After avant-garde artists had widened the use of traditional materials, styles and groups of creators to support the upgrading of psychotic artworks, psychiatric clinics became places of art production in the 20th century. As creative designing was institutionally embedded within these facilities from the 1950s onwards, questions about its functions within these contexts arose. This paper examines the lives and works of three non-professional artists living in German, Swiss and Austrian clinics by analysing six of their paintings and drawings. It asks about the reasons that led to the emergence of creative drives within them, about the needs they hereby satisfied and about the functions art had in their lives. In order to integrate their works within interdisciplinary research, the article draws on Erving Goffman’s theory of total institutions to examine whether the case studies used art to express autonomy and self-determination within their socially, locally and economically restricted environment.