Oct 19 2007
Thomas Kirkbride: Architect of Mental Health Care
Thomas Kirkbride revolutionized the care of the mentally ill, when he was working in Pennsylvania. He conceived the design for mental health care that became the blueprint for the design and construction of the Oregon State Hospital.Thanks to http://uchs.net/HistoricDistricts/kirkbride.html for the below information:
The movement to improve the treatment of the insane during the nineteenth century is an outstanding chapter in the history of American social and humanitarian developments. Dr. Thomas Story Kirkbride occupies a prominent position in that story, for he built a hospital for the mentally ill in Philadelphia prior to the Civil War that influenced the construction of similar institutions in thirty-one other states. Furthermore, the concept behind Kirkbride’s hospital, that the insane should be treated with the same personal consideration as other ill people, motivated a new understanding of, and regard for the mentally ill.
His hospital, constructed from 1856-59 at 49th and Market Streets in Philadelphia, introduced many innovations for the day, primarily in terms of spaciousness, airiness, and light. The hospital was composed primarily of wings extending off from the main central building. Despite modern additions, the original structure remains much as it was when built.History
Thomas Story Kirkbride apparently desired a career in medicine from early youth. Born on July 31, 1809, he began a study of medicine under a Dr. Nicholas Belleville, of Trenton, New Jersey, when he was eighteen. One year later, he entered the Pennsylvania Hospital, in 1828, to study, and received his degree in 1832.
Although not primarily interested in psychiatry during his training, Kirkbride gained some experience then concerning the insane. While studying under Dr. Belleville, he read and was impressed with Benjamin Rush’s volume, Rush on the Mind. Between 1812 and 1880, Rush’s volume constituted the only American book on the subject that stemmed from psychiatric work in the United States. From it, Kirkbride learned that the considerate treatment of insane people could be effective, much more so than the generally barbaric mode of treatment then current. Before starting his residence at the Pennsylvania Hospital in 1833, he spent some time as a resident physician at the Friends’ Asylum at Frankford, now a part of Philadelphia, and participated in the advanced techniques of treatment followed there. Once he had begun his residency, he again came into contact with the insane, and while at the Pennsylvania Hospital again treated them with personal concern and interest.
Upon completing his residency, Kirkbride established his own office and concentrated on what had been his main preoccupation, surgery. Between 1835 and 1840, he maintained his own practice. But when offered the superintendency of a new hospital for the insane in West Philadelphia, the Pennsylvania Hospital for the Insane, he accepted the job on October 12, 1840.
Seemingly fated to treat the insane, Kirkbride devoted the rest of his life to the mentally ill. Shortly after accepting his new position, Kirkbride visited similar institutions in New York and Massachusetts. He found most stimulating the practices of the Worcester State Hospital in Massachusetts, where in addition to medical treatment, patients received therapeutic treatment. They worked out of doors, in gardens, and could take rides and walk. Upon returning to Philadelphia, the new superintendent brought all of his experience into play. Essentially, his program endeavored to handle the patients as any sick people would be. Furthermore, in order to aid recovery he encouraged them to work in the gardens or shops; he organized a museum and library; and he provided lectures on a variety of subjects. He also sought to discover the causes of insanity, and he began to consider that for
the most influential causes of mental trouble in adults ‘we would have to go back to a defective early education the want of proper parental discipline,’ which in . . . (his) mind was always linked to deep parental affection.(1)
The inadequacy of his hospital became of greater and greater concern to Kirkbride as he labored in behalf of the insane over the years. He, therefore, initiated a campaign for a new institution, one which would be based on his philosophy, individual treatment. Finally, on July 7, 1856, the cornerstone for a new hospital was laid, and by 1859 the structure had been completed.This new hospital introduced innumerable innovations for its day. And as Dorothea Dix waged her struggle to stimulate the humane treatment of the insane, state after state adopted Kirkbride’s basic plan. Those states were helped in that respect by Kirkbride’s volume, On the Construction, Organization, and General Arrangements of Hospitals For the Insane With Some Remarks on Insanity and Its Treatment. Published in 1854, and again in 1880, it enjoyed a remarkably influential career.Even today, the volume is of great interest. There is nothing that is not covered by it as far as the construction and administration of hospitals for the insane are concerned. More important than the practical details, however, is the spirit of the volume. Kirkbride’s deep concern for those suffering from the tragedy of insanity permeates his book. The first sentence reads, in part,
The proper custody and treatment of the insane are now recognized as among the duties which every State owes to its citizens,…..(2);
It is only by a constant remembrance of the principles of an enlightened religion, and by untiring efforts to elevate, in every rational mode, and character of all these institutions, and by leaving nothing undone to extend and improve their facilities for treatment, that we shall be found practically to adopt that golden maxim which should be seen, or if not seen, at least practiced in hospitals for the insane everywhere,–”all things whatsoever ye would that men should do to you, do ye even so to them..”(3)
