Kirkbride Plan - History

History

The establishment of state mental hospitals in the U.S. is partly due to reformer Dorothea Dix, who testified to the Massachusetts legislature in 1844, vividly describing the state's treatment of people with mental illness: they were being housed in county jails, private homes and the basements of public buildings. Dix's effort led to the construction of the New Jersey State Lunatic Asylum, the first asylum built on the Kirkbride Plan.

Kirkbride developed his requirements based on a philosophy of Moral Treatment. The typical floor plan, with long rambling wings arranged en echelon (staggered, so each connected wing received sunlight and fresh air), was meant to promote privacy and comfort for patients. The building form itself was meant to have a curative effect: "a special apparatus for the care of lunacy, highly improved and tastefully ornamented." The idea of institutionalization was thus central to Kirkbride's plan for effectively treating patients with mental illnesses.

The asylums tended to be large, imposing, Victorian-era institutional buildings within extensive surrounding grounds, which often included farmland, sometimes worked by patients as part of physical exercise and therapy. While the vast majority were located in the United States, similar facilities were built in Canada, and a psychiatric hospital in Australia was influenced by Kirkbride's recommendations. By 1900 the notion of "building-as-cure" was largely discredited, and in the following decades these large facilities became too expensive to maintain. Many Kirkbride Plan asylums still stand today. Most are abandoned, neglected, and vandalized, though several are still in use or have been renovated for uses other than mental health care.