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The Toledo Asylum for the Insane: The Answer to Ohio’s Overcrowded Asylums and Infirmaries

(1883-1884)

 

The hospital initially opened its doors to patients as The Toledo Asylum for the Insane. At the time, Ohio already operated five so-called “insane asylums” including institutions in Cincinnati, Columbus, Cleveland, Dayton, and Athens; however these facilities were not adequate to provide enough space for the number of identified insane people within the state.[1] In 1882 the 7th Annual Report of The State Board of Charities to the Ohio State General Assembly called for “additional accommodations for at least one thousand insane” to reduce the overcrowding in the county infirmaries and existing five state run asylums, as well as those being housed in jails and at home.[2] As a result, in April 1883, the Ohio General Assembly passed House Bill 909 “to provide for additional accommodations for the insane of the state.”[3]  The bill created a commission charged with determining and implementing plans for either the expansion of current state asylum facilities or selecting a new site.  Further, the bill determined a budget of $500,000 to complete the project. Section five “authorized and empowered” the Commissioners of any county in Ohio to “sell or donate and convey to the state, for asylum purposes, any lands owned by their respective counties.”[4]

 

On October 17, 1883, Lucas County Commissioners answered that call. They proposed and passed a motion to donate “150 acres of the Infirmary Farm to the State of Ohio for the purpose of erecting thereon an Insane Asylum…”[5] In late 1883, “after much deliberation” the state appointed commission accepted the land donation by Lucas County. The land was rurally located, yet near a major city, ideally suitable to farming with an “even surface” containing dry soil that could be “brought to a high state of cultivation” and its proximity to Swan Creek “afford[ed] ample means for perfect drainage.”[6] Although these features may appear to be minimally important, they were truly the foundation of any 19th century asylum. Form and the function of the facility went hand in hand, with the asylum being the physical embodiment of the psychiatric concepts of the day. Gerald Grob writes that the “ideal hospital had to begin with the selection of an appropriate site located outside a populated urban area, but accessible by trains and roads. Such features as good drainage, an abundant water supply and fertile land were important.” [7] He continues that these features were not just important because they provided function and usefulness to an operational asylum, but also because they provided patients with opportunities both to work and to live in a peaceful, aesthetically pleasing atmosphere.

Drawing from Thomas Krikbride's 1854 book ""On the Construction, Organization, and General Arrangements of Hospitals for the Insane"

In addition to selecting the location, the state commission determined the asylum’s architectural design.[8] The five existing Ohio state hospitals, as well as the majority of other asylums across the country, followed the Kirkbride, or congregate plan. The Kirkbride plan, named for Thomas S. Kirkbride, was a linear building design that contained both administrative functions and patient care within one facility. The staff dorms and administrative tasks were contained in the central portion of the building and the patients were housed in wings that extended from both sides of the center building.[9] The design, location, and features of a Kirkbride facility were created with moral treatment in mind which included providing adequate space for patients, treatment areas, and a pleasant, rural atmosphere.  During the latter part of the nineteenth century the approach to treating mental health patients continued to change as did the architectural design of institutions. Toledo’s Asylum for the Insane would be the first built completely upon the detached ward, or “cottage” plan.  The Second Annual Report of the Toledo Insane Asylum discussed the benefits of the cottage plan as providing a way to sequester and classify patients in detached buildings rather than all under one roof. Additionally, trustees contended that the cottage plan was more humane and therapeutic, compared to the Kirkbride plan and allowed more flexibility as “the capacity of this institution can be increased at any time.”[10]  Further, the detached plan provided patients with more independence and a more “social atmosphere.”[11] (Image of Kirkbride Plan -  [12])

Courtesy of Ward M. Canaday Center for Special Collections, The University of Toledo Libraries.The story of TSH reflects larger historical trends. The mid to late 19th century gave rise to wide-spread, state operated, specialized institutionalization including hospitals for epileptics, feeble minded, and insane, schools for the deaf and blind, as well as orphanages and penitentiaries.[13] TSH was one, among many institutions built during 19th century within the state of Ohio and across the country to provide treatment for rising populations of the insane. At the same time, TSH is a unique example within this history as the first such asylum built completely on the detached ward or “cottage” plan. Hospital planners designed TSH, both physically and conceptually, based upon a humanistic treatment approach incorporating and implementing the advancing notions of insanity, therapeutic treatment, and humane care for asylum patients. (Image - "Scene at Toledo Asylum for Insane"- [14]

Locally, the state appointed commission organized a Board of Trustees to oversee the construction. By early 1884, the plans for the Toledo Asylum for the Insane were well underway. Trustees projected that the new and innovative hospital would begin accepting patients in 1886, however, construction delays and changes to the original plans caused the hospital opening to be delayed many months.

Next Installment- Toledo Asylum for the Insane: The Plans Expand  (1884-1887)

 



Endnotes

[1] Archival Search at OHS - Longview Hospital in Cincinnati Ohio, Columbus State Hospital, Cleveland State Hospital, Dayton State Hospital, and Athens State Hospital, http://collections.ohiohistory.org/starweb/l.skca-catalog/servlet.starweb.
[2] The Seventh Annual Report of The State Board of Charities to the Ohio State General Assembly (1882): 5-7, http://books.google.com/books?id=bOo1AQAAMAAJ&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false.
[4] Ibid., 182.
[5]Lucas County, Ohio - Board of County Commissioners, Commissioners' Journals (1883), 222, Bowling Green State University, Center for Archival Collections.
[6]First Annual Report of the Board of Trustees and Officers of the Toledo Asylum for the Insane (1884): 6, Ward M. Canaday Center for Special Collections, The University of Toledo Libraries.
[7] Gerald N Grob, The Mad Among Us: A history of the care of America’s mentally ill, (The Free Press: New York, 1994): 71-72.
[8]First Annual Report of the Board of Trustees and Officers of the Toledo Asylum for the Insane (1884): 6, Ward M. Canaday Center for Special Collections, The University of Toledo Libraries.
[9] Grob, The Mad Among Us, 72.
[10] Second Annual Report of the Board of Trustees and Officers of the Toledo Asylum for the Insane (1885): 5, Third Annual Report of the Board of Trustees and Officers of the Toledo Asylum for the Insane (1886): 11, Ward M. Canaday Center for Special Collections, The University of Toledo Libraries.
[11] Yanni, Carla. The Architecture of Madness. (University of Minnesota Press: Minneapolis, 2007): 79.[12] Kirkbride, Thomas Story. On the Construction, Organization, and General Arrangement of Hospitals for the Insane. (Philadelphia, 1854): 30. Available on https://play.google.com/books/reader?printsec=frontcover&output=reader&id=p-AbcIApx6QC
[13] Grob, 23-36, James W. Trent, Jr. Inventing the Feeble Mind: A history of mental retardation in the United States. (University of California Press: Berkley, 1994): 10-12, 39.  [14] "Scene at Toledo Asylum for Insane." Ward M. Canaday Center for Special Collections, The University of Toledo Libraries.

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