Psychiatric hospitals: perception does not equal reality

by Cody Dolan on September 10, 2010 · 22 comments

in stigma

In this space I’ve made fun of Burger King. I’ve torn down Chuck. And I’ve taken aim at fictional universes. I’ve spent a lot of time telling you what the entertainment industry gets wrong when it comes to psychiatric clinics, but I’ve yet to show you how easy it would be to get these settings right…until now. [In my head here’s where I’d turn to the camera with a dramatic flourish, backed by an uplifting score. Since this is a text-based medium, please picture this in your own head. To help form this image, know that I look exactly like a younger, more handsome George Clooney.]

Let’s recap before moving on. This is what the set designer for House thinks a group therapy room looks like:

And this is what they think a patient room looks like:

Does that look like a place you’d want to spend any amount of time? I submit that it is not. Locked windows that are backed by wire mesh and look like prison bars. Institutional gray/sickly green walls. A bed that wouldn’t look out of place in an old war movie (the kind where the men are stationed in a big tent full of cots).  Irascible jerk who is mean to everyone…well, I suppose Dr. House wouldn’t be in your local psychiatric clinic.

These are two of the better pictures I could find. (Surprisingly, no one out there on the Internet is interested in posting photos of a fake psychiatric hospital that was on a show last September). Still, you get the idea; this is not a place anyone wants to be. Even if you knew you needed help and knew that this place could provide that help, there’s no way you’d voluntarily check in.

So what should the ideal psychiatric hospital look like?  I’m glad you asked.


Here is a photo of a Menninger patient room, taken from the virtual tour available on our website:

Let’s just get this out of the way:

  1. The bedspreads may be straight out of the early 90s. We’d have to use carbon dating to be sure.
  2. The bulletin boards look like someone’s idea of a college dorm room.
  3. No one buys CDs any more.
  4. Do they still make boom boxes like that?

The accessories in the pictures are a little dated, but the floor layout and color scheme aren’t. These rooms have curtains. They’re carpeted. Everything isn’t pea green or beige. Patients get their own nightstand and desk and more than two colors are present. In short, it actually looks pleasant.

But what about other areas of The Clinic? Once again, I’m glad you asked. Here’s what amounts to a patient living room:

Now I’m biased because I once owned that exact couch (and no, I’m not kidding. I bought it at Gallery Furniture in Houston), but that looks pretty nice to me. I speak from experience when I say those couches may be the best napping couches ever made. In fact, I’m getting a little sleepy just looking at them. And no room is complete without pinto bean-shaped coffee tables.

Are patients allowed outside? Of course they are. And it’s a green wonderland of loveliness:

These living trees, green grass and paved walkways are a far cry from the tightly-fenced basketball courts, gravel paths and dead-leaf-strewn views you usually see on television.

Lots of shade, a comfy gazebo and covered walkways to provide some measure of relief for when it’s 107 degrees in August.

“I get it,” you say, “Menninger is awesome and we should all support it and give The Clinic tons of money for research and patient care and because it’ll make us feel good inside. But what about institutions not started by the Menninger family?” I’ve got you covered there as well.

Other facilities

Timberline Knolls Residential Treatment Center specializes in mood and eating disorders as well as addiction. It’s located in Illinois, near Chicago, and has an extensive website where anyone can view the photos below. Here’s an exterior view:

I am entirely comfortable admitting that this is nicer than the outside of my house. I want a porch like that, supported not just by wood joists, but by a huge column of stone. Nothing says class like stone pillars, and there are far too few of these things in my life.

Here’s the facility’s library:

Notice the comfy reading chair on the right. Once again, I want this in my house. That floor looks more comfortable than my couch.

Finally, here’s a patient room:

I don’t get the fascination with bulletin boards in patient rooms, but then I’m not a doctor. Still, this looks pretty A-OK to me. Collegial and cozy without trying too hard. Is that a spool of thread on the desk? I think I could get some knitting done in this room, so long as you don’t ask me to make anything that a normal human would wear.

“So you found one more nice place,” you say. “Big deal. I could find two places in Baghdad that make it look like it’s tolerable to live there.”

I’d respond by showing you the Austen Riggs Center, a well-known psychiatric clinic in western Massachusetts. Once again, I found all of these pictures on their website. Here’s a photo of a patient room. Sadly, it’s missing a bulletin board.

You get there by entering what looks like a colonial mansion:

Austen Riggs advertises an open, therapeutic environment with both inpatient and residential treatment programs. Patients there can use a “step down” program that helps them transition back to their everyday lives. Part of that transition means cooking meals in this kitchen:

I’m a terrible cook, and I’d jump at the chance to channel Gordon Ramsay here. Just look at that kitchen! I challenge you to comment below and truthfully tell me you aren’t in awe of it. It looks like it’s the size of my living room. (I should probably stop giving y’all the impression I live in a hovel.)

What’s the takeaway?

Psychiatric hospitals have come a long way since the 60s, but unfortunately that seems to be the last time anyone in charge of designing one for the big or small screen saw one. There’s nothing special about the rooms above; they all look like comfortable places people want to spend time in. Given that set designers create rooms like these all the time, it doesn’t seem like it’d be that hard to make psychiatric hospital settings look inviting, right?

Are you surprised to see how “normal” these rooms look? What were you expecting, and how could we work to combat those expectations? Let me know in the comments.

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