Asylum Architecture in the United States, including the architecture of psychiatric hospitals, affected the changing methods of treating the mentally ill in the nineteenth century: the architecture was considered part of the cure. Doctors believed that ninety percent of insanity cases were curable, but only if treated outside the home, in large-scale buildings. Nineteenth-century psychiatrists considered the architecture of asylums, especially their planning, to be one of the most powerful tools for the treatment of the insane, targeting social as well as biological factors to facilitate the treatment of mental illnesses. The construction and usage of these quasi-public buildings served to legitimize developing ideas in psychiatry. About 300 psychiatric hospitals, known at the time as insane asylums or colloquially as “loony bins” or “nuthouses,” were constructed in the United States before 1900. Asylum architecture is notable for the way similar floor plans were built in a wide range of architectural styles.
The medical profession of psychiatry, known as "Asylum Medicine" from about 1830 on, in insane hospitals was instrumental in the planning and development of asylum architecture. Nineteenth-century philosophers and architectural theorists argued that the natural and built environment shaped behavior. The doctors who promoted the establishment of mental hospitals used the same rhetoric as social reformers and park enthusiasts: that nature was curative, exercise therapeutic, and the city a source of vice. Early psychiatrists assumed that mental derangement was caused by environmental factors, particularly the tensions present in the individual’s current domestic or social environment, which in turn suggested that a changed setting might alleviate psychic pain. Psychiatrists, also known as medical superintendents, collaborated with architects to enhance the new social environment of the insane asylum. A series of plans, such as the Kirkbride plan and the Cottage plan, resulted from this collaboration, developed using theories that would help facilitate the treatment of patients.
The Quaker reformers, including Samuel Tuke, who promoted the moral treatment, as it was called, argued that patients should be unchained, granted respect, encouraged to perform occupational tasks (like farming, carpentry, or laundry), and allowed to stroll the grounds with an attendant and attend occasional dances. While the moral treatment could, with difficulty, be employed in an old house or adapted almshouse, this situation was considered a sad compromise. In the United States, doctors developed a highly specialized building type for 250 patients. Dr. Thomas Story Kirkbride devised a widely applicable set of planning principles that ensured classification by type of illness, ease of surveillance, short wards for good ventilation, and clarity of circulation.Kirkbride Buildings