Throughout history mental illness has been feared and denounced, though over time perceptions have changed. From lunatic asylums to specialist hospitals, the intentions of hospitalisation have developed extremely. One of the first institutions was established in Jerusalem in 490 A.D., a model which Europe followed in London in 1330, with The Bethlem Hospital. These asylums were secure in character and continued to force hospitalisation. It was not until the 1970s that the therapeutic effect of environment on mentally ill patients was considered (Sendula-lengic et al 2011).
This lengthy period of time emphasises how long it took for therapeutic space to even be acknowledged and shows how far psychiatric hospital development has already advanced. This information accentuates that historically suffering with mental health issues would have been even more challenging, as social exclusion occurred due to mental disorders provoking feelings of distrust and fear.
Fig. 5 Bethlem Hospital at St George's Fields, 1828
Fig. 6 - Late seventeenth-century map showing the placement of the new Bethlem Hospital in Moorfields.
Images above - Artists impressions of Bethlem hospital
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During the 1960s and 1970s reconciliation began, whereby institutionalism was identified as being an inhumane option, which needed to be replaced (Mental Health Foundation 2015). Psychiatry underwent an intense period of accusation and this led to the gradual extinction of asylum like psychiatric hospitals. In place stood alternative communal resources such as halfway houses, community centres and psychiatric units in general hospitals (Vietta et al 2000). These changes called for different architectural solutions to facilitate rehabilitation, as it was finally recognised that people interact with their environments by acclimatising to conditions. In relation to healthcare institutions, a place where a person will experience heightened levels of fear, architectural elements are paramount in cost-effective treatment (Sendula-Jengi et al 2011).
These developments signify that throughout history the effect of calming architecture has gradually been acknowledged as playing a huge role in rehabilitation, and as the breadth of knowledge increases around the subject of mental disorder, as a society we become more accepting of change.