As psychiatric care evolves, greater attention is being directed to the design of treatment environments that actively support patient recovery and well-being. Extensive research on therapeutic landscapes highlights the benefits of nature, daylight, and biophilic design, yet many modern psychiatric facilities still struggle to integrate these features into centralized, efficiency-driven layouts. This paper investigates the historical progression of psychiatric facility design in Vienna and explores how architectural elements-ranging from open gardens to preserved historical facades-can be leveraged to improve patient outcomes. Through a qualitative approach combining historical analysis and a field study at Klinik Hietzing, we suggest how openness, access to nature, and historical continuity contribute to more humane psychiatric environments. Interviews with key stakeholders at Klinik Hietzing highlight the benefits and challenges of blending pavilion-style layouts with modern hospital requirements, showing that spatial autonomy, garden therapy, and a continuity of historic design can effectively counteract the stigmatizing and isolating effects often found in large, centralized hospitals. These findings indicate that future psychiatric facility designs should incorporate patient-centered, dynamic, and sensory-rich features to create a holistic environment that promotes patient recovery and facilitates social engagement.