Institutions of Pre-Civil War America: The Mental Hospital and the Penitentiary

The penitentiary was designed as a reforming space in which convicted criminals could be confined and rehabilitated before being released back into society. The mental hospital was designed to cure the mentally ill by confining them in a controlled environment so that their temperaments could normalize and they could eventually perhaps return to their families outside of the institution.

Early penitentiaries began to appear in the late 18th century, and mental hospitals were established in the first few decades of the 19th century. New York, specifically, had both a fully functioning penitentiary and several insane asylums by the 1830s.[i] Although one institution was designed to discourage crime while the other was designed to treat mental illness, many similarities exist between their designs. These similarities suggest a social impulse in the early 19th century towards institutionalizing social problems like mental illness and prisons and keeping them private, away from the community.



Benjamin Rush (Figure 1),


Figure 1

a reform thinker who influenced the structure of penitentiaries in the late 18th century, hoped that the construction of the penitentiary would eliminate the need for public or corporal punishment (Figure 2).


Figure 2

In the same way, the medical superintendents who directed mental hospitals isolated the inhabitants of the mental hospital from the outside world and hoped to avoid physical punishment within the mental hospital. Indeed, Thomas Eddy (Figure 3),


Figure 3

the first director of Newgate (Figure 4),


Figure 4

wrote in his account of the penitentiary that in Newgate “corporal punishment is wholly abolished”.[ii] Rush believed that the loss of liberty should be enough punishment for the convict in prison.[iii]

The penitentiary was meant to provide a space in which the prisoner would achieve internal moral reform. The prisoners would not to be punished physically or publicly, because they would want their liberty back enough to facilitate their own reform. The loss of liberty was therefore a replacement to the old tradition of public, physical punishments, and was meant to eliminate the need for corporal punishment. The penitentiary was set apart from the community so as to make punishment private and invisible and to further isolate the prisoners within.[iv]

The mental hospital, too, avoided public spectacle by being set apart from the patients’ original community.[v] Within, the path towards a cure for the patients was designed to be “without cruelty or unnecessary punishment”.[vi] Therefore, both the penitentiary and the mental hospital kept punishment separate from the community by keeping it private within the walls of the institution. This separation was aimed at eliminating the need for public corporal punishment.


In a series of biographies collected by officers at the Auburn Prison from criminals upon release, a focus on the importance of a criminal’s upbringing is very prominent.[vii] These 173 biographies, recorded from 1829 to 1830, reveal on ongoing search for the origins of crime. The officials quickly drew the connection between the presence or absence of criminal behavior in an individual and that individual’s family life. As the officials of Auburn Prison saw it, “children lacking discipline quickly fell victim to the influence of vice at loose in the community. Inadequately prepared to withstand the temptations, they descended into crime.”[viii] This theory for the origins of criminality turned the criminal into a victim rather than an aggressor; it was the criminal’s family environment that made him or her turn out the way he or she did. Small deviations, left uncorrected, quickly snowballed into all-out criminal behavior. These deviations were allowed to pass by undetected due to familial neglect, and so many blamed criminals’ unstructured upbringings for their criminal behavior.[ix]

Similarly, mental illness was blamed on the social organization surrounding the patient. If an individual were raised to embrace disorder and reject tradition, he or she would be more prone to mental illness. Specifically, failure to accept religion was seen as strongly linked to mental illness.[x] A well-ordered family that respected tradition and religion could protect a child from the disordered society of 19th century America, and thus protect the child from falling mentally ill.[xi] A disordered family life, combined with the lack of order in the outside world, would leave a child’s mind disorganized and at the mercy of mental illness.

Seeing the same relationship between family life and criminality and between family life and mental illness shows that many in this period believed these two societal problems to be linked, since they had the same roots. Thus mental illness and criminality were different outcomes of the same problem, and not necessarily two entirely separate problems. Mental illness and criminality and were thus both treated in a similar way.



Benjamin Rush believed that the roots of both criminality and insanity lay in the stresses of everyday life and also blamed these stresses for the existence of crime. Rush named immorality and vice as the sources of crime and mental illness.[xii] These negative influences had become concentrated in newly urbanized America and spread like disease. An individual thus corrupted became more prone to crime and mental illness.

Similarly, the medical superintendents of the newly constructed mental hospitals (Figure 5)


Figure 5

blamed insanity on the “exceptionally open and fluid quality of American society.” Medical superintendents saw that this society lacked rigid structure and therefore believed that some minds gained too much freedom and succumbed to mania or other mental illnesses. Again, identifying the same problem as a cause of both criminality and mental illness linked the two problems since they had the same roots. It is therefore no wonder that the institutions designed to deal with these problems treated the problems in similar ways.


Both Rush and medical superintendents found the causes of crime and mental illness to be environmental; the solution to the problem was to move the convicts or patients into a new environment. This fundamental principle of environmental change is what guided the construction and implementation of the penitentiary and the mental hospital. These new environments were meant to “methodically corrected the deficiencies of the community”. The community outside of these institutions was too free; people were exposed to too much immorality and fluidity. Therefore, the solution was to design a strictly controlled space in which criminals and insane people could be rehabilitated.[xiii]

Mental hospitals were meant to create a “therapeutic environment that would change the lives and behavior of the patients.”[xiv] These well-ordered environments were a part of the practice of moral therapy, which was popular in the first half of the 19th century and stressed the important role of routine in curing mental illness.[xv] Displacing the criminal or the mental patient and placing him of her in a new, different environment, especially an environment not near his home (Figure 6),


Figure 6

would help remedy the negative effects of the criminal’s previous, toxic environment.[xvi]

The buildings of the penitentiary and the mental hospital were designed around the idea of curing criminality or mental illness. The goal of both institutions was to release inmates or patients back into society once they had been properly rehabilitated. Rush truly believed that convicts could be reformed and restored to full citizenship by placing them in the controlled environment of the penitentiary.[xvii]

Both Rush and the medical superintendents believed that there was hope for reform and rehabilitation for each and every prisoner or patient. Medical superintendents were “in complete agreement regarding the main purpose of their institutions: to bring about, if possible, the total recovery of the patient.”[xviii] Indeed, supporters of the mental hospital “confidently and aggressively asserted that properly organized institutions could cure almost every incidence of the disease”.[xix] In the same vein, Rush wrote that “There never was a soul so completely shipwrecked by vice that something divine was not saved from its wreck,” as long as the soul was contained for a time in his ideal penitentiary.[xx] He believed that the penitentiary was the universal cure for crime.



The structures of life for the prisoners and patients of the penitentiary and the mental hospital were similar because they both stressed discipline and order. Rush hoped that a meticulously controlled environment would eliminate all the corrupting influences of exterior society, and create a space in which prisoners could seek reform and rehabilitation. For him, this environment must revolve around solitude, silence, and labor.[xxi] Solitude would force the convict to consider his crime and make the decision to move towards reform. Only in silence could this kind of inner reflection take place, and thus silence must be combined with solitude.

The asylum was meant to be “a domain of pure morality, of ethical uniformity.”[xxii] Life in the mental hospital followed a strict, disciplined routine.[xxiii] Each day was meant to be “orderly, predictable, and regular.”[xxiv] Patients woke at the same time each day, followed the same schedule, and were all in bed by the same time each night.[xxv]This “clockwork regularity” was meant to teach self-discipline to the patients, teaching them to control themselves in the significantly less organized environment of the outside world.[xxvi]

The penitentiary and the mental hospital were based on the same principles and hoped to rehabilitate their inhabitants in the same way. Both sought to create a controlled environment in which the convicts or the patients could learn good habits and prepare themselves for their release and return to liberty. In the place of corporal punishment, routine and silence were used to encourage change and improvement.


The structures of these two types of institutions were designed in the style of moral architecture, a style that focused on the organization of the interior of the building to make it a catalyst for reform. This style was almost formulaic; note the similarities between the New Jersey State Lunatic Asylum (Figure 7)


Figure 7

and the New York State Lunatic Asylum (Figure 8).


Figure 8

Buildings designed using the moral architectural style had interiors that divided time and space. Rooms were carefully divided and each space was designed with a specific purpose, whether it be for labor, for eating (Figure 9),


Figure 9

or for sleeping. This hyper-controlled design style fit the theory that a specifically regulated environment was the only environment in which the insane or the criminal could be rehabilitated.[xxvii]

The similarities in the structure of the penitentiary and the mental hospital become apparent in the designs for the institutions as written by two men at the heart of these new structures. Thomas Eddy was the first director of Newgate, New York’s first state penitentiary. His book An Account of the State Prison or Penitentiary House, in the State of New York outlines how Newgate was designed and run, describing the lives of the prisoners and the employees of the penitentiary. Similarly, Thomas Kirkbride (Figure 10),


Figure 10

the first physician of the Pennsylvania Hospital of the Insane (the first modern insane asylum in the United States), wrote a book entitled On the Construction, Organization, and General Arrangements of Hospitals for the Insane. This book gives an outline for other mental hospitals to follow, including a description of the building itself as well as how the mental hospital should be run.

Both the penitentiary and the mental hospital were originally designed to have cells that housed only one individual each (Figure 11).


Figure 11

Indeed, both institutions hoped to reform or cure their residents through a focus on solitude. Kirkbride designed cells to be 9 feet by 11 feet, and at least 12 feet high (Figure 12).


Figure 12

[xxviii] Larger cells were designed for patients who needed an attendant at all times, but for the most part patients had their own cells. Newgate did not have enough space to keep each prisoner in his or her own cell, and instead each building had 54 cells that were 12 feet by 18 feet and held eight prisoners each. However, each building did have seven solitary confinement cells, which were 8 feet by 6 feet and 14 feet high.[xxix] The importance of keeping some inmates or patients in solitary cells emphasizes the importance of solitude in contemporary reform thinkers’ theories about curing criminality or insanity. In order to reform or recover, it was thought the inmates and patients must spend time alone, and thus both institutions were built with cells designed to hold one mane or woman each.


The separation of sexes was very important to the design of the penitentiary and the mental hospital. Eddy describes how women were all grouped together in one wing, and their courtyard is entirely separated from those where male prisoners spend time.[xxx] In this way, mingling between men and women was entirely prevented. Kirkbride also insisted that contact between male and female patients must be limited to an absolute minimum (Figure 13).


Figure 13

Women especially must be protected from forming undesirable acquaintances among the opposite sex.[xxxi] This separation of sexes suggests a fear of infection or spread of harmful ideas and influence, especially to women from men. This shared pattern of separation could show that thinkers like Eddy and Kirkbride believed that criminality and insanity could be spread in a similar fashion.


Another important form of separation within these institutions was the categorization of the inmates or the patients. Within the penitentiary, Eddy believed in classifying the criminals based on whether they were men with histories of violence and aggression, indifferent offenders, or first time offenders.[xxxii] The less villainous criminals would be corrupted by contact with the most evil men, and so separation was ideal. Mental hospitals also put time and energy into sorting their patients into different categories. Each hospital had its own system of classification, but it was agreed that the “noisy and violent” must always be separated from the “quiet and passive”.[xxxiii]

This idea of separation based on the severity of the criminality or the mental illness creates a parallel between the treatment of criminals and the mentally ill and the treatment of medical patients with contagious diseases. The designers of penitentiaries and mental hospitals seemed to believe in the ability of vice and insanity to spread through contact, and thus actively separated those less affected by the problem from those more given over to crime or mental illness.



Both institutions also hoped to promote good hygiene and health by providing good clean water to the inmates and patients. Eddy emphasized the fact that Newgate was designed with water pumps providing clean water to the inmates (Figure 14).


Figure 14

In the warmer months, inmates could bathe in the river.[xxxiv] Similarly, Kirkbride stressed the importance of providing mental patients with clean water. He also wrote that bathing was useful and even necessary to the treatment of mental patients.[xxxv] In these two institutions aimed at the reform and rehabilitation of individuals, cleanliness and hygiene were included as things that must be taught to the inmates and patients.


Along with solitude and hygiene, labor was encouraged and worked into the designs of the penitentiary and the mental hospital. Labor was a habit that must be acquired in order to be moral. According to Rush, habitual labor prevents bad habits at the same time as it encourages virtue.[xxxvi] Eddy’s ideas agreed wholeheartedly with Rush on this point, as he wrote that “The most efficacious means of reformation are to be found in that system of regular labour and exact temperance by which habits of industry and sobriety are formed”.[xxxvii] Both men believed that the environment within the penitentiary must teach the habit of labor in order to reform the convicts within.

Like Rush, the medical superintendents believed that the habit of labor promoted a healthy, moral lifestyle. This schedule was rigidly adhered to, and had “daily labor at the heart of it”.[xxxviii] The medical superintendents hoped that regular labor would teach the patients proper habits and bring “regularity to disordered lives.”[xxxix]

Labor by the prisoners and patients not only taught good habits and useful skills, but also provided a means for the penitentiary and the mental hospital to provide funding for their own operations.[xl] Patients were given a “useful occupation,” such as carpentry for men or domestic chores for women.[xli] One superintendent wrote, “useful work is a means of averting insanity; a means of keeping a sane mind sane; a means of lessening insanity of the mind.”[xlii]

Benjamin Rush supported the usefulness of labor, insisting that it supported good morals, and that idleness would lead to criminal behavior.[xliii] Thomas Eddy saw the workshops of Newgate as a way for prisoners to continue their trade within the penitentiary, or to learn a new trade that they could continue upon release.[xliv] The focus on labor, even with patients who were mentally unwell, suggests that both institutions recognized the need to produce some source of income and therefore made space for workshops work yards in the designs for their buildings.


The structures of the employees within these two institutions also share several similarities. First of all, both institutions were run by a board of several people chosen by the governor of the state in which the institution was situated. Newgate had seven Inspectors who met once a month to discuss the goings-on in the prison. Two of these Inspectors visited the prison each week to make sure that the keepers were doing their jobs correctly and to hear any complaints that the prisoners might have.[xlv]

Similarly, Kirkbride’s design for the mental hospital included a Board of Trustees of around 12 members who were to visit every part of the hospital at “frequent stated intervals”.[xlvi] These men would also oversee the mental hospital to make sure all of the employees were doing their jobs correctly. Therefore, both the penitentiary and the mental hospital had an external system of inspection to make sure that the employees were carrying out their mission correctly.

The actual task of organizing and running the institution was given to a single man in each institution. In the penitentiary, this man was the Principal Keeper, who is paid a salary so that that the job may ““command the services of a suitable character”.[xlvii] The Physician, who ran the mental hospital, was also paid a generous salary, because, as the “Superintendent and Chief Executive officer of the establishment,” he oversaw all of the patients’ treatments, and Kirkbride felt that only a very generous salary could attract a worthy candidate for the job.[xlviii] Both institutions therefore gave their head officers a salary proportional to the enormous responsibility that came with the job. The monetary incentive seems to be an acknowledgement that no one would carry out the job simply out of the charity of his heart.

Both institutions kept a team of assistants directly under the Principal Keeper or Physician. Newgate had 12 assistant keepers, one of whom was the Deputy Keeper, to become Principal Keeper if the position were to become suddenly vacant.[xlix] These men were supposed to keep good manners, in order to set a good example for the prisoners. Kirkbride wrote that insane asylums should keep about one attendant for every eight patients.[l] Then, there were a small number Assistant Physicians; at the Pennsylvania Hospital for the Insane, which had about 250 patients, there were two Assistant Physicians.[li] At the penitentiary, an Agent was hired to purchase all materials needed for the prison and sell all materials produced in the prison.[lii] Similarly, the Steward in the mental hospital made all purchases necessary for the mental hospital and kept the institution’s accounts.[liii] These similarities in how the institutions were run further emphasize the common approaches taken towards the construction of the penitentiary and the mental hospital.


            The mental hospital and the penitentiary began appearing at the same moment in American history. The ideas of reformers in the early 19th century influenced both institutions, and in many ways the institutions were very similar. These similarities suggest a social impulse towards institutions that hide away societal problems like crime and mental illness and keep these problems private. Inside these institutions, the movement towards solitude and silence was carried out through similar means in both institutions, indicating a shared sense that somehow solitude could lead to reform. Since the roots of both mental illness and criminality were identified as an individual’s family life and environment, the designs for the mental hospital and the penitentiary looked similar, because they sought to correct the same bad influences.

One final interesting parallel is how the population of the mental hospital increased in the same way that the population of the prison did (see the work of Caleb Rodrigues on this site)

AVERAGE ANNUAL ADMISSIONS TO THE AMERICAN MENTAL HOSPITAL, 1820-1870 (Keeping in mind that new hospitals brought the mean down quite a bit, and so the increase in admissions was in fact much more rapid than shown here)[liv]




-Lucy O’Brien


[i] Rothman, David J. “The New World of the Asylum.” The Discovery of the Asylum; Social Order and Disorder in the New Republic. Boston: Little, Brown, 1971. Print.130.

[ii] Eddy, Thomas. An Account of the State Prison or Penitentiary House, in the City of New-York. New York: Isaac Collins and Son, 1801. Google Books. Web. 19 Oct. 2016. 14.

[iii] Kann, Mark E. “Benjamin Rush: Patriarch of Penal Reform.” Punishment, Prisons, and

Patriarchy: Liberty and Power in the Early American Republic. New York: New York UP, 2005. N. pag. Print. 104.

[iv] Sullivan, Robert R. “The Birth of the Prison: The Case of Benjamin Rush.” Eighteenth-Century Studies 31, no. 3 (1998): 333-344. (accessed October 24, 2016). 339.

[v] Rothman 137.

[vi] Rothman 133.

[vii] Rothman 65.

[viii] Rothman 65.

[ix] New York Prison Association. First Annual Report. New York, 1845. 30-35.

[x] Rothman 114.

[xi] Rothman 121.

[xii] Kann 91.

[xiii] Rothman 133.

[xiv] Grob, Gerald N. Mental Institutions in America: Social Policy to 1875. New York: Free, 1973. Print. 176.

[xv] Grob, Gerald N. The Mad Among us: A History of the Care of America’s Mentally Ill. New York: The Free Press, 1994. Print. 27.

[xvi] Sullivan 339.

[xvii] Kann 103.

[xviii] Grob 174.

[xix] Rothman 131.

[xx] Kann 103.

[xxi] Kann 94.

[xxii] Foucault, Michel. Madness and Civilization: A History of Insanity in the Age of Reason. Translated by Richard Howard. New York: Random House, 1965.

[xxiii] Rothman 133.

[xxiv] Grob 176.

[xxv] Rothman 145.

[xxvi] Dwyer, Ellen. Homes for the Mad: Life Inside Two Nineteenth-Century Asylums. New Brunswick: Rutgers University Press, 1987. Print. 15.

[xxvii] Rothman 83.

[xxviii] Kirkbride, Thomas S., M.D. On the Construction, Organization, and General Arrangements of Hospitals for the Insane. Philadelphia: n.p., 1854. Google Books. Web. 11 Oct. 2016. 15.

[xxix] Eddy 18.

[xxx] Eddy 18.

[xxxi] Kirkbride 60.

[xxxii] Eddy 51.

[xxxiii] Rothman 147.

[xxxiv] Eddy 19.

[xxxv] Kirkbride 8.

[xxxvi] Kann 94.

[xxxvii] Eddy 53.

[xxxviii] Rothman 144.

[xxxix] Rothman 144.

[xl] Kirkbride 62.

[xli] Grob 178.

[xlii] John Fonerden to Kirkbride, June 19, 1859, Kirkbride Papers, IPH.

[xliii] Kann 96.

[xliv] Eddy 33.

[xlv] Eddy 20.

[xlvi] Kirkbride 39.

[xlvii] Eddy 25.

[xlviii] Kirkbridgåe 40.

[xlix] Eddy 27-28.

[l] Kirkbride 64.

[li] Kirkbride 44.

[lii] Eddy 23.

[liii] Kirkbride 45.

[liv] Grob 371.

[lv] Grob 372.


Figure 1- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Print Collection, The New York Public Library. “Benjamin Rush” New York Public Library Digital Collections. Accessed November 27, 2016.

Figure 2- Paget, H.M. “Perkin Warbeck In The Pillory.” Digital image. Art and Picture Collection, The New York Public Library. New York Public Library Digital Collections. 1884. Accessed November 14, 2016.

Figure 3- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Print Collection, The New York Public Library. “Thomas Eddy” New York Public Library Digital Collections. Accessed November 27, 2016.

Figure 4- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Print Collection, The New York Public Library. “State Prison Greenwich Village” New York Public Library Digital Collections. Accessed November 27, 2016.

Figure 5- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Photography Collection, The New York Public Library. “Kirkbride’s Insane Asylum, play ground.” New York Public Library Digital Collections. Accessed November 27, 2016.

Figure 6- Art and Picture Collection, The New York Public Library. “Blackwell’S Island Lunatic Asylum.” New York Public Library Digital Collections. Accessed November 29, 2016.

Figure 7- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Photography Collection, The New York Public Library. “State Lunatic Asylum, Trenton, N.J.” New York Public Library Digital Collections. Accessed November 29, 2016.

Figure 8- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Photography Collection, The New York Public Library. “N.Y. State Lunatic Asylum.” New York Public Library Digital Collections. Accessed November 29, 2016.

Figure 9- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Photography Collection, The New York Public Library. “Thanksgiving at the Home for the Friendless. New York.” New York Public Library Digital Collections. Accessed November 29, 2016.

Figure 10- Butler, Howard Russell. A Portrait of Thomas Story Kirkbride. 1898. An Address on the Occasion of the Presentation by Members of His Family of a Portrait of Thomas Story Kirkbride to the College of Physicians. By John Bassett Chapin.

Figure 11- Interior of  a Convict’s Cell. 1858. Harper’s Weekly. Correction History. Accessed October 17, 2016.

Figure 12- Kirkbride model asylum at Trenton, New Jersey. Date unknown. (“On the Periphery: A Survey of Nineteenth-Century Asylums in the United States,” accessed November 28, 2016,

Figure 13- Art and Picture Collection, The New York Public Library. “The Retreat And Yard.” New York Public Library Digital Collections. Accessed November 27, 2016.

Figure 14- The Miriam and Ira D. Wallach Division of Art, Prints and Photographs: Photography Collection, The New York Public Library. “Penitentiary washstand.” New York Public Library Digital Collections. Accessed November 29, 2016.