Northampton State Hospital
The Northampton State Hospital was built to cure the insane in the Moralist tradition, a branch of Heroic medicine which focused on placing the ill in beautiful environs to stabilize the mind. At its heart, the Heroic Moral system posited that mental illness was generated from an imbalance of the four humors: blood, phlegm, black bile and yellow bile. It never worked. Despite its failings, the State Hospital continuously expanded for more than a century because there was no other place for society to treat and warehouse the poor and mentally ill, accepting more than 2500 patients at a time and logging more than 64,500 admissions before federal funding for decentralized initiatives and the Northampton Consent Decree ultimately closed its doors.
The original design specified a maximum of two hundred patients, but this limit was raised to two hundred and fifty by the statewide hospital commissioners even before the doors opened. Staff received the first patients on August 16, 1858. Within six weeks the population would reach 220, most of whom were transfers from other institutions long overwhelmed on the eastern side of the state. After only two months of operating the Board of Trustees speculated that the limit could be raised to three hundred patients.
House of EarleIn 1864, Dr. Pliny Earle became the hospital’s second superintendent. He immediately began to cultivate a strong work therapy program by expanding the farm, and constructing a greenhouse as well as other service oriented buildings. During his tenure, Dr. Earle was consistently critical of claims regarding the nearly 100% cure rates of insanity reported by his peers, which he detailed in his book The Curability of Insanity.
“In brief, then, it appears that it may fairly be asserted, first, that all estimates based upon the assumption that either seventy-five, or seventy, or sixty, or even fifty per cent. of the persons attacked with insanity can, at the time of admission to the hospitals, be cured and returned to the class of permanent producers in the sphere of human labor, are necessarily false, and consequently are … ‘a delusion and a snare.'”
Earle, Studies relative to the curability of insanity., 1880
Dr. Earle states the basic assumption about the character of mental illness is incorrect, that while physicians and the public believe it to be a superficial ailment, thousands of cases suggest otherwise. Earle also takes on Moralist heroes like Dr. Edward Jarvis, whom Earle knew personally and was present at the laying of the Northampton State Hospital cornerstone. Fatefully, Dr. Earle contests the construction of massive asylums, specifically “the culpable wastefulness of the builders of Danvers [State] Hospital,” which had originally been designed for a maximum of 500 patients but warehoused 700 only a few years after opening. When he retired in 1885, Dr. Earle was given an apartment within the asylum out of gratitude for his twenty-one years of service. The population at Northampton had reached 476 patients.
By the turn of the century the State Hospital at Northampton became the Northampton Insane Hospital, and two years later, Northampton State Hospital. Under superintendent John A. Houston, construction on new buildings continued, including the 1900 stable, a cow barn in 1902, as well as infirmary wards built on either end of the hospital in 1902 and 1903. Yet the population of patients was always in excess of the available space, staff and resources. When completed in 1903 the South Infirmary for women was filled immediately, and in the annual report of that year, the trustees hoped to transfer more patients to another institution, the State Colony for the Insane, as soon as it was constructed.
“… the number of patients the hospital is caring for is largely in excess of our accommodations, and that the overcrowding taxes the resources of the hospital to the utmost. This condition is likely to become worse, in spite of the increased accommodations afforded by the new buildings for women just completed and the one for men about to be built. The trustees feel that, in justice to the patients now here and to those who are soon to come, it is their duty to ask for means to erect other buildings…”
Northampton State Hospital 1903 Annual Report, 1904
In 1907, the same year Bishop’s Crook lamps were installed around the hospital grounds, Clifford W. Beers, a former patient of several institutions, wrote A Mind That Found Itself. In it he argues that, contrary to what the public has been led to believe, no one knows how to cure insanity. That year the population at Northampton stood at 726 patients.
In 1925, work began on Memorial Complex, the largest expansion of Northampton State Hospital, designed to accommodate up to 1000 patients. Set apart from the original “Old Main” section of the asylum, Memorial Complex became the focal point for most of the construction, expansions, and later operations of Northampton State Hospital. Memorial Complex allowed the population to swell to more than 2100 patients in 1935.
After nearly a century of constant construction, Northampton State Hospital only continued to grow. In 1952, the year the first anti-psychotic, Thorazine, was introduced, 2,331 patients were served by 509 staff. And in a few years, the asylum reached approximately 2500 patients, the highest recorded concentration in the history of Northampton State Hospital. The Haskell building, which today still serves as an office for the Department of Mental Health, was added in 1959.
Northampton DecreeWithin minutes of encountering the deplorable conditions within the walls of the asylum attorney Steven Schwartz vows to not leave. Schwartz would eventually serve as the lead attorney in the law suit which closed NSH.
“I remember standing at one of the windows that had iron mesh through the window, looking in and it was at that time that I sort of became almost paralyzed with… it wasn’t fear it was a deep sense of pain. There were a number of people who had their nose pressed to the window wanting to get out. A nurse came, pushed them aside gently, unlocked the door and let us in.
By the time I walked back across to what would be the central corridor I had seem maybe 40 people, the vast majority of them were either laying on the floor. All in hospital gowns, I don’t remember anyone having their own clothes. Some people were locked in rooms and there was a fair amount of screaming and noise. The stench was overwhelming and it was at that time that I knew I needed to stay.”
Sparks, “Steven Schwartz, Northampton State Hospital Narratives “
On January 6, 1978 the United States District Court approved the Brewster Consent Decree, also known as the Northampton Decree, which made clear a patient’s constitutional right to treatment in the least restrictive environment possible. Under its terms, the State Hospital was to reduce, over three years, its number of patients to fifty.
This process, which ultimately led to the closure of the asylum, would take fourteen years. In 1980, Northampton State Hospital registered its 64,500th admission, while simultaneously attempting to reduce the total population. Patients were either reassigned to other, usually smaller, facilities or were simply dismissed. Ex-patients entered a largely ignorant and sometimes hostile community. For some, poverty and homelessness were as immediate as the citywide controversy. Debate raged through the local news, in council meetings, and at dinner tables around Northampton. Emptying the Madhouse in the May 1981 issue of Life magazine delivered the ordeal of the State Hospital to an international audience.
“Although many ‘dehospitalized’ patients benefit from humane aftercare programs, others do not. ‘The majority get dumped amid the broken promises,’ says professor of psychiatry and author Dr. James Cohen. Although William Hopkins has been in and out of Northampton State (NSH) 10 times, he receives no follow-up care at all. Hallucinating between fleeting moments of clarity, butting his head against store windows, pounding his forehead until it bleeds, he is easy prey for thieves, taunting schoolchildren and city traffic. Hopkins has been lost in the exodus from institution to community. He is not alone.”
Friend, “Emptying the Madhouse: The Mentally Ill Have Become Our Cities Lost Souls”
The Northampton Decree also helped create human service programs funded on the State and Federal level. Human service agencies like The Center for Human Development (CHD) and Service Net began to fulfill some of the regional psychiatric needs with innovative programs. However, even today, available funding is only sufficient to treat a fraction of the number of patients incarcerated state and nation-wide under the State Hospital system.
When it was abandoned in 1986, after 130 years, the wards of Old Main were home only to silence and stillness. Operations at Memorial Complex continued until 1993 when the last twelve patients were reassigned and the Northampton State Hospital was officially closed.
Plans to preserve and reuse the buildings, particularly Old Main, gained some popularity around the turn of the millennium. However city administrators only considered demolition in order to redevelop the property. In 2006 Old Main was finally torn down. During the demolition the cornerstone and its time capsule were recovered. The surviving contents rest at Forbes Library, including printed pamphlets such as Insanity and Idiocy in Massachusetts, by Dr. Edward Jarvis. By the following summer, Memorial Complex was gone.Today a mixed apartment and condominium development, renamed Village Hill for marketing purposes, sits atop Hospital Hill where Old Main used to stand. Kollmorgen, a local defense contractor, purchased the central parcel of the Memorial Complex before itself being sold to L3 Communications.
Before the State Hospital, the poor and mentally ill were often locked in attics, jail cells, or left to the streets. A century and a half of continuous growth in patient numbers, without adequate funding, caused patients to be abandoned behind the walls of the asylum. Today excellent programs are available through state and federally funded agencies for some. But for others, prison is the only source of care for chronic mental illness, and the streets have yet again become a river of souls.
- Earle, Pliny. Studies Relative to the Curability of Insanity. Boston: Rand, Avery, &, Printers to the Commonwealth, 117 Franklin Street., 1880.
- Friend, David, and Michael O’Brian. “Emptying the Madhouse: The Mentally Ill Have Become Our Cities Lost Souls.” Life, May 1, 1981.
- Jarvis, Edward, and Gerald N. Grob. Insanity and Idiocy in Massachusetts Report of the Commission on Lunacy, 1855. S.l.: Harvard University Press, 1971.
- Steven Schwartz, Northampton State Hospital Narratives. Directed by Christopher J Sparks. United States, 2010. Film.
- “Trustees Report.” In Northampton State Hospital 1903 Annual Report, 61. Boston, MA: Wright & Potter Printing, 1904.