An Asylum is a State Hospital that housed and cared for the insane wherein Physicians and attendants utilized humane treatments in hopes of curing the patient’s mental illness. These impressive institutions were built rurally with ample space for gardening, farming, outdoor recreation and various forms of occupational therapy.

Originally, the mentally ill were jailed or confined until the rise of moral treatment. The earliest forms of moral treatment were compassion, comfort, good hygiene, good air, good food, exercise, work and innocent recreation as well as lessening the use of physical restraints and allowing patients to have freedom within the hospital and its grounds.

There are two prominent types of asylum design:

1. The Kirkbride plan, which emerged from and symbolizes moral treatment.

2. The Cottage plan, which emerged as an alternative.

Originating in 1847 at Trenton, New Jersey, the Kirkbride plan consists of an impressive four-to-five-story Administration building in the center of the plan with two-to-three-story buildings aka: wings, staggered on both sides of the center.

The wing furthest from Administration housed the violent patients unlike the wing closest to Administration which housed the manageable type.

Male and female patients were separated between the left and right. The chapel, kitchen, laundry, library, auditorium and boilers were centralized behind Administration.

Employees were located on the first and second floors of Administration filling roles of Steward, Matron, Assistant Physician, Apothecary, Supervisor, Teacher, Chaplain, Treasurer, Attendant, and Superintendent who served as Physician and Chief Executive Officer.

The upper floors were living quarters for the Superintendent and his family. Often, water tanks were located within the cupolas upon the roof or within a centralized dome atop Administration to provide the asylum with water pressure.

This plan was fully developed in 1854 by Dr. Thomas Story Kirkbride, M.D., in his book entitled, On the Construction, Organization and General Arrangements of Hospitals for the Insane. The hospital was designed to utilize the natural light of the sun and create an airiness in the ward with the use of large windows, tall ceilings and wide hallways – no room was dark or stagnant.

His aim was to create an institutional environment that was awe-inspiring and comfortable, to accommodate a variety of social and mental classes and provide treatment for them, and to confine the patients without giving the hospital a prison-like appearance.

Statistics: There were roughly 80 Kirkbrides in the United States. Some notable Kirkbrides are Danvers State Hospital, a location used in the horror/mystery movie Session 9; Buffalo State Hospital, which is currently under renovation and Weston State Hospital, which is a preserved historic attraction offering tours to the public.

The Cottage plan consists of individual buildings that are one-to-two-stories containing a specific class and sex of patient based on their diagnosis. This plan was ideal for State Schools because many of the patients were physically disabled, which made moving-about difficult.

The campus was designed to resemble a small village with each building connected to an internal tunnel system for the transportation of patients, staff, and piping. Each village had its own power station, laundry facility, dining hall, kitchen, library, storeroom, and Administration building as the centerpiece of the campus.

The Administration building is typically adorned with a large cupola on the roof for ventilation and decoration – some kept track of time and chimed on the hour.

Statistics: There were roughly 250 cottage plan institutions in the United States. One notable cottage plan is Pennhurst State School and Hospital, a center for mentally and physically disabled, which was the centerpiece of the Halderman v. Pennhurst and a 1968 report anchored by local news correspondent Bill Baldini entitled, Suffer the Little Children.

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Dorothea Dix lobbied for change: the State was to change the way it cared for the insane. After traveling the country documenting the conditions of prisons, asylums and alms-houses, she sent a report to each state detailing the maltreatment she observed.

"Insanity sensibly treated is as certainly curable as a cold or fever. Recovery is the rule; permanent disease is the exception."

Her national bill, which took six years to pass both houses of Congress in 1854, asked for twenty-thousand square miles of land to be sold for the care of the insane, but deemed unconstitutional in the hands of President Franklin Pierce, who vetoed it.

In 1848, Dorothea's bill for the establishment of the New Jersey Lunatic Asylum passed unanimously and her "first-born child", the New Jersey State Lunatic Asylum, opened as the first public mental hospital in New Jersey designed under the Kirkbride plan by Dr. Thomas Story Kirkbride, Superintendent of the Institute of the Pennsylvania Hospital and dear friend and long-time supporter of Miss Dix.

Within the same year, the establishment of the Pennsylvania State Lunatic Hospital for the Insane was also successful: her "second-born child".

Dorothea made many visits to the Harrisburg Asylum, eventually residing in the Trenton Asylum as a patient until her death, but the "children" continued to be born.

Aged, broken and full of suffering, it appears she did not want to die, for she knew the fight was not over, "I think even lying on my bed, I can still do something," (Francis 372) spoken two months before her death in response to a friend wishing her many more years to come. On July 17, 1887 Dorothea passed away in her tower apartment at the Trenton Asylum, in the declining hours of sunlight.

There below her stretched the park-like expanse of the grounds of the asylum, and there, sitting under the trees or wandering along the paths in the fullest enjoyment of liberty possible to their sad condition, were the poor children of affliction, whose former miseries in chains and cages had first started in her the vow of consecration never to the end to be broken (Francis 373).

_{Tiffany, Francis. Life of Dorothea Lynde Dix, Cambridge: The River Side Press, 1891.}