The first patients were received on August 16, 1858. Within 6 weeks the population would reach 220, most of whom were transfers from other institutions long overwhelmed. The original design specified a maximum of 200 patients, but this limit was raised to 250 by the state-wide hospital Commissioners before the asylum opened. After only 2 months the Board of Trustees speculated that the limit could be raised to 300 patients.

The first superintendent Dr. Prince resigned in 1864 and Dr. Pliny Earle was selected as his replacement. Dr. Earle immediately he began to cultivate a strong work therapy program by expanding the farm, constructing a greenhouse as well as other service oriented buildings. When he retired in 1885 Dr. Earle was given an apartment within the asylum out of gratitude for his 21 years of service. The population had reached 476 patients.

The turn of the century was marked with a change in name from the State Hospital at Northampton to the Northampton Insane Hospital, and two years later to 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. In 1907, the same year Bishop’s Crook lamps were installed around the hospital grounds “A Mind That Found Itself” was published. In it Clifford W. Beers, a former patient of several institutions argues that contrary to what the public had been led to believe no one knew how to cure insanity. That year the population at Northampton stood at 726 patients.

Designed to accommodate 1000 patients, in 1925 work began on the largest expansion of Northampton State Hospital: Memorial Complex. 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, and it 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 same year Thorazine, the first anti-psychotic was introduced 2,331 patients were served by 509 staff. The Haskell building which still serves as an office for the Department of Mental Health was added in 1959.

On January 6, 1978 the United States District Court approved the Brewster Consent Decree which made clear a patient’s constitutional right to treatment in the least restrictive environment possible. Under terms set forth in the Decree the State Hospital was to reduce the number of patients it served to 50 by 1981. This process would ultimately take 14 rather than 3 years.

In 1980 Northampton State Hospital registered its 64,500 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 city-wide controversy. Debate raged though the local news, in council meetings, and at dinner tables around Northampton.

After 130 years the wards of Old Main, the original hospital building were home only to silence and stillness when it was abandoned in 1986. Operations at Memorial Complex continued until 1993 when the last 12 patients were reassigned. Northampton State Hospital was officially closed.

Plans to preserve and reuse the buildings had gained some popularity around the turn of the millenium however city administrators only seriously considered demolition to redevelop the property. In 2006 Old Main was finally torn down, and by the following summer Memorial Complex was gone.