The towns' inability to cope with a rapidly rising and undigested anti-social population was not the only impetus behind state involvement in mental health. Another important component was the move away from "demonology" toward moral treatment of the insane, a cause which was loudly and publicly championed by such social reformers as Boston's Dorothea Lynde Dix. Her energetic career (1841-1887) had significant local as well as national and international impact.
At mid-century, the humanistic approach toward care of the insane was generally accepted, yet controversy still surrounded the form or building arrangement such institutions should assume. Some, heavily represented on the State Board of Charities, favored the dispersion of the dependent as opposed to their congregation. The other faction in the controversy, which found many supporters in the Association of Medical' Superintendents, favored a large, highly centralized complex. Chief proponent of the centralized plan was Thomas S. Kirkbride, M.D., L.L.D. (1809-1883), a founder of the American Psychiatric Association, physician to the Pennsylvania Hospital for the Insane, and friend of Dorothea Lynde Dix.
Kirkbride devised a specific institutional model, thereinafter known as the Kirkbride Plan, which was built upon in all thirty states then in existence and in several European cities. H.H. Richardson, for example, built a variation of the Kirkbride Plan hospital in Buffalo, NY in the early 1870s in cooperation with Frederick Law Olmsted. The Kirkbride Plan provided that mental hospitals should:
Danvers State Hospital, originally known as the State Lunatic Hospital at Danvers, was significant in both architectural and social history. Designed in 1874 by noted Boston architect, N.J. Bradlee, it is an implementation of the nationally recognized Kirkbride plan. When built it represented the latest contemporary advances in technology and engineering as well as architecture. Later additions refelct changes in mental health care philosophy and contribute to an understanding of the overall functioning of the hospital. Historically, Danvers State Hospital was significant for its leading role in treatment of the insane including an advanced occupational therapy program, early training facilities for staff, and a long-term concern with community health issues. Thus, Danvers State Hospital possess integrity of location, design, setting, materials and workmanship. Concern for the disadvantaged, including the poor, the sick, and the mentally disturbed, it was recognized as a responsibility of the public sector in Massachusetts since its early 17th century settlement period. Until the mid-19th century, the charge for their care rested primarily with the towns in which they resided through locally established poor farms: As the towns' duties in 'this regard- became unwieldy and largely' unfulfilled, due to in part to the pressures of immigration and rapidly increasing numbers of unsettled poor, the state stepped in first establishing the Board of Commissioners of Alien Passengers (1851) and in 1863 the Board of State Charities. Though still administratively combined, different facilities and types of care were gradually provided to victims of varying types of misfortune. For example, by 1863, three state hospitals specifically to care for the insane had been built: at Worcester (1877), at Taunton (1854), and at Northampton (1856).
l. be built “in the country” though accessible at all seasons
2. be set on grounds of at least 100 acres
3. house a maximum of 250 patients
4. be built of stone or brick with slate or metal roof and otherwise made as fireproof as possible
5. be composed of 8 wards, separated according to sex, and built according to other specifications as to size, location, and material of accommodations
6. be organized with wings flanking a central administration building
7. house the most "excited" patients in the end or outermost wings
8. provide an abundance of "pure fresh air"
Kirkbride's hospitals were intended as monuments to the belief that most insane are curable and thus that the function of the hospital is primarily curative and not custodial. That curative process was to be greatly enhanced by pleasant surroundings, fresh air, and pure water. Fully developed Massachusetts' examples of the Kirkbride Plan exist at Danvers and at Worcester.
The immediate crisis which precipitated the building of a mental hospital north of Boston was the imminence in the early 1870s of the closing of the city facility at South Boston. By 1873, Worcester, Taunton, and Northampton and the 1866 Tewksbury Asylum for chronic patients were already housing 1300 patients in facilities designed for 1000; another 1200 were scattered about in other less specialized institutions. In that year, authorization was given for a "state lunatic hospital" at Danvers. It was to serve primarily Essex County patients and to accommodate an overflow from South Boston of at least 200.
Bradlee's design for Danvers State Hospital was based on his unbuilt 1867 plan and 1868 plan for an insane asylum at Winthrop. Many locations were picked including Nahant, Chelsea, Dorchester and Roxbury but the state purchased land in Winthrop. After numerous appeals to relocate Winthrop to another location, Danvers was finally chosen. A logical choice of the Danvers commissioners in December 1873, he prepared for this project by researching hospitals at Worcester, MA Poughkeepsie, NY, Concord, NH, Philadelphia, Trenton, and one under construction at Morristown, NJ. On this basis, he asked for $900,000 almost half again what the commissioners had allotted in April and picked draftsman, James F. Ellis to be superintending architect during its construction. The Danvers site, originally 197.25 acres purchased for $39,542.50, was chosen for its beauty, privacy, view, and farming potential. Eighteen miles north of Boston, 2 miles west of Danvers, 7 miles from the coal port at Salem, accessibility to visitors and a supply of heating fuel were also deciding factors. The "Swan's Crossing" station (later renamed Asylum Station) on the Lawrence Branch of the Eastern Railroad sat on the northern border of the tract. Under the supervision of Lynn engineer Charles Hammond, an overall site plan was drawn up, locating the main building on the crown of Hathorne Hill and providing also for a support network of roads and room for a farming operation.
Bradlee's 1867 plan for State Lunatic Hospital at Winthrop
Bradlee's 1868 plan for State Lunatic Hospital at Winthrop
Bradlee's 1874 plan for the State Lunatic Hospital at Danvers
Bradlee's 1867 drawing for State Lunatic Hospital at Winthrop
Bradlee's 1868 drawing for State Lunatic Hospital at Winthrop
Bradlee's 1874 drawing for the State Lunatic Hospital at Danvers
Bitter controversy over the building of Danvers State Hospital centered around its configuration, ornamentation and cost. Construction began May l, 1874, eventually cost a whopping $1,464, 940. 57. Many agreed that "Danvers rank(ed) among the foremost in its facilities for convenience in practical operation, its provisions for securing that purity of atmosphere which is necessary to the perfection of hygienic conditions and in its general adaptation to the purpose for which it was intended." They lauded "the plan, the style, the architect, and the thoroughness and pennanence of the work already performed."
In 1877 an inquiry was held into cost overruns during which the issue of the hospital's style, dubbed "Domestic Gothic" by Bradlee, inevitably surfaced. The Commissioners defended their plans which when exhibited at the International Exhibition in Philadelphia, received the only award made to this country for plans for an insane hospital. Others lined up behind Senator Sanborn who, calling it the "Hospital Palace at Danvers", argued that "even many a royal palace is neither so large nor so pretentious architecturally as the hospital at Danvers." (Sanborn, E.F.; The Hospital Palace at Danvers ; 1877). Pliny Earle, then Superintendent at the State Lunatic Asylum in Northampton "decried the trend to excessive ornamentation in hospital architecture, preferring comfortable interiors to 'gorgeous exteriors', suggesting that domes, towers, and turrets are very appropriately situated 'at universities like Harvard and Yale but are scarcely appropriate' when they stand as monuments over the misfortune and the miseries of men. "(Lucy Sanborn, The towers and turrets were in fact necessary to the building's ventilating system, not merely stylistic features.)
The investigating committee concluded that several errors in judgment had been made. While the hospital commissioners were “superseded” early as a reprimand, a $150,000 appropriation was awarded to allow the completion of construction. The first patient was admitted May 13, 1878. Provision of pure water, an important component in 19th century mental health therapy, was also the subject of argument during the construction and early years of the hospital. The nearby Ipswich River was explored early as a source. Ultimately, the town of Danvers, which had in 1874 established its own water supply from Middleton Pond at Wills' Hill, indicated its willingness to service the hospital's needs as well. In 1876, an agreement was struck whereby the town would build its own intermediate reservoir on the grounds to supply a gravity feed system via a series of ten 5000 gallon tanks in the attic.
By the turn of the 20th century, Danvers State Hospital had outgrown its site and facilities. Therefore, in 1902 an additional 100 acres straddling the towns of Danvers and Middleton, was purchased and a major building campaign was undertaken. Twentieth century additions to the hospital reflects not only growth of the patient population, but also an increased emphasis on occupational therapy and current theories of decentralized care. Large barns (demolished) were built as were new buildings for the men who helped out the farming venture. Grove Hall and Farm Hall and for women chronic patients (Middleton Colony 1903). In fact, after the very first year of its operation, once the layout was decided, roads, fences, piggery, corn barn, wagon shed, manure cellar, and apple orchard were in place. After only the second, 50 cords of wood and 10,386 lbs. of fresh pork were realized. The farm continued to grow and prosper and soon became a famous model. The Danvers onion, locally derived by the Gregory Seed Co., was among the many vegetables grown. Elaborate pleasure gardens were established adjacent to the Kirkbride complex to supplement recreational therapy programs. In fact, the Danvers State Hospital was so remarkable that it attracted 12,000 yearly visitors as early as 1880. In addition to visiting patients, they brought contributions of books, magazines, and flowers and conducted religious services. Thus, was established a pattern of community involvement for which the hospital would later become noted.
As originally established, the Danvers hospital was to be run by a resident Superintendent appointed by an unpaid lay Board of Trustees, chosen by the Governor. Central authority lay with the Board of State Charities (after 1879-The State Board of Health, Lunacy and Charity). In 1898 the leadership role of the Commonwealth of Massachusetts radically advanced with the information of the State Board of Insanity, the first in the United States. Landmark legislation:
l. took the poor out of the almshouses and put them under state control.
2. introduced occupational therapy and social services.
3. emphasized mental hygiene, and called for professional training of nurses and attendants.
Danvers State Hospital became a leader in the implementation of these progressive and humanitarian tenets, becoming one of "the most advanced institutions of the kind in the country providing all practical means possible for intelligent treatments of insanity as a disease." (Frank E. Moynaham (Publisher), Danvers, Massachusetts (Danvers: Danvers Mirror, 1899) Danvers State made extensive early use of occupational therapy. In addition to working the farm and greenhouses, patients repaired facilities (like the reservoir-1912), dug tunnels (like the one to the Nurses' Home-1913), and built small buildings (like the 1917 slaughter house built from patient-made concrete blocks). They also made shoes and participated in other crafts and Montessori kindergarten exercises. Patient crafts were sold to the public and exhibited (along with displays about the hospital's latest therapeutic techniques) at exhibitions; like the Boston Mechanics Hall Textile Show (1916) and the one at Stoneham (1919). Mental and physical hygiene at Danvers State was guided by the most advanced contemporary thinking (despite epidemics such as the great outbreak of bacillary dysentery of 1908 in which 36 died). Primary ingredients in the program were recreational therapy (gardens, etc.) fresh air supplied by an advanced ventilating system, and especially hydrotherapy. It was believed that the use of water baths to ameliorate the clogged condition of the brain would allow for the discontinuance of irritating restraints and depressing drugs and advanced pathology department supported the hygiene effort.
Danvers State Hospital established the second nursing school in Massachusetts (1889) and the second nurses' home in the state (Gray Gables-1898). It had already pioneered by being the first Massachusetts mental hospital to hire a woman doctor (1879). By the end of the 1920s, two large nurses' homes had been built on the property, one for female nurses and the other for male.
The hospital was a leader in the area of community involvement from the start. As early as 1907, the Superintendent was advocating a preventive mental health program. In 1909 the "Danvers Series" was inaugurated to share the results of research at the hospital. By 1912 there was an active community mental health program. "From such beginnings grew the Massachusetts Plan in which the state hospital is regarded as the center of mental hygiene and psychiatric activity throughout the district." About the same time the Massachusetts Plan was being popularized, 1938, the current Department of Mental Health was set up. It succeeded the Commission on Mental Diseases, which had replaced the State Board of Insanity in 1916.
Cini, M. M. (1983). National Register of Historic Places Nomination Form. Boston, MA. and John Gray