Admission hospitals: 20th-century additions to English mental hospitals, heritage significance and challenges

Abstract Considered within a broader exploration of special challenges and opportunities inherent in health-related built heritage, this article discusses the virtual absence of 20th-century mental healthcare facilities from English heritage lists. It aims to examine the reasons for such an absence and reflect on potential solutions towards a more balanced representation. Building activity related to mental healthcare in England was extensive throughout the 20th century and also varied considerably: from interior reconfigurations of existing structures to additions of nondescript buildings and wartime temporary structures, as well as new building types and flagship commissions that attracted central government funding and prestigious private architectural designers. Given this wide range, the discussion here focuses on one new building type that emerged as a variation of earlier asylum typologies at the turn of the century and continued to evolve until its later decades. That is, the primary focus is on what became known at different times as Reception, Admission, or Early Treatment Hospitals (henceforth ‘admission hospitals’), and effectively served as a connecting thread across a series of critical policy and practice changes. By demonstrating the varying qualities and architectural features of these built structures and the critical policy and scientific developments in the field of mental healthcare during the 20th century to which these structures were associated, the article argues that some of these admission hospitals ought to be considered for heritage protection as successors to the 19th-century asylums. On this basis, the article discusses the suitability of specific evaluation systems, primarily historic thematic framework approaches that prioritise the analysis of historical contexts and linkages. The article also reflects on the relevance of broader developments in the field of heritage that can be seen as contributing to more holistic approaches, such as intangible heritage, heritage democratisation, multivocal narratives, or even rights-based approaches. Finally, considering the limited work in this area, as well as the number of examples already lost, the article stresses the need for urgent action if any sufficiently intact surviving structures are to be identified, recognised for their particular contribution to the mental healthcare field and safeguarded for the future.