Architecture of healthcare and social inclusion in interwar Czecho-slovakia: Pezinok Psychiatric Institute and the Masaryk Institute for Young People with Intellectual and Physical Disabilities in Bratislava

Matúš Kiaček

Cite this article
Kiaček, M. (2023) ‘Architecture of healthcare and social inclusion in interwar Czecho-slovakia: Pezinok Psychiatric Institute and the Masaryk Institute for Young People with Intellectual and Physical Disabilities in Bratislava’, Architecture Papers of the Faculty of Architecture and Design STU, 28(3), pp. 18-27.



The formation of an independent Czechoslovak Republic created a space for the institutionalisation of health and social care and the institution of a new legacy as a reflection on the state’s social policy. In addition to social and medical work in the field, as well as improvements in housing and hygiene conditions in both cities and the countryside, it became crucial to modernise and expand the network of healthcare and social facilities, including those for the people with disabilities. Although there were medical advancements in institutional care for people with mental and physical disabilities, such as rehabilitation, hydrotherapy, hippotherapy, electroconvulsive therapy, or therapy at work, attempts at social inclusion were rare and the care only improved slightly. There were only a few innovative institutions that pioneered social inclusion of patients, through proper education and adaptable architecture.

The paper focusses on the subject of healthcare and social inclusion of young people with intellectual and physical disabilities in interwar Czechoslovakia, presented in the architecture of the Institute for People with Nervous and Mental Health Disorders in Pezinok (1930s–1940s) and the Masaryk Institute for Young people with Intellectual and Physical disabilities in Bratislava (1935). The aim is to identify crucial problems, confront visions and reality, and to prove that, despite difficulties and minor results, even then there were innovative architectural and medical reflections on the needs of people with disabilities.

The Pezinok Institute was the first clinic in central Europe to offer treatment of children with epilepsy and mental disabilities. The institute was owned by the joint-stock company Pezinské železité kúpele (Pezinok Ferrous Spa), established by the construction entrepreneur Rudolf Frič (1887–1975), who redesigned and rebuilt the clinic and added new functionalist buildings (1930s–1940s). In an expert capacity, the project was professionally overseen by Professor Karol Matulay (1906–1998).

For chronic child patients with epilepsy and intellectual disability, work therapy and hippotherapy were particularly effective, so that the facilities established workshops, ovens, and greenhouses where patients learnt practical craft skills. The institute believed that elementary education and practical skills would socialise patients, adapt them to general society, and decrease their dependence on the government and their relatives.

The early phase of the institution’s construction consisted of rebuilding a ferrous iron spa in the early 1930s and its adaptation to a men’s ward. In 1940 the campus was expanded by absorbing the neighbouring plot of land with the former antimony factory, the buildings of which were provisionally adapted to a women’s ward and the gardens of the two sites were connected. The campus was enlarged in stages by the construction of other ward pavilions, private patient pavilions, an office building, workshops, complementary facilities and others, including landscape redesign and new outdoor facilities such as horse riding. The further planned expansion of the facility, based on the pavilion plan, including the construction of new wards and a school, was halted by the worsening war situation and the increasing social hate and feeling of superiority to any minority, including the one with disabilities, as claimed by the Nazi ideology.

The Masaryk Institute, as the first of its kind in Slovakia, aimed not only to establish institutional health and social care, but also to integrate its patients into the society. According to its initiator, professor Karol Koch, it was requisite to adapt the architecture to the needs of the people with disabilities, while not allowing them to feel that their environment differed from that of the others. Therefore, the facilities would include ateliers, workshops, aulas and studies, a theatre hall and library, to educate and socialise the patients.

The innovative nature of the institute’s program was imprinted in its progressive functionalist design by Milan Anton Pavol Harminc (1905–1974), with a pavilion for people with physical disabilities, another pavilion for people with mental deviations, and one central social and educational pavilion with a hospital ward. The cascading structure of buildings located on a hill made it possible to arrange the buildings in a more concentrated manner, ensuring sufficient ventilation and sunlight, as well as the separation and segregation of patients and facilities.

Unfortunately, due to financial shortages, and strategic change in the institutionalisation of government healthcare, the Masaryk Institute for Young People with Intellectual and Physical Disabilities has never been built. It proved that as opposed to the society, the government was not prepared for the ambitious vision of inclusion of people with disabilities.

The paper has tried to verify that, despite obstacles and partial achievements, the Czechoslovak interwar architecture managed to reflect the actual demands of health and social care of people with both intellectual and physical disabilities. However, both examples prove only partial fulfilment of the medical and social goals of Czechoslovak interwar health and social care of the people with disabilities.

Keywords: social care, disabilities, interwar Czechoslovakia, social inclusion, Harminc, youth, health, psychiatric institute, Frič