hospital courtyard by Architecture+ and Black River Design
Westphalen Photography courtesy Architecture+ Vermont Psychiatric Care Hospital courtyard by Architecture+ and Black River Design
Rendering by Zeidler Partnership for the Juravinski Centre by Architecture+ and Zeidler at St. Joseph's Health System in Ontario, Canada.
courtesy Architecture+ Rendering by Zeidler Partnership for the Juravinski Centre by Architecture+ and Zeidler at St. Joseph's Health System in Ontario, Canada.

Driving the change in mental wellness design today is a fast-changing understanding of what exactly happens in the minds of anyone, from patients to office workers to stay-at-home parents and their kids, as they interact with the world around them. At the Spero Academy in Minneapolis, the Minneapolis office of national firm HDR created a school for children with autism and special needs that reflects up-to-date research into the sensitivities of neuro-atypical students.

With a location on Kwikwetlem First Nation ancestral territories and a demand for care for this population, cultural practices were intentionally embedded within the treatments and the design of the [Healing Spirit House].

“The project is designed for the senses,” says HDR’s Anosha Zanjani, the LA behaviorial health design specialist. As studies have shown, sudden changes in noise, lighting, and other external stimuli can be distressing to autistic children, and so the Spero Academy features carefully calibrated transitions between different aural and visual zones, providing time and space for students to acclimate to their surroundings.

Healing Spirit House by HDR
Ed White Healing Spirit House by HDR
Healing Spirit House by HDR
Ed White Healing Spirit House by HDR

Healing Spirit House, another project from Zanjani’s team, in Coquitlam, British Columbia, includes art and design motifs based on the cultural traditions of the Kwikwetlem First Nation who live near the mental health facility.

“This facility serves both Indigenous and non-Indigenous youth and their families. However, with a location on Kwikwetlem First Nation ancestral territories and a demand for care for this population, cultural practices were intentionally embedded within the treatments and the design of the facility,” says Zanjani, citing information from extensive post-occupancy surveys and other sources proving how members of marginalized groups, and Indigenous communities in particular, often experience negative emotional responses to the cold, sterile atmosphere common to so many institutional buildings. “It’s so important to foster a sense of belonging.”

Taking the data and insights from clinical psychology and integrating them into architectural practice is a pressing imperative, according to Frederick Marks, AIA, founding board member of the Academy of Neuroscience for Architecture, an organization advocating better and more comprehensive mental health design.

Healing Spirit House by HDR
Ed White Healing Spirit House by HDR
Healing Spirit House by HDR
Ed White Healing Spirit House by HDR
Healing Spirit House by HDR
Ed White Healing Spirit House by HDR

“It should start with architecture schools,” Marks says. “Social and cognitive science should have some impact on what’s being taught.”

Inasmuch as architects have always sought to create buildings conducive to human flourishing, the profession has never really had objective, quantifiable metrics for determining the success or failure of a given design. Now, Marks says, sophisticated instruments like EEG brain-analysis devices and computer eye-tracking scanners make it possible to study an individual’s response to their environment in real time. While assimilating these innovations will likely take time, Marks does note that firms like HKS and HDR are hardly alone in keeping mental health specialists on staff, with other major offices like Gensler and CannonDesign also adding trained psychologists to their rosters. “That’s very good news,” he says.

While important advances are happening in the design of mental health facilities, and the health of the built environment in general, there does remain one major area in which architecture still faces a rather steep climb: Mental health within the profession. This issue was evident during the “The Impact of Mental Health & the Environment” conversation at the 2022 AIA Grassroots leadership event in February.

If we don’t do something about it in our profession, people will stop joining it. This is a wake-up call.
The Behavioral Health Pavilion by Architecture+ and NBBJ at the Nationwide Children’s Hospital in Columbus, Ohio.
Edward Caruso Photography courtesy Architecture+ The Behavioral Health Pavilion by Architecture+ and NBBJ at the Nationwide Children’s Hospital in Columbus, Ohio.
The Behavioral Health Pavilion by Architecture+ and NBBJ at the Nationwide Children’s Hospital in Columbus, Ohio.
Edward Caruso Photography courtesy Architecture+ The Behavioral Health Pavilion by Architecture+ and NBBJ at the Nationwide Children’s Hospital in Columbus, Ohio.

Korey White, AIA—a senior associate architect and planner at the Chicago office of DLR Group and leader of the AIA Strategic Council’s 2021 mental health work group—helped lead the conversation. She says the number of attendees at the virtual event, and the frankness with which they spoke about their own mental health struggles, was unprecedented. While she’s unaware of any large-scale studies of mental health and workplace culture for the architecture field, she explains that the AIA has identified mental health as an important issue that it is exploring incorporating into a variety of resources, including potentially the Guides for Equitable Practice. In the meantime, she says, many firms are taking the initiative to get ahead of the issue.

At HDR, that means a wellness program and flexible work arrangements. Two years ago, HDR also brought in Abraham Carrillo as its global inclusion and diversity director who oversaw the creation of “employee network groups,” including supportive groups for people of color, veterans, women, young professionals, and the LGBTQ+ community—Zanjani also collaborates with these groups to raise awareness and educate about mental health.

Illustration by Calvin Sprague

“There’s this old belief that to be an architect, you have to give up your life and be permanently stressed,” says Sophia Sparklin, AIA, founding principal at BSPARK Architecture of Great Falls, Mont. “Working through the weekend has been considered a law of physics,” Sparklin says. Architecture itself—the realm of the fluorescent-lit, open-floor office with the whirr of the laser cutter and the whoosh of the espresso machine—has too often neglected the mental well-being of its own practitioners; in that connection, Sparklin has been an active campaigner for reform in her role as a representative to the AIA’s Strategic Council, presenting a report last year that included structural as well spatial recommendations for improving working conditions in design. Little things like better acoustics, dedicated privacy suites, and adaptable workspaces have already produced a more comfortable office atmosphere for Sparklin’s staff, and the architect is eager to see her colleagues take steps likewise aimed at curtailing the burnout that seems increasingly endemic to the field.

“If we don’t do something about it in our profession, people will stop joining it,” she says. “This is a wake-up call.”