The healthcare built environment has effects on patient's wellbeing. These effects are even heavier on sensitive patient such as psychiatric ones. Therefore the environment design can be a key factor in promoting the patients' well-being and the care process. This paper investigates how this vision is influencing the design of psychiatric facilities in the Italian context, known for its radical innovation of mental health services due to Law 180 (1978). The article identifies the current built environment issues of the psychiatric ward, the design indications available and the possible future actions to meet the needs of users and to improve wellbeing and care process.