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Construction began in 1927 on a 600-acre rural campus, Rockland State Hospital
, as it was then known, initially had 5,768 beds. With a working farm, its own power plant and industrial shops staffed by patients who manufactured everything from mattresses to brooms and furniture, Rockland was then considered among the best-planned psychiatric hospitals in the world. In 1931 the hospital opened to 60 male patients, all transfers from Manhattan State Hospital.