Kirkbride Plan | Indians, Insanity, and American History Blog

Thomas Kirkbride

During the heyday of insane asylums, every aspect of building design had a purpose. Buildings were designed to uplift troubled minds, separate types of insanity, and provide fresh air, sunlight, and lovely views. Thomas S. Kirkbride was an expert on asylum design, and wrote a comprehensive book on it called On the Construction, Organization and General Arrangements of Hospitals for the Insane in 1854.

Nothing escaped Kirkbride’s notice. When he wrote about proper bathing accommodations, he specified that a little cold water should flow into the tub before any hot water, so that no vapor would be produced. Ceilings in patient rooms should be twelve feet high, and corridors in the wings of the building should be twelve feet wide. All stairs used by patients should be made of iron. Though he felt that large, supervised dormitories were the best solution for most patients, Kirkbride recognized that some patients would appreciate the privacy of a private room. Throughout this extensive book, Kirkbride demonstrates a vast experience in caring for the insane and considering both their welfare and comfort.

Danvers State Lunatic Hospital, built on the Kirkbride plan

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Dr. Thomas Kirkbride, courtesy National Institutes of Health

In the early part of the 19th century, moral treatment (see May 18, 2010 post) included the idea that patients’ surroundings could contribute to their treatment and healing .

Dr. Thomas S. Kirkbride (July 31, 1809-Dec. 16, 1883), one of the founders of the Association of Medical Superintendents of American Institutions for the Insane (which later became the American Psychiatric Association), developed a building plan that he felt would improve the asylum experience for patients. It consisted of a centralized administration building with a wing on either side, one for males and one for females.

Kirkbride believed that careful building design could help with treatment. Each ward was set back a little from the previous one so that every room would have fresh air and sunlight. Grounds were lushly landscaped, and the buildings themselves were set in rural environments to give nature a chance to heal tired minds.

Unfortunately, these huge buildings became victims of overcrowding, which then led to many abuses. They fell out of favor by the end of the century. Below are two examples of the “Kirkbride Plan” for asylums.

St. Elizabeths, (1909-1933?) courtesy Library of Congress

Danvers State Lunatic Hospital

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