Including patients, staff and visitors in the design of the psychiatric milieu

Nathan H. Perkins (School of Landscape Architecture, University of Guelph, Guelph, Canada)


ISSN: 0263-2772

Publication date: 28 June 2013



Participation by patients, staff and visitors in healthcare design and planning offers multiple benefits in addressing the complex challenges of creating salutary environments for hospital patients, staff and visitors. The purpose of this paper is to present the benefits of participatory design and design imperatives to facilities architects and landscape architects.


The paper describes three case studies in which participatory methods were used to engage users in decision making over 15 years and creates a framework using “design imperatives” that has been successful in the design of outdoor settings.


Nine design imperatives can be used to design facilities that achieve a range of therapeutic benefits for patients, staff and visitors.

Research limitations/implications

The research limitations of this paper are those of using case studies in general. The implications suggest that papers such as this can be used in future hypothesis‐driven research.

Practical implications

Designers do not have the luxury or ability to base myriad design decisions on experimental research findings, as almost all design is unique and a hypothesis waiting to be tested. The result is that guiding principles, or design imperatives based on participatory methods, can form the basis for design decision making.

Social implications

The social implications are that some form of participatory decision making in facilities design has benefits to multiple constituencies, specifically, patients, staff and visitors.


Although this paper refers to many existing studies and places the results and conclusions within a context that is supported by the literature, much of the value is because the results are based on practice. More than a dozen projects form the basis for concluding that general principles of design, person‐environment interactions and participatory methods lead to desirable and beneficial outcomes.



Perkins, N. (2013), "Including patients, staff and visitors in the design of the psychiatric milieu", Facilities, Vol. 31 No. 9/10, pp. 379-390.

Download as .RIS



Emerald Group Publishing Limited

Copyright © 2013, Emerald Group Publishing Limited

Please note you might not have access to this content

You may be able to access this content by login via Shibboleth, Open Athens or with your Emerald account.
If you would like to contact us about accessing this content, click the button and fill out the form.
To rent this content from Deepdyve, please click the button.