Bridging the Gap: Adaptive Reuse of Carrington Hospital as a 'Missing Middle' for Mental Health Care in Tāmaki Makaurau

Abstract

This thesis responds to a critical gap in mental healthcare systems, a challenge particularly acute in Aotearoa New Zealand but relevant globally: the "missing middle" This term refers to people with moderate to severe mental health needs who are too unwell for primary care alone yet do not meet the threshold for specialist or inpatient services. Caught between these systems, they often face social isolation, housing insecurity, and cycles of crisis. The research explores how architecture can respond to this gap, proposing that adaptive reuse can create supportive, community-based environments that promote recovery, dignity, and belonging.

The project is situated in Tāmaki Makaurau Auckland and focuses on the adaptive reuse of the former Carrington Hospital (Building One), a Category 1 historic place with a complex legacy of mental health care. Located within the Wairaka Precinct Masterplan, a site of ongoing urban regeneration, Carrington serves as a test case to explore how heritage structures can host new models of care while respecting their historical and cultural significance. The research is guided by the question: How can the adaptive reuse of the former Carrington Hospital create a new architectural model for the "missing middle" in mental health care, one that promotes recovery through de-institutionalised design, community integration, and a meaningful dialogue with its heritage?

The methodology combines qualitative literature review and analysis of existing policy frameworks, such as the He Ara Oranga report and the Auckland Unitary Plan and evidence-based precedent studies to develop a set of design principles. These principles are then applied and tested through design-led inquiry, resulting in a proposal that reimagines Carrington as a Community Wellness Hub with integrated transitional housing. The design establishes a “stepped care” framework within one connected site, enabling residents to move gradually from supported to independent living while remaining engaged with community and nature.

This thesis concludes that this specific approach to adaptive reuse functions as a multi-layered act of healing: it provides a therapeutic environment for the "missing middle," fosters social integration for the wider community, and heals the building's stigmatised past by inverting its narrative from one of confinement to one of care. The project demonstrates a replicable model where architectural regeneration is intrinsically linked to social and psychological wellbeing.