The Kirkbride Plan

Dr. Thomas Story Kirkbride

Dr. Thomas Story Kirkbride (1870)

If you ever deign to look up information on old asylums, you’re bound to come across the term “Kirkbride Plan”. The Kirkbride Plan was a way to treat mental illness by providing more humane treatment to patients. This would require a sprawling hospital facility and vast grounds. The idea was that if the insane were in a relaxed environment, away from large populations and problems, that sanity would be restored to those who’d lost it. This idea was nice, but somewhat unrealistic in lieu of more modern knowledge surrounding mental health. The author of the Kirkbride Plan was the influential Dr. Thomas Story Kirkbride (or, as I like to call him– “Eyebrow”).

Dr. Kirkbride was born to Quaker parents in rural Pennsylvania on July 31, 1809. He was formally educated at University of Pennsylvania Medical School from 1828 to 1832 where he’d trained to become a surgeon. However, after graduating, the thirty-one year old doctor was approached by the Board of Directors for the newly established Pennsylvania Hospital. The board extended to him the position of Chief Physician (or superintendent), which he accepted.

Kirkbride sought to change the way the medical world viewed insanity. During the mid-1800’s, people with mental illness were treated deplorably. Many of the insane were forced to live in prisons or in workhouses. Dr. Kirkbride strongly advocated “Moral Treatment” of patients through compassion and respect. Likewise, social reformer Dorothea Dix also saw the need for change in the mental health industry.

The idea that insanity could be a treatable disease was unheard of at this time. Those who were afflicted with insanity were victims of a demonic visitation. Some also believed the madness was caused by the moon. (This is where the term “lunacy” comes from.) Other possible sources of insanity included, but are not limited to: excessive drinking, lead poisoning, measles, religious fervor and disappointed love.

Pennsylvania was founded by Quaker William Penn, so it is no surprise that Quakers also founded the Pennsylvania Hospital, which became the first institution to extend treatment to “lunaticks or Persons distemper’d in Mind,” as the original 1751 charter stated. (Quakers, for those who don’t know, are stalwart religious people with a strong belief in maintaining peace. They do not believe in fighting and object to harming others.) As the hospital superintendent, Dr. Kirkbride adhered strongly to a belief that those suffering from insanity “are not disabled from appreciating books…or enjoying many intellectual and physical comforts.”

At the Pennsylvania Hospital, many patients were admitted because grief, ill-health, intemperance and anxiety which had foisted the person into a state of insanity. Though, other causes such as religious excitement, tobacco use, prolonged lactation, nostalgia and exposure to the sun were also cited as suspected causes of insanity.

The Pennsylvania Hospital has been instrumental in more accurately understanding the causes of mental illness and also in discerning effective treatment for patients. While only half of Dr. Kirkbride’s patients ever recovered from their mental illness and resumed their places in the world, one could venture to say that his Kirkbride Plan was a success– especially considering that medications treating the modern-day chemical imbalances did not exist in the mid-1800’s.

While Dr. Kirkbride’s success with the mentally ill earned him notoriety, his legacy extends to the Association of Medical Superintendents of American Institutions for the Insane (AMSAII) — better known now as the American Psychiatric Association– of which he was a founding member and also to the numerous medical facilities which were built as monuments which were to facilitate the Kirkbride Plan.

Keep the page bookmarked for tomorrow’s general details on Kirkbride Buildings which include some famous asylums such as Weston State Hospital, Athens State Hospital and Danvers State Hospital.

* The Construction of Hospitals for the Insane by Dr. Kirkbride (Selection of Chapters)


3 thoughts on “The Kirkbride Plan

    • Up until that point, people didn’t think you could treat insanity. That he cured several people made him well-known in medical circles– so well known, they asked him to help found the AMSAII. His plan was the adopted standard for treating the mentally ill for at least 60 years– until the advent of modern medicines. Yes, what he did was kick-start treatment of the mentally ill. I’d say that’s a very good thing.

      If you look at some of the things believed to cause mental illness, we now have an explanation of some of them– for example the “prolonged lactation” of the past might be the “postpartum depression” of today. If Kirkbride hadn’t thought you could treat mental illness, those people wouldn’t have any help.


Comments are closed.