Norristown State Hospital

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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
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.

History of the Asylum

Construction

Norristown 17.jpg

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. The design for the original complex came from Philadelphia based Wilson Brothers & Company, also known for their design of Drexel University and Reading Terminal.

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 Almshouse, as well as private hospitals, such as Friends Hospital and the Institute at the 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 survive, 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: 1880 to 1909

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 separation 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 of 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 occupational 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. Accommodation 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 jurisdiction 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 Assembly Hall (Building #33) and the Female Convalescent Building (Building #16).


Merger and Expansion: 1910 to 1945

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 universally. The usage of psychotropic (anti-psychotic) medications began in the early 1950's with the advent of Thorazine. Medications were perceived 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: 1946 to Present

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 cost-cutting 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 of 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 residential buildings have been set to adaptive re-use, such as the original superintendent's house, which is now a Crisis Residential 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).

First Female Physician

Dr. Alice Bennett,a graduate of the Women’s Medical College of Pennsylvania was appointed head of the Women’s Department at Norristown Asylum, the first woman in the nation to direct a female division in a mental institution. This notion removed all possibilities of abuse or immodest behavior by male patients and staff. Dr. Bennett profited from the Victorian notion that as a woman physician, she could best treat patients of her own sex and in turn, introduced her own ideas of patient management.

She encouraged independence and self-esteem and which, through its humane example, would elicit behaviors of kindness and civility in the patients who were encouraged to make visits home, to engage in “productive” occupations like housework, sewing, and knitting and to take advantage of the fresh air and beautiful grounds. She also made special note of holiday celebrations which drew the female patients together.


Alleged Experimentation

In 1892, the Board of Public Charities accused the medical staff, under the order of Dr. Alice Bennett of surgical experimentation after the removal of the ovaries of six women were reported as a cure for insanity. Under the alluring title, "An Experimentation in Castration" the New York Medical Record editorially gives the following unique item of news:

       "An interesting experiment has suddenly come to grief at the Norristown Insane Asylum, Pa. Some of the medical 

staff became much impressed with the value of castrating women as a therapeutic measure in insanity."

James J. Levick states, “Insanity is a disease of the brain, not of some organ remote from it; and when manifestation of insanity seem to be especially associated with functional disturbances of some one organ, this disturbance is secondary to the brain disorder, not the cause of it.” Those who opposed this procedure greatly rejoiced that, “the hospitals and the profession are saved from a scandalous proceeding.” However, practices such as these were also common place in neighboring Trenton State Hospital under the infamous Dr. Cotton, where teeth were removed to cure psychotic features. It was further questioned whether Gynecology should be practiced in Asylums at all, and if an insane person should be treated gynecologically just as any other person would be treated, and that an examination, diagnosis and treatment ought to be instituted independent of her mental condition.

Layout of the Campus

Norristown State Hospital was built in three separate stages, all of which represent different stylistic approaches to architecture and psychiatric therapies. The first phase of construction lasted from: 1878 until 1910, which encompassed most of the Transitional-Kirkbride complex, and is in the Victorian High Gothic Style, or the slightly toned-down Edwardian. The next came phase, which was the largest of the campus, came between 1937 and 1940, and was noted for its larger and more utilitarian buildings. This period of stae hospital construction was particularly noted for its banality, and has been criticized as "warehousing" patients. The final stage of growth was in the mid-1960's, which saw the demolition of a number of older structures, and their replacement with their sterile 'art deco' equivalents. The names of buildings that follow are how they would be known, circa 1940:

Building #1 Female Acute Ward Building- Active; the original was demolished in the 1960's and rebuilt across the street as an active inpatient unit for the state hospital. The original building #1 was a red brick structure with an interior courtyard built in 1883. It was the only building from the original complex not to be finished on schedule because of a lack of funds. The current structure of Building #1 is made from white bricks and a limestoen facade, with a more contemporary design.

Building #2 Female Ward Building- Active; currently used by the Department of Nursing for the state hospital. It was built in 1880 and was originally designed to accommodate mid-acuity patients for the Female Department.

Building #3 Female Ward Building- Demolished; It was built in 1880 and was originally used for mid-acuity patients for the Female Department.

Building #4 Female Ward Building- Demolished; It was built in 1880 and was originally used for low-acuity patients for the Female Department.

Building #5 Male Ward Building- Abandoned; It was built in 1880 and was originally used for low-acuity patients for the Male Department. In more recent years it was leased for offices by the Philadelphia Mental Health Care Corporation (PHMCC).

Building #6 Male Ward Building- Abandoned; It was built in 1880 and was originally used for mid-acuity patients for the Male Department.

Building #7 Male Ward Building- Demolished; It was built in 1880 and was originally used for mid-acuity patients for the Male Department. It is now a community garden.

Building #8 Male Acute Ward Building- Abandoned; It was built in 1880 and demolished in 1937, rebuilt that same year as a new ward for high acuity patients.

Building #9 Male Hydro-therapy Building- Demolished; It was built in 1887 and originally it was designated as the male infirmary ward until 1937 when medical procedured were conducted in the medical-surgical building. It re placed the prior one story co-ed infirmary on the grounds.

Building #10 Female Hydro-therapy Building- Demolished; It was built in 1887 and originally it was designated as the male infirmary ward until 1937 when medical procedured were conducted in the medical-surgical building. It replaced the prior one story co-ed infirmary on the grounds.

Building #11 Unknown- A brief report from 1907 stated that Ward #11 had "a destructive fire [that] almost destroyed ward building No. 11. Fortunately, the fire occurred early in the evening and by prompt action all the inmates were saved and no one was injured." However, its fate was never specified.

Building #12 Female Acute Ward- Abandoned; active until fairly recently as an inpatient unit for the state hospital.

Building #13 Male Ward for Untidy Patients- Active; Built in 1937 for the care of the "untidy", it is currently leased to the STAR Program. "Untidy" is the archaic distinction used for patients who are not capable of bathing themselves.

Building #14 Female Ward for Untidy Patients- Abandoned; Built in 1937 for the care of the "untidy",which is the archaic distinction used for patients who are not capable of bathing themselves. Also known in its later life as Constiution House; it was in use into the 1990's as a Gero-Psychiatric unit and as a records repository.

Building #15 Female Nurses Home- Active; It was built in 1897 and was ssed as staff housing for female nurses and students and the hospital's nursing school. Its original capacity was 105-beds. However, at some point it had a destructive fire which damaged much of the original building. It is now being leased to Circle Lodge as a community residence for mental health consumers.

Building #16 Female Convalescent Building- Demolished; It was built in 1907 fro $50,000, and boasted that it had enough beds for svenety female patients. The term 'Convalescent' was used in the period for what was then known as "shell-shock" or "Railroad Spine". Re-purposed in the early 1970's as a private psychiatric respite program. It was abandoned in 1988, and demolished in 2009.

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. However, it has not seen active use since the early 1970's.

Building #18 Superintendent's House- Abandoned; used to accommodate the lodgings of the superintendent, and thus never keeping him far from his work. It was at a later time used as a doctor's lounge by hospital staff and was active well into the 1990's.

Building #19 Administration Building- Active; BUilt in 1878 and is still used as the primary office for the state hospital's administration since 1880. Their entrance way is decorated with old photos and portraits of superintendents. The famous cupola was removed as a cost-cutting measure sometime in the familar past, but no date has been specified.

Building #20 Chapel- Demolished; only the basement survives as an underground tunnel.

Building #21 Kitchen- Active; used to provide food for both male and female refactories. Now used for storage and assorted things.

Building #22 Male Refactory- Active; It was built in 1887 and was originally a cafeteria for male patients. Now used for state hospital security.

Building #23 Female Refactory- Active; It was built in 1887 and was originally a cafeteria for female patients. Now used for storage by the state hospital.

Building #24 Surgical Building- Demolished; Built in 1908, it was intended to serve as a center for more complicated surgeries. It was reappropriated in 1937 to serve a strictly gynocological function.

Building #29 Carpentry Shop- Active; current purpose unknown.

Building #31 Storage Building- Demolished.

Building #32 Employees Building- Abandoned; Staff housing and lounge built in hte late 1930's for individuals who lived on campus.

Building #33 Assembly Hall- The original 1909 building was demolished in the mid-1960's. The lower floor of the 1909 held an ornate dance hall, while the upper floor contained an auditorium for religious and assembly purposes, with gradual sloping floor, large stage and fixed theater seats for one thousand two hundred patients. A pipe organ was also installed through the generosity of the Commonwealth's Legislature. The current Building #33 is from the late 1960's, and was intended to replace that structure, which was believed to be in disrepair. It is sometimes used for arts festivals; however, that is rare anymore. There is still a chapel in it's basement with a chaplain present at times in the early morning.

Building #34 Pathological Lab and Morgue- Active; The oringal structure was built in 1906, but was demolished and rebuilt some thirty years later. It is currently the state hospital cafeteria and lounge. Additionally, at some point in its history it served as a patient library.

Building #35 Hartranft Cottage- Demolished; formally a staff dormitory, similar to Building #32. Now it is the site of a police barracks. Presumably it is named after the governor who founded Norristown State Hospital.

Building #36 Males Nurses Home- Demolished; Built in 1895 it was used as staff housing for male nurses and students of the nursing school on hte grounds of the hospital. It was intended to be the male equivalent of Building #15

Building #37 Male Convalescent Building- Demolished; used for what was then known as "shell-shock" and "railroad spine".

Building #38 Laundry Building- Partially Demolished, Built in 1938, part of it stands as part of the above ground hospital tunnels.

Building #39 Charles Johnson Cottage for Consumptive Males- Demolished; Built in 1937 and served as a TB Hospital for men, in use until 1969, demolished thereafter.

Building #40 Hackett Cottage for Consumtpive Females- Demolished; It was built in 1937 and served as a TB Hospital for women. It was still in owkring order and in use until 1969, demolished thereafter. A cottage built in 1899 preceeded it on the site, but was also demolished as it could only hold twenty women.

Building #41 Supply Storage Building- Active; Built in 1937 and still in use for the same purpose it was designed.

Building #43 Greenhouse- Active; Built in 1887, but replaced several times. It is still used by the state hospital for the sale of produce on Wednesdays and Thursdays.

Building #45 Old Superintendent's House- Active; Possibly the oldest building on the campus, with no specified date of construction. It served as the home of the superintendant until 1908. It was reappropriated as a residence for doctors thereafter, particularly resodents. It is 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. It stood as the original location of state hospital security.

Building #47 Staff Garage- Abandoned.

BUilding #48 Psychology Department- Active; Built in the mid-1960's and used for community lectures and public events.

Building #49 Boiler House- Active.

Building #50 Female Disturbed Building- Active; It was built in 1938 as a pairing to Building #51, with similar floor plans, to house the criminally insane. It is currently being leased to Montgomery County Emergency Service, but it was in use as the state hospital's forensic unit until 1988.

Building #51 Male Disturbed Building- Active; It was built in 1937 as a pairing to Building #51, with similar floor plans, to house the criminally insane. It is the current state hospital forensic center for both men and women.

Building #52 Medical Surgical Building- Abandoned; Built in 1937 to relieve the prior hospital infirmaries, and replace them with modern medical practices. It was converted and used as Norristown State Hospital Admission Building, following hte closure of Building #17, from the 1970's until the early 2000's.

Building #53 Senile Building- Active; Build in 1939 and previously used to treat patients with various degrees of Dementia. Currently it is being leased to RHD-CHOC as a community homeless shelter.

Images of Norristown State Hospital

Main Image Gallery: Norristown State Hospital