Institute of the Pennsylvania Hospital

Institute of the Pennsylvania Hospital
Established	1835
Construction Began	Female Dept: 1836 / Male Dept: 1856
Opened	January 1, 1841
Closed	1997
Current Status	Active and Preserved
Building Style	Pre-1854 Plans (Female bldg), Kirkbride Plan (Male Bldg)
Architect(s)	Isaac Holden (female bldg) and Samuel Sloan (male bldg
Location	Market St, Philadelphia, PA
Architecture Style	Late Georgian
Alternate Names	*Pennsylvania Hospital for the Insane Department for Mental and Nervous Diseases at Pennsylvania Hospital Institute of the Pennsylvania Hospital

The Institute of the Pennslvania Hospital, formally Pennsylvania Hospital for the Insane, was a private psychiatric hospital operating in West Philadelphia from 1841 until its closure in 1997. The building is currently being lease to Blackwell Human Services and the Kirkbride Center, and remains functional within the human services field; however, it is still owned by the University of Pennsylvania Health System. It was greatly expanded in the 1950's to accomodate a larger inpatient population. However, because of changing perception of psychiatry and insurance protocol the facility was forced to close its doors. In 2004, the NHPRC was issued a grant to organize, preserve and make publicly accessible the Institute of the Pennsylvania Hospital's archival collection.

There is a tremendous amount of confusion about the Pennsylvania Hospital in Philadelphia, PA. This is because there were infact two seperate facilities bearing the name. The first, founded in 1751 by Dr. Thomas Bond and Benjamin Franklin was located on Eighth and Pine Streets, and was completed in 1755. This facility is still operational, albeit not for its original purpose. It now largely is maintained because of its historica value to the city and state. This original facility found itself overwhelmed by the number of 'lunatic' patients, and regularly had their insane wards overcapacity. The board of director voted to build a second hospital, in what was then rural West Philadelphia, as was the style of such institutions at the time. This second hospital was known as the Institute of the Pennsylvania Hospital, as to draw distinction from their primary facility. This was also the hospital that Dr. Thomas Story Kirkbride was Superintendent, who is regarded as the father of American Psychiatry.

History

Under Dr. Kirkbride

In 1832 the Board of Managers of the Pennsylvania Hospital recognized the necessity of opening a separate asylum with the sole purpose of caring for the insane. A resolution was passed shortly therafter, as the mentally ill had at that time outnumbered the sick and injured patients. The Pennsylvania Hospital purchased a 101-acre farm in West Philadelphia in 1835 from Matthew Arrison a local merchant. The cornerstone for this new facility was laid on July 26, 1836 on the corner of 44th and Market Streets. The question of selecting an appropriate superintendent was complicated because of the absense of other large psychitric facilities in the America at the time. Locally, only Friends Hospital, then known at the Frankford Asylum, was operational and was only financially viable because of donations from the Society of Friends. The Board of Manager voted on October 12, 1840 and elected to hire the thirty-one year old alienist, Dr. Thomas Story Kirkbride, as the head of the new hospital. Dr. Kirkbride was born in Morrisville, where his family resided, and graduated from the University of Pennsylvania Medical School only two years prior. He was at the time finishing his residency at the Frankford Asylum before his selection.

Dr. Thomas Kirkbride

Thomas Story Kirkbride gained national reknown because of his particular methods. He developed a more humane way of treatment for the mentally ill that became widely influential within American Psychiatry. Today, the former Institute campus exists as a multi-purpose social-service facility. The new hospital, located on a 101-acre (0.41 km²) tract of the as yet unincorporated district of West Philadelphia, offered comforts and a “humane treatment” philosophy that set a standard for its day. Unlike other asylums where patients were often kept chained in crowded, unsanitary wards with little if any treatment, patients at Pennsylvania Hospital resided in private rooms, received medical treatment, worked outdoors and enjoyed recreational activities including lectures and a use of the hospital library. The hospital featured two "Kirkbride Plan" buildings, which were separated by a creek and pleasure grounds.

The first building was a long thin building located west of the Schuylkill River. This building would eventually become the female department. Though the building does reflect the Kirkbride Plan it was actually constructed before Dr. Kirkbride was given full supervisory duties. Construction began under the control of architect Isaac Holden but later illness forced Issac to return to his home country of England. The building was then finished by a young Samuel Sloan, who worked as a carpenter on the Eastern State Penitentiary. Sloan finished the building in 1841. The building was a rather simple design compared to later Kirkbride Plan buildings. Constructed of stucco covered brick, it was three stories tall with a central administration section flanked on either side by a set of wings. The top of the administration section was crowned with a large dome. On both the front and back of the administration section were stone porticoes. The interior of the building was well furnished, the lavishly carpeted corridors were twelve feet wide. The building features iron stairs, well lighted wards, and iron water tanks in the dome over the administration section, which provided fresh water to all of the building. At the rear corners of either side of the building were smaller, one story, "U" shaped buildings. These buildings were used to house the most noisy and violent patents, so that they wouldn't disturb the calmer, more manageable patients in the main building.

Superintendent Kirkbride developed his treatment philosophy based on research he conducted at other progressive asylums of the day including the asylum at Worcester, Massachusetts. Out of his philosophy emerged what would become known as the Kirkbride Plan, which created a model design for psychiatric hospital that was employed across the United States throughout the 19th century. This plan would be used for the hospital’s second building. On July 7, 1856, the cornerstone for a new building, built with the money from individual contributions, was laid at 49th and Market Streets, five blocks west of the original building. The new structure, which was to house only male patients, was dubbed the Department for Males, while the original building officially became known as the Department for Females. Dr Kirkbride commissioned Architect Samuel Sloan to design the new building. Built of stone and brick, the new building was laid out, as Kirkbride expressed, "in echelons." A large rectangular building, 3 1/2 stories tall, with gable roof and central dome, and a 2 story pedimented portico on its western facade, provided the central focus of the hospital and also housed its administrative offices. Extending from the center of this building to the north and south are two symmetrical wings about 250 feet long, 3 stories tall with gable roofs and ventilation cupolas at their furthermost termini. These wings were in turn connected to another pair, which extended to the east approximately 230 feet, paralleling each other, and of the same general appearance. At each terminus of the these rear wings was a final E-shaped wing which extended out approximately 250 feet. The north E wing housed troublesome patients, and the south E wing has since been removed. No wings are exactly in line, thus allowing fresh air to reach each wing on all four sides. Each of the patients' rooms in the wings had its own fresh air duct, the air being driven in from the towers at the terminus of each wing. There were 16 wards in the hospital, one for each of 16 distinct classes of patients, and each ward had its own parlor, dining room, and bathroom. Outside, there were gardens, shops, and walks for the patients.

The Institute: 1883 to 1911

The Pennsylvania Hospital for the Insane flourished under Kirkbride until his death on December 16, 1883, though for decades after his death, Philadelphia natives colloquially referred to the hospital as "Kirkbride's." Dr. John B. Chapin, the former Superintendent of the Willard State Hospital in New York, assumed the role of Superintendent of the Pennsylvania Hospital for the Insane after Kirkbride's demise. Chapin resigned from his duties in 1911, and was succeeded by Dr. Owen Copp, who initiated a School of Nursing for Men at the Hospital.

The Institute: 1912 to 1958

With the dawn of the 20th Century, a particular fascination with professional laboratory science was ushered in. It was posited that by more closely examining the brain and its inner workings, physicians could be able to determine the mysteries of mental illness. Neurologists and Micro-biologists concluded that insanity was a 'disease' of the nervous system, and it should be treated directed. Researchers collected brain specimens of deceased insane patients to search for clues about the nature of such pathologies. These early neuro-psychiatrists were no longer convinced that 'humane treatment' alone was sufficient to bring about psychiatric recovery for most of the clinical population. They looked for more allegedly scientific methods in conducting their variosu therapies. Reflecting this changing view, the Institute's name was changed in 1918 from 'the Pennsylvania Hospital for the Insane' to the "Department for Mental and Nervous Diseases at Pennsylvania Hospital". This name remained with the hospital for the next four decades. It was also during this period that professional nurses and personnel trained in psychiatry replaced the former attendants.

In 1913, Dr. Edward A. Strecker joined the hospital as an assistant physician. Over his forty-six years of tenure at the hospital, he became a preeminent author and teacher of clinical psychiatry. In 1920, Dr. Strecker established one of the first psychiatric outpatient community clinics in the world at Pennsylvania Hospital's 8th and Spruce Street campus. This facility, which would later become Hall-Mercer Community Mental Health Center, continues to operate as a well regarding outpatient provider in the City of Philadelphia. Additionally, as a pioneer in the treatment of alcoholism, Dr. Strecker was one of the first physician to pressume that alcoholism should be treated as a disease of the mind, not an ethical failing on the part of the individual. In 1935, Pennsylvania Hospital was the first psychiatric institution to hire a recovering person as an addiction counselor, a practice that has since become commonplace. Dr. Strecker, and his former alcoholic patient, Francis Chambers, Jr., developed the "dual diagnosis therapy" approach for recovery alcoholics, combining abstinence and ongoing psychological counseling. Following his deaht, the Institute's substance abuse unit was renamed "The Strecker Program" in his honor; and in 1989, it was named "Treatment Center of the Year" by the American Council on Alcoholism.

During the early 20th century, The Institute also introduced outpatient treatment for those with, what was then known as "psycho-neuroses", -- everyday family and work-related problems, such as: anxiety, sleeplessness, depression or low self-esteem. Psychotic patients in the Institute were transferred to the 44th Street location to make way for outpatient services geared to the community at large. The Institute thus became one of the few hospital programs nationally to treat patients ranging from the severely mentally-ill, to those needing help with the stresses of their everyday living. This is commonly regarding as the beginning of the deinstitutionalized movement, which in tragic irony, would ultimately have the Institute itself shut down.

Once surrounded by 130-acres of grounds, the hospital by the 1930's was now contained in approximately 27-acres bounded on the North and South by Haverford Avenue and Market Street, and on the East and West by 48th and 49th Streets respectively. The hospital continued to expand, and had many new buildings added during this period. Two additions were made to the Kirkbride original structure. The auditorium on the northern side of the north wing, which runs east to west (which still stands. Additionally, a wing was extended back from the primary entrance building and connects with the northern extension off the original central building. The land to the north of the original structure was developed and ccupied by a series of maintenance and clinical buildings, all constructed between 1929 And 1959. Open grounds to the south and east of the hospital wards were still open to the public at this time. However, a number of interior alterations of the original structures were done as a means of keeping up with modernization of medical practices. The 22foot high ceilings were lowered, many of the grands halls had been interrupted by individual partitions, and most of the smaller patients' rooms were converted into offices for hospital staff.

The Institute: 1959 to 1997

In 1959, the Female Department Building on 44th Street was closed due to the City of Philadelphia exercising its right of eminent domain of the property. Items from the original building were auctioned off with a frightening degree of haste. Shortly thereafter, the building was demolished to make way for the City's subway and mass transit projects. All patients were moved to the Male Department on 49th Street, which becmae the exclusive facility for the Institute. A new, five-story "North Building" opened to accommodate the consolidation of departments. Within a decade this building became the site of the area's first inpatient treatment center for adolescent children. It is this structire that was listed on the National Register of Historic Places and was designated a National Historic Landmark on October 15, 1966.

In 1969, Hall-Mercer Community Mental Health and Mental Retardation Center was moved to its own building, as the need for outpatient care greatly expanded in the past five decades.

The Kirkbride Center

Kirkbride Center in 2012

Following the closure of the Institute in 1998, three tall housing projects and a multi-purpose social-service facility were built near the grounds of the original 1841 Kirkbride hospital. Other parts of the property were sold for commercial and residential development in 2001, and in the due course of time many historic buildings belonging to the complex were demolished. There are still a number of abandoned structures on the property that are not currently being leased. The primary building of the former Institute was aquired in 1998 by Blackwell Human Services, to which they agreed to pay $700,000 a year for 130,000 square feet at the facility now operated as the Kirkbride Center. The lease agreement is part of a flurry of activity at the 27-acre West Philadelphia campus. As of 2010, the structure remains part of the Blackwell Human Services Corporation, and houses: the West Philadelphia ACES Charter School, Pennsylvania Hospital's Mill Creek School, Philadelphia Health Management Corporation's Adolescent Residential Treatment Center and Traveler's Aid's emergency family shelter. Over the frotn entrance of the 1959 expansion the engraving 'Institute of the Pennsyvlania Hospital' remains. The large Victorian dome of Dr. Kirkbride's original hospital, with its elaborate frescos, is also still standing, but it is in poor condition, as it has not been maintained in several decades.

The current 'Kirkbride Center' is the area's largest non-hospital inpatient program with 137-beds serving the Philadelphia area; drug and alcohol, long and short term residential, detoxification, and methadone treatment are all available as inpatient services on-site. While the Kirkbride Center still maintains a psychiatric ward, their specialization is significantly religated to 28-day drug rehabilitation. They do, however, like to celebrate Dr. Kirkbride and his contribution to the development of mental healthcare.

The Institute in the News

• Penna. Hospital Faces Uncertain Fate In Alliance It's Been Independent Since Its Founding In 1751. Now, It Is Being Swept Up In A Surge Of Consolidations.
• Penna. Hospital Ends Contract With U.s. Healthcare The Institution Said The HMO's Rates Were Too Low. It Was The Second Cancellation Since 1988.
• Pa. Hospital May Sell Psychiatric Institute The Historic Institute Of Pennsylvania Hospital Has Lost Money In The Last 4 Years. Corecare Systems May Buy It.

Other Adjacent Hospitals

• Friends Hospital
• Philadelphia State Hospital
• Norristown State Hospital
• Episcopal Hospital
• Pennsylvania Hospital
• Philadelphia Almshouse

Hospitals designed on Dr. Kirkbride's plan:

• Trenton State Hospital Originally 'New Jersey State Hospital at Trenton, NJ (1848)
• Jacksonville State Hospital at Jacksonville, Illinois. BUilt in 1848, and demolished in the 20th century.
• Harrisburg State Hospital Originally Pennsylvania State Lunatic Hospital at Harrisburg, PA. Built in 1853, Kirkbride Plan building demolished in 1893
• Taunton State Hospital at Taunton, MA. Built in 1853, demolished in 2009.
• Western State Hospital at Hopkinsville, KY. Built in 1854. Rebuilt in 1867 after a fire.
• Dayton State Hospital at Dayton, OH Built in 1855.
• Northampton State Hospital Originally Northampton Lunatic Hospital at Northampton, MA. Built in 1858, demolished in 2007.
• Institute of the Pennsylvania Hospital at Philadelphia, PA. Male Department built in 1859.
• Kalamazoo Regional Psychiatric Hospital at Kalamazoo, MI. Built in 1859, demolished.
• Bryce Hospital at Tuscaloosa, AL. Built in 1859. Sold to the University of Alabama
• Dixmont State Hospital at Pittsburgh, PA. Built in 1862, demolished in 2005.
• Weston State Hospital Originally Trans-Allegheny Lunatic Asylum at Weston, WV. Built in 1863. Currently a museum.
• Mount Pleasant State Hospital at Mount Pleasant, IA. Built in 1865.
• Hudson River State Hospital for the Insane at Poughkeepsie, NY. Built in 1868. Closed in 2007.
• Anna State Hospital at Anna, IL. Built in 1869.
• Central State Hospital at Anchorage, KY. Built in 1869, demolished 1996.
• Danville State Hospital at Danville, PA. Built in 1869.
• Buffalo State Hospital at Buffalo, NY. Built in 1870.
• Catonsville State Hospital Originally Maryland Hospital for the Insane, at Catonsville, MA. Built in 1872, demolished in 1962.
• Northern Illinois State Hospital at Elgin, IL. Built in 1872, demolished in 1993.
• Winnebago State Hospital at Oshkosh, WI Built in 1873, demolished in 1969.
• Independence State Hospital at Independence, IA. Built in 1873.
• Athens State Hospital Originally Athens Lunatic Asylum at Athens, OH. Built in 1874, renovated and reused by Ohio University.
• Warren State Hospital at Warren, PA. BUilt in 1874.
• Broughton Hospital at Morganton, North Carolina . Built in 1875.
• Greystone State Hospital at Hanover, NJ. Built in 1876.
• Napa State Hospital at Napa, California Built in 1876, Kirkbride demolished in 1949.
• Worcester State Hospital at Worcester, MA. Built in 1877.
• Danvers State Hospital at Danvers, MA. Built in 1878, demolished in 2006.
• Eastern Michigan State Hospital Originally Eastern Michigan Asylum for the Insane at Pontiac, MI. Built in 1878, demolished in 2000.
• Kankakee State Hospital at Kankakee, IL. Built in 1879.

Images of Institute of the Pennsylvania Hospital

Main Image Gallery: Institute of the Pennsylvania Hospital

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Links & Additional Information

• The Art of Asylum Keeping By Nancy Tomes
• An in-depth history of the hospital
• About Dr. Thomas Story Kirkbride
• See Philadelphia State Hospital at HistoricAerials.com: Male Building Female Building
• The Kirkbride Center- offical website
• Dr. Kirkbride and his legacy
• History of the building of the Kirkbride Center
• The Institute's contribution to Psychology