Part of "The Vanishing Body" series
In my continued series on the Vanishing Body for my Humanity and Ethics, I am going to write a brief essay on the body in the psychiatry ward. Often, the body in the psychiatry ward, afflicted with disease, is culturally viewed different than the body in, say, the hospital recovering from a stroke, or a heart attack, or shoulder surgery. It might be viewed differently by medical professions as well. And definitely patients. This essay covers a bit of that and different ways to address the body in the psych ward.
What happens to a body in a psychiatric ward?
Clinically, there are medications and treatment team meetings. Therapy sessions and group recreational time. These matter, of course, for healing acute psychiatric illness. But I mean something simpler: What does it feel like to exist in that space? To move through halls designed for surveillance and safety? To breathe air thick with the knowledge that you are somewhere no one wants to be—not just sick, but that kind of sick. Air that carries no memory of the outside world, no trace of weather, seasons, or the rhythms that make spaces feel alive.
Psychiatric wards are engineered for observation. Vital, yes. Every corner sharpened for monitoring, every surface stripped of anything that might offer comfort. There is this sense that the architecture whispers a suspicion: Your body is a threat. Your impulses need policing.
Could design reshape the daily experience of hospitalized patients? Could it shift public perception of wards from institutions of confinement to places of healing?
Schizophrenia and the Tyranny of Reason
We picture mental illness as chaos and a loss of reason. But Psychiatrist Iain McGilchrist reframes schizophrenia as a prison of rationality. The opposite of emotional chaos. He states that schizophrenia is not characterized by a "Romantic disregard for rational thinking and a regression into a more primitive, unself-conscious emotive realm of the body and the sense." The mental illness is less about an overtly emotional firing of the brain and instead "an excessively detached, hyper-rational, reflexively self aware, disembodied and alienated condition."1 The mind turns against itself, scalpel in hand.
The brain evolved to navigate the world through embodied intuition, blending emotion and reason in seamless movement through space. In mental illness, this gets stuck in a loop of rationality. That effortless sense of being in your body—what Merleau-Ponty called "motor intentionality"—shatters. You hyper-monitor every breath, every gesture. Your body becomes a foreign object and your mind hires its own warden. You live in your head that feels exiled from your flesh.
And then we place you in wards where fluorescent lights bleach shadows. Where locked doors punctuate corridors. Where the air hums with vigilance, broken only by the sounds of other patients, each carrying their own exile from society. These spaces are well engineered for control and constant monitoring. Design choices that prioritize observation over embodied connection.
It's like holding a mirror to a hall of mirrors.
We're treating people whose minds may already be trapped in cages of hyper-rationality—obsessive self-scrutiny, mechanical thoughts, emotional detachment—by doubling down on that same logic. Surveillance for the over-surveilled. Control for the over controlled.
What if the cure mirrors the disease?
The Hyper-rational Ward
Cinema understands this phenomenon. In One Flew Over the Cuckoo's Nest, the ward represents a form of docility. In Shutter Island, the Ashecliffe Hospital's sterile labs and labyrinthine corridors literalize the protagonist's fractured psyche. Architecture reflects the psychological torment and confusion of its inhabitants. In Joker, Arthur Fleck's final scene in Arkham's white room seems inevitable. As if to say, this is the only place that knows how to deal with somebody like you.
These films reveal that spaces tell stories. They tell the same story: minds are problems, bodies are risks. You lose sense of your reality and you end up in a space that feels equally unreal.
Consider the trade-offs embedded in these design choices. Fluorescent lights ensure visibility but disrupt circadian rhythms. Bare, bolted furniture prevents weaponization but denies tactile comfort. Long sight-lines ease monitoring but strip away privacy. These aren't malicious choices—they're practical responses to real risks. But the accumulation creates environments that feel more like labs than places where humans heal.
Spaces That Heal, Spaces That Harm
A global comprehensive study of 31 contemporary psychiatric hospitals reveals the scope of the problem. Of the facilities surveyed, 27 used what is termed the "campus model"—interconnected buildings with internal corridors designed to prevent patients from accessing outdoor spaces during daily movement. Only 4 employed the "village model," where patients must walk through landscape to reach treatment areas. The dominance is stark: every single American facility in the study employed the campus approach, even those on rural sites where village designs would have been feasible. The preference reflects institutional thinking. It's easier to secure corridors than gardens, simpler to control indoor routes than outdoor pathways. Regardless of what patients' bodies actually need to heal, the priority remains embedded in environments not necessarily designed for patient well-being.
There are alternatives.
One UK facility revived the 19th-century "village model." Patients walk outdoors between cottages and treatment hubs—twice daily, rain or shine. Inner fences allow garden access without compromising security. Landscape becomes therapy, not obstacle.
An American recovery center designed "houses" for 6-10 patients, each with intimate lounges and kitchens. Social spaces graduate from private (bedroom) to semi-public ("neighborhood") to communal ("downtown"). Choice restores agency. Architecture acknowledges that healing requires the ability to control your level of social engagement—to retreat when overwhelmed, to emerge when ready.
A Canadian facility placed its treatment hub beside public zones. Cafés, libraries, and vocational spaces blur the line between hospital and community. The proximity breaks down the barriers that feed stigma. The building communicates healthcare and not a place of exiled bodies.
These designs demonstrate what becomes possible when safety and dignity aren't seen as opposing forces. The study identifies five core treatment values that contemporary psychiatric care should support—privacy and dignity, least restrictive environment, choice and independence, architectural reflection of the treatment journey, and community involvement. The innovations above show these values can be built into actual spaces.2
What Bodies Deserve
It's 3 AM and the fluorescent lights are still humming overhead. Your body knows it should be dark. Every cell asking for the circadian rhythm that's been stripped away in the name of visibility. The staff can see you clearly, but your brain can't find sleep. The medical principle of "do no harm" gets complicated when you're living under lights that disrupt the very biological processes your healing depends on.
The door to the courtyard is locked after 9 PM. Your need for fresh air, for the feeling of weather on your skin, doesn't fit the schedule. The psychiatry ward itself whispers: We don't trust you alone with your own body. Autonomy becomes a question—can you control anything about your own comfort? Can you choose between social spaces when you're feeling overwhelmed or ready to engage?
During visiting hours, your sister brings your nephew. He's seven and scared of the long hallways, the way voices echo, the way all the furniture is bolted down. You realize he's seeing you through the building's eyes—as someone who can't be trusted with normal things. The space is teaching him what kind of person you are.
A stroke patient gets a room with natural light and family photos on the nightstand. A psychiatric patient gets enclosed TVs and observation protocols. Same hospital. Same goal of healing. Different assumptions about who can be trusted with basic human comforts. Justice asks why having a psychiatric diagnosis means losing access to natural light and privacy. Why do we treat some patients as people and others as risks?
The architects didn't sit in a meeting and decide these people deserve less dignity. They made practical choices—easier to clean, safer to monitor, simpler to control. But the accumulation of all those practical choices becomes a moral statement about whose bodies deserve dignified care. And that matters.
Some architects are starting to ask different questions. Instead of "How do we control this space?" they're asking "How do we create spaces that honor the full complexity of human experience?"
The Right to Belong
My first psychiatric rotation was in a city’s indigent care hospital. A patient confessed: "Nobody wants to be the person who gets off on the 13th floor." So they’d exit early, climbing stairs to hide their shame. When healing requires disguising your body’s need for care, what does that say about the space we’ve built?
Our most logical wards may deepen the wounds they treat. We combat hyper-rationality with hyper-rationality. Alienation with alienation.
As village gardens and graduated "houses" prove, we can build spaces that honor both safety and soul. Spaces where light has warmth, access to the sunshine and outdoors, and the space itself can be a place of healing.
Because sometimes sanity begins when a space shouts:
Your body belongs here.
McGilchrist, I. (2009). The Master and His Emissary: The Divided Brain and the Making of the Western World. New Haven, CT: Yale University Press
Mclaughlan R, Lyon C, Jaskolska D. Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design. Medical Humanities 2021;47:e11.
I like the image of the seven year-old nephew coming to visit and learning what “that kind of sick” means through the architecture and atmosphere of the building.