Norristown State Hospital

Norristown State Hospital
Established	May 5, 1876
Construction Began	March 21, 1878
Construction Ended	1966
Opened	1880
Current Status	Active
Building Style	Transitional
Location	Norristown, PA
Architecture Style	High Victorian Gothic Revival
Peak Patient Population	4,954 in 1947
Alternate Names	Norristown Asylum for the Insane, State Lunatic Hospital at Norristown

Norristown State Hospital, formally the 'State Lunatic Hospital at Norristown', is an active psychiatric hospital run by the Commonwealth of Pennsylvania, and has been operational since its opening in 1880. At its height it maintained a clinical population of a a few thousand, but in more recent years has declined to that of about 150 beds. It is the only remaining facility active in South-western Pennsylvania with the closure of Allentown State Hospital in 2010. It serves the five surrounding Pennsylvania counties- Philadelphia, Bucks, Montgomery, Delaware and Chester.

Construction

In May 1876 Governor John Hartranft formed a blue-ribbon commission to study the civic need for additional state asylums to tend to the overcrowded county almshouse. In that same year, under Public Law 121, the Pennsylvania Legislature called for the establishment of a state mental hospital to serve the Southeastern District of Pennsylvania. A two hundred and sixty five acre tract in the northern part of Norristown borough (which now split between the city of Norristown and East Norriton Township) was chosen for the hospital grounds, and work began on March, 21, 1878. $600,000 was secured by the state legislature for this project and the construction of its seven wards. This year can be found engraved at the top of the tower on the administration building at Norristown (Building #19), at the front of the hospital complex.

Upon completion on February 17, 1879 there were only two other state-owned hospitals operating, one in Danville, which opened in 1872, and one in Harrisburg, that opened in 1851. At the time, other plans were underway to construct another at Warren. Norristown was built to alleviate the overcrowding in the psychiatric wards of the Philadelphia County Almshouse, as well as private hospitals, such as Friends Hospital and the Institute at Pennsylvania Hospital. At its opening, the hospital was turned over to the Board of Trustees with its thirteen members for operation, which still controls and oversees the welfare of the physical hospital and its operation. From its opening, the hospital was opened to both sexes and continued to be divided into independent male and female departments until 1923. Serving nearly 3,000 patients, in 1924 the hospital was reorganized under a single superintendent.

As with most state hospitals at the time, there was a farm with livestock and crops on the grounds and the patients helped to operate the facility until the 1970's. Norristown State Hospital continues to operate a farmer's market on the grounds currently at its greenhouses, which are open to the public. However, nothing is grown on site, and most of the former farmland are currently under the jurisdiction of Norristown Farm Park. Roads and sewers were built on the property, most of which remain active, and a large portion of the grounds were enclosed by an cast-iron fence, eight feet high. This cast-iron fence is still operational and can be seen from Steriege and Stanbridge street. Barns and a root-house were also constructed at the hospitals opening, many of which also still surivive, and sewage was emptied into Stony Creek until it was found to be injurious to local wildlife.

The general dimensions of the separate ward buildings are 277 ft in length by 90 ft in depth. Each ward building consists of a basement, used for steam-heating ducts and workshops, and two main stories, each containing two wards and giving four wards to each building. Each ward is complete in itself, with separate rooms, dormitory, dining-room, bath-room, etc. The wards are ventilated by stacks with steam coiled at the base for creating the drought that draws the air from the wards.

Early Years

Norristown State Hospital received its first patient, a woman, on July 12, 1880 under the supervision of Dr. Robert H. Chase and Dr. Alice Bennett. Two more women arrived on July 13th followed by the first two men on July 17th. Very soon thereafter groups of individuals were admitted from other state hospitals and county almshouses. By September 30, 1880, there were 295 men and 251 women receiving inpatient care and treatment.

Norristown State Hospital was the first of the Pennsylvania state hospitals to construct its buildings deviating slightly from the "Kirkbride Plan", best known as "Transitional Plan". Instead of constructing a single monolithic building, the individual patient wards were separated and free-standing. These building were connected with a series of underground tunnels, including a central tunnel which stretches across the property. Norristown still maintains the schematics of Kirkbride's original plan, with it seperation of male and female departments, as well as leveling the acuity of patients by ward.

There was a tremendous emphasis during the early period on a 'humane' approach to psychiatric treatment ("moral therapy") allowing the individual as much liberality as his/her condition would permit, which was common ofr the period. Several low-acuity wards were unlocked for periods of time, and grounds privileges was a common feature of daily life. Work assignments became a significant feature of a patient's daily routine, many focusing on the workings of the state farm. They were not limited to farm work, other occpational departments include: Administration, Bakery, Billiard room, Boiler room, Bric-a-brac shop, Brush shop, Butcher, Carpenter shop, Dispensary, Garden, Kitchen, Laundry, Machinists, Mattress shop, News-room, Out-door improvement, Painters, Plasterers, Plumbers, Printing office, Scroll saw shop, Shoemakers, Stables, Store-rooms, Tailors, Wards and dining rooms and Weavers. However, with the change in Pennsylvania State Law in the 1970's, hospital patients were no longer permitted to be involved in farm labor. Thereafter, the farmlands were employed by separates agencies of the city of Norristown, namely Norris-City and Norristown Farm Park.

The hospital was organized into three sections - men, women, and a business section headed by a steward. Each section was completely independent of the other, with almost completely separate services. The staff of the men's unit was for sometime all men, and the staff of the women's unit all women. A Nursing School was established in 1897, at this time the hospital census had passed two-thousand patients. Accomodation was also made for nurses on the grounds with the construction of a 'Nurses Home', which is still standing, but not operating under the direct jursidiction of the state hospital.

During the year 1901, 213 employees were listed on the books, most of whom either resided on the grounds or in the neighboring residences. Proportion of attendants to average number of patients was 1 to 9.5. The wages that were paid to attendants totaled some $59,903.00. Weekly per capita cost of operations was $3.29.

An expansion of the asylum's campus was completed between 1907 and 1909, with the construction of several new buildings funding by a state grant. This period saw the construction of: the Acute Admissions Building (Building #17), the Superintendant's House (Building #18), the Nurses' Home (Building #15), the Aseembly Hall (Building #33) and the Female Convalescent Building (Building #16).

Merger and Expansion

In 1923 the hospital's Board of Trustees voted to combine under one management with a medical superintendent. Dr. Frederick C. Robbins was the first superintendent under this combined system. The 1920's and 1930's saw the development of specialized departments such as Social Work, Occupational Therapy, and Psychology. Some years later, Volunteer Resources, Pateint Recreation, and Vocational Services were formally established as independent departments. Specialized treatment units for substance abuse, social rehabilitation, psycho-geriatrics, adolescents, and forensics, among others, were developed during the latter 1940's and into the 1960's.

The renowned Dr. Arthur P. Noyes became Superintendent in 1936 and remained in that position until 1959. Dr. Noyes started the Psychiatric Residency Program which was to be in operation for almost fifty years, and which gained national prestige. He also opened new hospital gates (Gate #2, #3 and #4) and introduced many innovations in therapeutic treatment. His magnum opus, 'Modern Clinical Psychiatry', is considered a classic in the field of Psychiatry. Additionally, Dr. Noyes oversaw one of the largest expansions of Norristown with a large grant from the commonwealth of Pennsylvania. Structures constructed at this time include: Female Ward for Untidy Patients (Building #8), Male Ward for Untidy Patients (Building #13), Male Disturbed Building (Building #51), Female Disturbed Building (Building #50), the Senile Building (Building #53) and the Medical Surgical Building (Building #52).

During the 1930's and 1940's electro-shock therapy (ECT), insulin coma therapy, and lobotomies became common methods of treatment univerally. The usage of psychotropic (anti-psychotic) medications began in the early 1950's with the advent of Thorazine. Medications were perceieved as being able to help control and lessen the severity of many of the symptoms and behaviors associated with psychotic disorders.

Two "Consumptive Sanitoriums" were also found on the grounds, Hacket Cottage (Building #40) and Johnson Cottage (Building #39), for the treatment for Pulmonary Tuberculosis. These were employed and active for public use until 1969, when they were closed by the state and demolished shortly thereafter. However, the circular concrete driveway for their front entrance can still be seen near Gate #4, and near Building #50.

Later years

The late 1960's and early 1970's popular psychiatry stressed an emphasis on placement of many patients into the community and county-funded outpatient clinics, known as BSU's (Base Service Unit). As a result, the census of Norristown State began to drop significantly, as well as at all the other state hospitals nationally. The census of the inpatient population dropped from about 3,200 in February 1968 to slightly over 1,700 in May 1973. This decline continued into the 1980's and 90's with wards being regularly shutdown by the state as a costcutting measure. The passing decades also brought a change in the day-to-day therapeutic process the hospital would employ. By the early 1970's, each patient had an individualized personal treatment plan and met regularly with a multi-disciplinary treatment team, per the regulations implemented by the state and insurance carriers. This regulations continues to the present with each patient having a period of therapeutic treatment and psycho-educational participation each day verbalized in an individual treatment plan.

With the closure of other state psychiatric facility Norristown State appropriated a larger geographical jursidiction. When Philadelphia State Hospital closed in 1990 a large number of their acute patients were transfered to units in Norristown for continuity of care purposes. Just the same, when Haverford State Hospital was shutdown in 1998, the greater part of their inpatient population was also transfered. Norristown is also the site of a repository of medical records, particularly of sites that have already been shut down.

A number of the original 1880 complex have been destroyed or replaced over the years. The last bit fo construction to take place on the site was Building #48, which houses the Psychology Department and Building #1, which is an active inpatient unit for the state hospital. A number of the older residenital buildings have been set to adaptive re-use, such as the original superintendent's house, which is now a Crisis Residneital Program. The acute admissions building is also used at times by local fire academies for common drills.

In more recent years, Norristown State Hospital has assimilated multiple patients and staff from the closures of other state hospitals so now it is the only remaining state hospital in Southeastern Pennsylvania. Many buildings on the grounds are no longer operational. Others still are leased to other mental health agencies, namely: Circle Lodge CRR, Horizon House-ACT, Community Homeless Outreach Center (CHOC), STAR-Carelink and Montgomery County Emergency Services (MCES).

Layout of the Campus

Norristown State Hospital was built in four separate stages, all of which represent different stylistic appraoches to architecture and psychiatric methods. The first phase of contruction lasted from: 1878 to 1880, which encompassed most of the Transitional-Kirkbride complex, and is in the Victorian High Gothic Style. The next came betweem 1906 and 1909, which followed the 'Cottage Plan', and exhibited a slightly toned down Edwardian style. The third phase, which was the largest, came between 1937 and 1940, and was noted for its larger and more utilitarian buildings. The final stage of growth was in the mid-1960's, which saw the demolition of a number of structure, and their replacement with their sterile art deco equivilents. The buildings follow:

Building # 1 Feamle Acute Ward Building- Original demolished in the 1960's and rebuilt across the street as an active inpateint unit for the state hospital. Building # 2 Female Ward Building- Active; currently used by the department of nursing for the state hospital. BUilding # 3 Feamle Ward Building- Demolished, originally used for mid-acuity patients. Building # 4 Female Ward Building- Demolished, originally used for low-acuity patients. Building # 5 Male Ward Building- Abandoned, originally used for low-acuity patients. Building # 6 Male Ward Building- Abandoned; originally used for mid-acuity patients. Building # 7 Male Ward Building- Demolsihed, now a community garden. Building # 8 Male Acute Ward Building- Abandoned; original 1880 building demolished in 1937, rebuilt that same year. Building # 9 Male Hydro-therapy Building- Demolished; Originallt the male infirmary ward until 1937 when it move to the medical-surgical building. Building # 10 Female Hydro-therapy Building- Demolished; Originally the female infirmary ward until 1937 when it was moved to the medical-surgical building. Building # 12 Female Acute Ward- Abandoned, active until fairly recently as an inpatient unit. Building # 13 Male Ward for Untidy Patients- Active, leased to the STAR Program. "Untidy" is the arachaic distinction used for patients who are not capable of bathing themselves. Building # 14 Female Ward for Untidy Patients- Abandoned, "Untidy" is the arachaic distinction used for patients who are not capable of bathing themselves. It was in use into the 1990's as a gero-psych unit and a records repository. Building # 15 Female Nurses Home- Actice, used as staff housing. Now being leased to Circle Lodge CRR. Building # 16 Female Convalescent Building- Demolished, used for what was then known as "shell-shock". Re-purposed in the early 1970's as a private psychiatric respite program. Building # 17 Acute Admission Building- Abandoned, when it was active it was used to filter some of the more acute patients coming onto the grounds. Building # 18 Superintendant's House- Adandoned, used to accomodate the lodgings of the superintendant, and thus never keep him far from his work. Building # 19 Administration Building- Active, still used as the primary office for the State Hospital's business since 1880. Building # 20 Chapel- Demolished; only the basement survives. Building # 21 Kitchen- Active; used to provide food for both refactories. Now used for storage. Building # 22 Male Refactory- Active; originally a cafeteria for male patients. Now used for state hospital security. Building # 23 Female Refactory- Active, originally a cafeteria for female patients. Now used for storage by the state hospital. Building # 24 Surgical Building- Demolished; Purpose unknown. Building # 29 Carpentry Shop- Active; current purpose unknown. Building # 31 Storage Building- Demolished. Building # 32 Employees Building- Staff housing and lounge Building # 33 Assembly Hall- Original 1907 building demolished in the mid-1960's. Building # 34 Pathological Lab and Morgue- Active; CUrrently the state hospital cafeteria and lounge. Building # 35 Hartranft Cottage- Staff Dormitory, demolished. Now the site of a police barracks. Building # 36 Males Nurses Home- Demolished, used as staff housing. Building # 37 Male Convelescent Building- Demolished, used for what was then known as "shell-shock". Building # 38 Laundry Building- Partially Demolished, part of it stands as part of the hospital tunnels. Building # 39 Charles Johnson Cottage for Consumptive Males- TB Hospital for Men, in use until 1969, demolished thereafter. Building # 40 Hackett Cottage for COnsumtpive Females- TB Hospital for Women, in use until 1969, demolished therafter. Building # 41 SUpply Storage Building- Active for the same purpose it was designed. Building # 43 Greenhouses- Active, still used by the state hospital for the sale of produce on Wednesdays and Thursdays. Building # 45 Old Superintendant's House- Active, Served as the home of the superintendant until 1908. Reappropriated as a residence for Doctors. Currently being leased to a Crisis Residential Program. Building # 46 Gate House- Demolished, used to monitor visitors to the grounds until other gates were opened in 1936. Building # 47 Staff Garage- Abandoned. Building # 49 Boiler House- Active. Building # 50 Female Distrubed Building- Active, leased to Montgomery County Emergency Service, in use as the state hospital's forensic unit until 1988. Building # 51 Male Disturbed Building- Active, the current state hospital forensic center for both men and women. Building # 52 Medical Surgical Building- Abandoned, used as Norristown State Hospital Admisssion Building from the 1970's until the early 2000's.

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