The Kirkbride Plan

1844 – Reformist Dorothea Lynde Dix (April 4, 1802 – July 17, 1887) testified to the New Jersey legislature about the insufficient and inhumane treatment of individuals suffering from mental illness. They were housed in residences, county jails, basements, attics, prisons, and other tucked-away places to effectively be forgotten. Through her efforts, the United States established state-run hospitals. Philadelphian psychiatrist and psychiatry pioneer Thomas Story Kirkbride (July 31, 1809 – December 16, 1883) devised a revolutionary plan based on the philosophies of moral treatment and environmental determinism. The Kirkbride Plan promoted use of long wings staggered in such a way they could receive sunlight and fresh air while maintaining comfort and privacy. The collective work of Dix and Kirkbride led to the construction of the New Jersey State Lunatic Asylum (the Trenton Psychiatric Hospital) in Trenton and Ewing, New Jersey in 1848. It was the first institution built under the Kirkbride Plan.

Hospitals built under the plan often featured farmland to provide patients with physical exercise, therapy, and exposure to life. Others operated with self-contained towns, creating a semblance of community among those interned. For decades, the facilities provided aid and treatment to hundreds of patients. The original intentions of creating better care for mentally ill patients sadly dwindled as time went on: by the middle of the twentieth century, the conditions inside numerous institutions were poor. Overcrowded facilities, abusive staff, and patient neglect made a shocking increase. By the 1970s, the state had to close many of the sizable structures due to their high maintenance costs and/or mistreatment.

Many of the structures still stand day, though most have been abandoned, neglected, or vandalized. A handful are still in use while others are being renovated for other purposes.

Trenton, New Jersey

Trenton Psychiatric Hospital

1848

The Trenton Psychiatric Hospital (also known as the New Jersey State Hospital at Trenton and the New Jersey State Lunatic Asylum) was founded by Dorothea Dix on May 14, 1848. It was the first psychiatric facility built under the Kirkbride plan, as well as the state of New Jersey’s first public mental hospital. A total of 86 patients were admitted and treated under Dr. Horace A. Buttolph, the Trenton Psychiatric Hospital’s first superintendent. Dr. Henry Cotton was appointed medical director in 1907. Cotton believed mental illness to have direct connection to infections within the body. This led him to instruct his staff to extract teeth and remove other body parts, leaving patients scarred and mutilated. Cotton left the Trenton Psychiatric Hospital in 1930 and died three years later, but his legacy at the hospital continued: tooth extraction remained a treatment until 1960, thirty years after his departure.

Jacksonville, Illinois

Jacksonville Developmental Center

1848

The five-and-a-half-story-tall Illinois State Asylum and Hospital for the Insane was established on March 1, 1847 after Dorothea Dix lobbied for the state to build a psychiatric hospital to care for the mentally ill people who had been sequestered away. Construction began in 1848, but would not open until November 3, 1851 – two years later than Dix had hoped. The facility was the only psychiatric hospital in Illinois until 1869, with the construction of the Anna State Hospital. It was renamed “Illinois Central Hospital for the Insane” in 1869 and “Jacksonville State Hospital” in 1910. In 1974, the facility began to focus its care on developmentally disabled and delayed patients, and changed its name once again in 1975: “Jacksonville Mental Health and Developmental Center.” Due to budget constraints, it closed in 2012.

Anna, Illinois

Anna State Hospital

1869

The Anna State Hospital was built in Anna, Illinois as a 270-bed public psychiatric institution. Today, the hospital is open as the Choate Mental Health and Developmental Center. The current facility has faced multiple allegations of patient abuse and neglect since the late 1990s. In 2022, the center was under fire for over 1,500 vivid accounts of violence towards patients. The hospital also lied to state investigators when questioned.

 

Little Rock, Arkansas

Arkansas State Hospital

1883

State legislature approved building the Arkansas State Hospital in 1873, but construction did not begin until 1881. The facility opened on March 1, 1883 with one patient involuntarily committed a few days before. The hospital was renamed to the Arkansas State Hospital for Nervous Diseases in 1905 and the Arkansas State Hospital in 1933. During the 1930s, a dairy farm was added, where around one-hundred able-bodied patients were forced into unpaid work. It was expanded with the Benton Farm Colony in 1936. State legislature put an end to all farm operations in 1957. As the only public psychiatric hospital in Arkansas, it experienced major overcrowding: the 1,750-patient capacity hospital was inhabited by 5,046 patients by the end of 1935. The hospital also took in patients with intellectual and developmental disabilities. In 1959, the Arkansas Children’s Colony was built specifically for the care of such individuals, alleviating some of the overcrowding. The Arkansas State Hospital’s original buildings fell into unsafe disrepair by 1960; the Kirkbride building was torn down in 1963. In 2008, a new 132-bed facility was built in its place. As of 2023, the Arkansas State Hospital is still in operation, focusing on acute care over chronic illness.

 

Santa Clara, California

Agnews Developmental Center

1885

The Great Asylum for the Insane opened in 1885 in Santa Clara, California. The original building was destroyed in the 1906 San Francisco earthquake, killing a total of 117 patients and staff. The facility was the site of the largest loss of life from the disaster. The bodies were buried in mass graves on the property. The hospital was rebuilt and reopened around 1911 as the Agnews State Mental Hospital. It featured a train station, self-contained town, shops, farms, a steam-generating power plant, and a fire department. A second campus was added in San Jose in 1926. The first patients with developmental disabilities were admitted in 1965. By 1972, programs for the mentally ill were discontinued. The west campus closed in 1998 and the east campus followed in 2009.

 

Athens State Hospital

Athens State Hospital

Location: Athens, Ohio
Built: 1868
Status: Still standing

Bryce Hospital

Location: Tuscaloosa, Alabama
Built: 1861
Status: Still standing

Buffalo State Hospital

Buffalo State Hospital

Location: Buffalo, New York
Built: 1870
Status: Still standing

Athens State Hospital

Athens State Hospital

Location: Athens, Ohio
Built: 1868
Status: Still standing

Bryce Hospital

Location: Tuscaloosa, Alabama
Built: 1861
Status: Still standing

Buffalo State Hospital

Buffalo State Hospital

Location: Buffalo, New York
Built: 1870
Status: Still standing

Cherokee State Hospital

Cherokee State Hospital

Location: Cherokee, Iowa
Built: 1902
Status: Still standing

Clarinda State Hospital

Clarinda State Hospital

Location: Clarinda, Iowa
Built: 1884
Status: Still standing

Danvers State Hospital

Location: Danvers, Massachusetts
Built: 1871
Status: Demolished in 2006

Dixmont State Hospital

Location: Cherokee, Iowa
Built: 1902
Status: Still standing

Fergus Falls State Hospital

Fergus Falls State Hospital

Location: Pittsburgh, Pennsylvania
Built: 1862
Status: Demolished in 2006

Greystone Park State Hospital

Greystone Park State Hospital

Location: Morris Plains, New Jersey
Built: 1876
Status: Demolished in 2015

Hudson River State Hospital

Hudson River State Hospital

Location: Town of Poughkeepsie, New York
Built: 1868 – 1871
Status: Mostly demolished

Independence State Hospital

Independence State Hospital

Location: Independence, Iowa
Built: 1873
Status: Still standing

Northampton State Hospital

Location: Northampton, Massachusetts
Built: 1856
Status: Still standing

St. Elizabeths Hospital

Location: Southeast, Washington D.C.
Built: 1852
Status: Still standing

Taunton State Hospital

Location: Taunton, Massachusetts
Built: 1854
Status: Partly demolished, still standing

Weston State Hospital (Trans-Allegheny Lunatic Asylum)

Location: Weston, West Virginia
Built: 1858 – 1881
Status: Still standing

Worcester State Hospital

Worcester State Hospital

Location: Worcester, Massachusetts
Built: 1870 – 1876
Status: Mostly demolished in 1991 and 2008

  • 1848
    The Kirkbride Plan

    Dorothea Lynde Dix and Thomas Story Kirkbride's plan to revolutionize the treatment of mental illness is put into motion.

    The New Jersey State Lunatic Asylum (Trenton Psychiatric Hospital) is the first to be built under the Kirkbride Plan.

  • 1869

    The Anna State Hospital

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