Architectural and Structural Engineering of Nineteenth- and Twentieth-Century Mental Health Institutions and Psychiatric Hospitals with Respect to Fire Causes and Mitigation Strategies

This paper sheds light on civil facilities that are home to the underrepresented and overlooked population with mental illnesses. More specifically, this paper examines the primary architectural engineering features of psychiatric hospitals from the lens of fire hazards. Psychiatric hospitals rose in popularity in the nineteenth century for individuals deemed unfit to live with the sane population. While they began with good intentions, these hospitals came to represent practices and poor living conditions for mentally ill patients. These conditions, when combined with a wide variety of mental illnesses, resulted in increased risks. One of the most significant risks in psychiatric hospitals was fire—with nearly all psychiatric hospitals examined herein experiencing at least one structural fire despite premier fire control inclusions. A brief history of psychiatric hospitals is presented first, followed by a discussion on various aspects of structural fire design. Then, an analysis of structural fires in psychiatric hospitals throughout the world is performed, and three general and common fire causes and mitigation strategies are presented. Perhaps current and future professionals can better mitigate fire risk in healthcare design by understanding where past architects and designers lacked in designs for vulnerable populations.

This paper examines an often overlooked portion of the world’s mental health history by shedding light on one of the most significant risks associated with nineteenth- and twentieth-century psychiatric hospitals: fire. A brief introduction to historic mental health facilities and their populations is presented first, followed by a discussion on fire control methods of the past. Then, seven prominent facilities, or asylums, with a history of fire are analyzed for cause and mitigation strategies. As a result, three prominent contributions are discussed and include architectural and structural design, fire mitigation methods, and population characteristics. The goal of this analysis is to increase awareness of the many and broad vulnerabilities of populations (past and present) such as the mentally ill when placed in care facilities. Perhaps current and future professionals can better mitigate fire risk in healthcare design by understanding where past architects and designers lacked in designs for such people.