The Kirkbride Plan

1844 – Reformist Dorothea Lynde Dix (April 4, 1802 – July 17, 1887) testified to the New Jersey legislature about the insufficient and inhumane treatment of individuals suffering from mental illness. They were housed in residences, county jails, basements, attics, prisons, and other tucked-away places to effectively be forgotten. Through her efforts, the United States established state-run hospitals. Philadelphian psychiatrist and psychiatry pioneer Thomas Story Kirkbride (July 31, 1809 – December 16, 1883) devised a revolutionary plan based on the philosophies of moral treatment and environmental determinism. The Kirkbride Plan promoted use of long wings staggered in such a way they could receive sunlight and fresh air while maintaining comfort and privacy. The collective work of Dix and Kirkbride led to the construction of the New Jersey State Lunatic Asylum (the Trenton Psychiatric Hospital) in Trenton and Ewing, New Jersey in 1848. It was the first institution built under the Kirkbride Plan.

Hospitals built under the plan often featured farmland to provide patients with physical exercise, therapy, and exposure to life. Others operated with self-contained towns, creating a semblance of community among those interned. For decades, the facilities provided aid and treatment to hundreds of patients. The original intentions of creating better care for mentally ill patients sadly dwindled as time went on: by the middle of the twentieth century, the conditions inside numerous institutions were poor. Overcrowded facilities, abusive staff, and patient neglect made a shocking increase. By the 1970s, the state had to close many of the sizable structures due to their high maintenance costs and/or mistreatment.

Many of the structures still stand day, though most have been abandoned, neglected, or vandalized. A handful are still in use while others are being renovated for other purposes.