Institute of the Pennsylvania Hospital (Kirkbride Center)
Philadelphia was the center of medical education and treatment in the American colonies and in the new republic, and an important aspect of the work from the start was caring for psychiatric patients. One of the original two wings of the Pennsylvania Hospital was devoted to them, and by the early 1800s, the insane outnumbered those with physical ailments by two to one. In 1832 the Board of Managers agreed to purchase a large farm at what is now 44th and Market Streets in West Philadelphia on which to build a separate facility to house mentally ill patients.
Originally called the Pennsylvania Hospital for the Insane, and renamed the Institute of the Pennsylvania Hospital in the twentieth century, the facility was commonly called “Kirkbride’s.” This was an acknowledgement of the importance of Dr. Thomas Story Kirkbride (1809-1883), who served as its director from 1840 until his death. Although trained as a surgeon, Kirkbride became interested in psychiatry and was appointed the resident physician at the innovative Friends’ Hospital in then rural Frankford. In his two years there (1832-1833), he became a proponent of its humane Quaker-inspired “Moral Treatment” of mental patients—which eschewed physical restraints and punishment. He then moved to the Pennsylvania Hospital and was appointed to head the new facility in West Philadelphia when it was still under construction.
That first building, which opened in 1841, was designed by Isaac Holden (ca. 1800-1884). Greek Revival in style, its layout was modeled on Friends’ Hospital: essentially a large country house, with common facilities in the central block and flanking wings for men and women patients. Like Friends’, it was set in large, landscaped grounds and was designed to provide a soothing, recuperative environment. Individual bedrooms had ordinary furniture and were sunnier, better heated and ventilated, and had better plumbing than most homes. Kirkbride and his family lived nearby in a large 1794 house that was part of the farm purchased by the hospital.
Early in his tenure at the hospital, on October 16, 1844, Kirkbride hosted in his home a historic meeting of the superintendents of thirteen American psychiatric hospitals. They agreed to found the Association of Medical Superintendents of American Institutions for the Insane -- the first national medical society and the forebear of the American Psychiatric Association.
Much expanded over the years, this first hospital building was demolished in 1959, but the second major building, facing what is now 49th Street, survives. It was built in 1854-1859 to provide entirely accommodations for male patients--an arrangement that Kirkbride preferred. The general layout and details of the design, made by Kirkbride’s friend Samuel Sloan (1815-1884), were conservative--based on Holden’s Greek Revival building, which it faced across the hospital gardens. But the plan was much expanded, with echelons of wings extending far outward from the central block, carefully laid out to provide high-ceilinged rooms and airy well-lit hallways.
Kirkbride proselytized both this architectural model and the compassionate care of patients. His monumental handbook, On the Construction, Organization, and General Arrangements of Hospitals for the Insane with Some Remarks on Insanity and Its Treatment appeared in two editions (1854 and 1880), and it spawned the construction of more than 70 “Kirkbride Plan” hospitals in the United States.
In 1997 the Pennsylvania Hospital moved its psychiatric unit back to its Center City location and sold the historic building. Since 1999 it has been operated by the Kirkbride Center, a privately-owned treatment center for mental illness and addiction.