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The purpose of this paper is to describe the architectural design considerations and effects of moving patients from an adapted Victorian medium secure unit to a purpose built facility.

Patients and staff views of the old and new unit environments were compared in terms of homeliness, architectural features, ward atmosphere (WAS) and patient satisfaction.

The new unit was rated as more homely. The change of environment did not increase risk behaviours and was associated with a reduction in symptomatology.

Limitations of the study include the small‐sample size and choice of measure of WAS. More research is needed into the constituents of “planned” environments where the physical environment is the primary intervention.

These include the need for close collaboration among architects, clinicians and patients in order to maximise the therapeutic benefit of the built environment.

This paper contributes to a small literature that “bridges” architectural, psychiatric and environmental domains.