Fighting for Preservation: Worcester State Hospital and the Death of a Kirkbride

Over the past twenty years the field of mental health care has undergone a vast and sweeping amount of change under the watchful eye of health insurance companies and patient advocacy groups. As more patients are moved into community settings and outpatient treatment programs, more and more of the Gothic inspired asylums of old are being left to crumble, regardless of the fact that a great number of them have been listed on historic registers at both the state and national level. While some of the buildings have been rescued for redevelopment, others have fallen to the wrecking ball and been laid to rest in the annals of history.

Dr. Thomas Story Kirkbride fathered the most influential hospital design in history in the latter half of the 19th century, a unique design that now bears his name. Kirkbride believed that a mentally ill patient's treatment should focus on the patient as a person rather than as a manifestation of their disease. Born a Quaker, Kirkbride saw every member of the human race as a brother and developed a method of therapy called moral treatment that not only dictated the patient's therapy but also influenced the construction of the hospitals of the time.

From the sky, a Kirkbride hospital looks very much like a bat with its wings spread. A main administration building was flanked by tiered wards that stretched back from the center, one for males and one for females. The best behaved patients were kept closest to the main building while the most violent, chronic patients were kept in the outermost wards where they were less likely to disturb the treatment of the less involved patients. Each room had a view of the lavish, park-like grounds as the hospitals were typically set on hills in bucolic, pastoral settings which Kirkbride believed lent to the positive experiences moral treatment encouraged for the patients.

Massachusetts alone constructed four Kirkbride Hospitals in the mid-1800's. The oldest, Worcester State Hospital, was the first publicly funded asylum in the state and the clock tower of its administration building can be seen from most points in the city of Worcester. The hospital grew so big that the Kirkbride design was modified slightly to give the impression that the bat wings wrapped back around the campus in a "U" shape. Eventually a more modern facility was also added to the campus but the Kirkbride continued to thrive, taking in patients, world class doctors, and medical students from a variety of disciplines. When Sigmund Freud visited the United States in 1909, Worcester State Hospital was the only asylum he visited while developing and sharing his theories on psychology.

The beginning of the end for Worcester State Hospital came in 1991 when the Kirkbride suffered a five alarm fire that wiped out much of the wards and damaged portions of many other buildings on the grounds. It was decided that the damage was so extensive the buildings would be demolished and the hospital's services were transferred either to the newer Bryan Building or to other area hospitals. The Kirkbride was boarded up and stood abandoned until the summer of 2007 when the first piece of construction equipment appeared to demolish one of the most photographed buildings in Massachusetts.

For the second time in three years a grass roots effort rose up to help save the hospital, similar to when demolition began on Northampton State Hospital, Worcester's sister to the west. Un fortunately activists were no match for state development and all but two buildings at Worcester were demolished to make way for a new multimillion dollar hospital facility that will proved 326 psychiatric beds and will be the most expensive construction project in Massachusetts history. After making an appearance in the National Trust for Historic Preservation's publication Preservation, the clock tower designed by Ward P. Delano has been saved. The plan is to make the building structurally sound, then seal it up as a landmark.

Worcester State is just one of many hospitals that have either been partially or completely destroyed. The stigma associated with the castle-like giants still pervades and many are happy to see them go, taking with them the memories of the "snake pits" that some of these places did indeed become. However, as we progress through yet another century of reform, what will happen as these monuments to medical history disappear? If we wipe the slate clean, how will we ever learn from this deep and sometimes troubling era in mental health treatment?

Each year more and more books are published on the subject of asylums and the care of the mentally ill. As the general public continues to grow in acceptance of mental health issues, the amount of literature available also increases. Thankfully many of these buildings have been documented by authors, researchers, photographers, and artists. Vintage postcards that were produced showing the hospitals as the Victorian marvels that they once were have begun to surface more often and furniture, books, architectural accents, and other pieces have been rescued from these buildings into museums or private collections. At the same time though, how many more of these buildings will be destroyed in the next year before we have had the chance as a nation to examine why these buildings existed and what is happening now that we show a slowly growing trend towards a need for reinstitutionalization?

The life of Worcester State Hospital as a Kirkbride has ended to make way for the next generation of mental health care. It remains to be seen how many more of these iconic buildings will disappear in the near future as those of us who have had the singular opportunity to photograph and write about these buildings are grateful to have been a part of the past, if only for a short amount of time.