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Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design
  1. Rebecca Mclaughlan1,
  2. Codey Lyon2,
  3. Dagmara Jaskolska2
  1. 1School of Architecture and the Built Environment, The University of Newcastle, Newcastle, New South Wales, Australia
  2. 2NTC Architects, Melbourne, Victoria, Australia
  1. Correspondence to Dr Rebecca Mclaughlan, School of Architecture and the Built Environment, The University of Newcastle, Newcastle, NSW 2308, Australia; rebecca.mclaughlan{at}


History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.

  • architecture
  • cultural history
  • mental health care

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  • Contributors The research methodology was conceptualised by RM and CL. Data collection was completed by RM, CL and DJ. Analysis was completed by RM and CL, in accordance with the conceptual model developed by RM for her doctoral thesis (2014). Figures/diagrams were created by RM. The manuscript was prepared by RM.

  • Funding This study was funded by the Victorian Health and Human Services Building Authority (commissioned study).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information. The primary method undertaken for this research relied on data publicly available on the internet.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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