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Secure Mental Health
Secure mental health facility design is among the most technically and ethically demanding work in the built environment. Every decision, from anti-ligature specifications and sightlines to mechanical services and materials, carries direct clinical weight. We work with NHS trusts, independent providers and construction partners to deliver secure environments across the UK that are safe, regulatory-compliant and designed around the people who use and work in them.
Speak to our secure mental health facility design team
What sets us apart in secure mental health facility design
We’ve delivered secure mental health projects across the UK within live operational settings, where design decisions directly affect patient safety and clinical outcomes. Our teams know the regulatory frameworks that govern this sector: NHS England’s Environmental Design Guide for medium secure services, HTM standards and CQC requirements. That knowledge is built into how we work, from the first briefing conversation to handover.
The particular difficulty of this sector is holding two demands in balance: security that functions without dominating, and clinical environments that feel considered rather than institutional. We manage multi-layered approval processes, coordinate with clinical and estates teams in parallel, and keep programmes on track in settings where any disruption has a direct impact on patient care.
Physical security
Designing safety into every detail
Security in a mental health facility isn’t a specification added at the end of a design process. It’s a structural input from the outset. Anti-ligature requirements apply to fixtures, fittings, services and furniture throughout patient areas. Sightlines, circulation routes and access control need to be resolved spatially before mechanical and electrical systems are specified. Getting that sequence right is what keeps projects on programme.
Regulatory frameworks
Knowing the standards that shape this work
Secure mental health services in England operate across three tiers: high, medium and low secure. Each carries distinct physical, procedural and relational security requirements and the design brief shifts substantially between them. NHS England’s Environmental Design Guide for medium secure psychiatric services establishes that security and therapeutic care are integrated concepts, not competing ones. That principle is the starting point for everything we do in this sector.
Therapeutic environments
Spaces built around recovery
CQC’s 2024/25 Mental Health Act monitoring report identified ward environment quality as a persistent concern across NHS inpatient settings. Research published in BMJ Open in 2024 found that well-considered design features, including open sightlines, sensory spaces and homely finishes, benefited both patients and staff. The quality of the built environment has a measurable effect on clinical outcomes.
Secure mental health facility design in practice
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Understanding secure mental health facility design
Frequently asked questions (FAQs) about secure mental health facility design.
Secure mental health facility design is the planning and engineering of clinical environments that provide both therapeutic care and physical security for patients detained under the Mental Health Act. It covers architecture, mechanical and electrical services, anti-ligature specification, access control and compliance with NHS and Care Quality Commission standards.
Secure mental health provision in England is structured across three tiers: low, medium and high secure. Low secure units accommodate patients with moderate risk profiles. Medium secure units serve those requiring more intensive intervention, including transfers from prison. High secure facilities such as Broadmoor and Rampton are reserved for patients presenting the most serious risk to others.
Anti-ligature design is an approach to specifying fixtures, fittings and building fabric that removes or reduces anchor points that could be used for self-harm. It applies to door furniture, light fittings, pipework, window ironmongery and curtain tracks, among other elements. Anti-ligature specification is a legal and regulatory requirement in all inpatient mental health environments.
The NHS Environmental Design Guide for medium secure psychiatric services is a planning and design standard published by NHS England. It sets out the physical, spatial and security requirements for medium secure units, and establishes that security and therapeutic care are integrated rather than opposing priorities. It applies to all new-build and refurbished medium secure facilities.
Timescales for a secure mental health facility are typically longer than for standard clinical buildings. Regulatory approvals involve NHS estates, clinical and planning teams alongside any Ministry of Justice requirements, and phased works within live environments add further complexity. New-build medium secure units commonly take between four and seven years from initial brief to practical completion.
