More than an Institution: Farview State Hospital

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The view from Farview State Hospital extends for miles. Visible in this picture is the Superintendent’s home. Circa 1920 Image credit: PA State Archives RG23.992 Farview State Hospital.

Driving along Route 6 in Wayne County, the view extends for miles. The Moosic Mountains dominate the landscape with their graceful peaks and quiet valleys. Small ponds and lakes add shades of blue to the landscape, and there are only a few small houses and farms in sight. It’s hard to imagine a more beautiful scene in Pennsylvania. It shouldn’t come as any surprise that these “restful and healthful qualities” have attracted tourists and admirers since the early 19th century.[1] The area’s beauty, isolation, and healing features, however, have also welcomed another group of Pennsylvanians: the intellectually disabled. Since 1912, thousands of patients lived on top of a Wayne County mountain plateau at Farview State Hospital, Pennsylvania’s first and only institution devoted to the care of the criminally insane.

From its modest beginning of a few wards and administrative buildings, the patients and staff at Farview worked hard over the decades to expand the hospital and its grounds and turn it into a self-sufficient community with all the facilities needed for the care of mentally insane patients. By the 1960s the institution had grown to become the home of over 1400 patients from all over Pennsylvania, complete with dozens of buildings and a 300 acre farm. For 84 years, Farview served as a home and community for patients who needed care and attention unavailable in prisons or other mental institutions. The hospital’s colorful history, full of challenges and dramatic transformations, sheds light on society’s changing views regarding proper care for the intellectually disabled, as well as the experiences of Pennsylvania’s intellectually disabled citizens.

Pennsylvania was a leader in the treatment of intellectual disabilities long before Farview State Hospital was built. Pennsylvania Quakers founded the first American hospital with organized care for the intellectually disabled in 1752. However, most Americans in the 18th and early 19th centuries generally viewed intellectual handicaps as a moral/spiritual failing worthy of punishment and shame. As a result, most disabled people ended up in prisons or poorhouses. It was not until the 1840s that society began to understand intellectual disabilities as medical issues and build special hospitals dedicated to its treatment. The medical community and public’s changing ideas on the rights of mentally ill citizens spurred changes in living conditions for patients. Securing better care and treatment, it later became clear, was the driving force behind many reforms in Pennsylvania’s mental health care system.

After lobbying by activist Dorothea Dix, the Pennsylvania state legislature founded one of the first public mental hospitals in Harrisburg in 1851, and built several others throughout the 19th century. In 1869 the Pennsylvania Board of Public Charities was established to inspect all charitable, penal, and correctional institutions in the Commonwealth. The board believed that the scientific and compassionate treatment of mental illness was critically important. By the 1890s six mental hospitals had been built under the Board’s direction and became homes for thousands of Pennsylvanians.

Nevertheless, care for the mentally ill still had a long way to go in the late 19th century. The Board of Public Charities created a Committee on Lunacy in 1883 to inspect Pennsylvania’s mental hospitals. Their annual reports revealed that facilities were often overcrowded and did not offer adequate care for patients. Hospitals also housed all mental patients together regardless of their individual issues, a practice that made life more difficult for patients and doctors alike. Mentally ill individuals with violent or criminal tendencies were even less fortunate and often received no treatment at all. Instead they were sent to prisons, almshouses, or other facilities that could not provide any care. The committee quickly concluded that specialized mental institutions were needed to improve the health and living conditions of all patients.

Polk State School, the first of these specialized facilities, was founded in 1893 to treat children with mental disabilities. For twenty years the committee also lobbied the state legislature for funds to establish an institution for criminals who suffered from mental illness. One of the strongest supporters of such a hospital was Dr. Thomas Fitzsimmons, a Wayne County native and mental health expert who was passionate about the treatment of the criminally insane.

Fitzsimmons believed “that this particular class of mentally affected patients could be handled, treated, and cared for at a much greater advantage to themselves if they were segregated” in their own hospital.[2] At the same time, members of the Committee on Lunacy worried that the criminally insane were a danger to non-violent patients and should be separated lest they harm or encourage others to adopt “criminal traits and habits.”[3] For the good of everyone involved, it seemed, building a new institution for the criminally insane was necessary.

After decades of petitions and lobbying, Dr. Fitzsimmons and the Committee on Lunacy were finally able to convince the state legislature to fund a new institution “specially built for the purpose” of treating the criminal insane.[4] On May 11, 1905 an act of the state legislature created The State Hospital for the Criminal Insane and Dr. Fitzsimmons was chosen as its first superintendent. Once funding was appropriated from the legislature, it was only a matter of choosing where the new hospital should be built.

The new hospital for the criminally insane would need lots of open land for the construction of buildings and a farm to grow food for patients and staff. Like other mental institutions built in the late 19th century, it also needed to be in a remote area “easily accessible by railroads from all parts of the Commonwealth.”[5] At the time, medical professionals believed that isolating the mentally ill was therapeutic, protected them from public scrutiny, and relieved communities of the burden of care. “The separate confinement of this class” according to Dr. Fitzsimmons, “is most desirable.” Though this practice has been largely discredited today, it was regarded as the most humane and effective method of treatment at the turn of the century.

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Founding Superintendent Dr. Thomas Fitzsimmons during Farview’s construction. Circa 1908. Image credit: PA State Archives RG23.992 Farview State Hospital.

At Dr. Fitzsimons’s urging, a location was chosen near his childhood home in Waymart, a sleepy town about 20 miles west from the New York border. 784 acres just outside of Waymart were donated to the state by the Delaware & Hudson Railroad Company and construction of hospital and ward buildings began shortly after in 1906. The location, on top of a large plateau, had a commanding view of the surrounding countryside and inspired the name of the new hospital: Farview.

Farview’s buildings were designed by James C.M. Shirk, a Philadelphia architect who had previously worked on the State Lunatic Hospital in Harrisburg. Shirk, drawing inspiration from mental hospitals in Washington, D.C. and New York, designed Farview to function as a prison without walls. Dormitories, dayrooms, and other buildings were grouped together with connecting brick passageways that created two large enclosed exercise courts for patients. This allowed patients to have access to building interiors and outdoor space while simultaneously restricting their access to areas outside the Farview complex. Even though construction of some buildings continued through 1913, Farview’s first patient was admitted to the hospital on December 17, 1912.

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Patient beds. Circa 1915. Image credit: PA State Archives RG23.992 Farview State Hospital.

At the end of the hospital’s second year Dr. Fitzsimmons was in charge of 182 total patients, most of whom were transferred from other mental institutions and prisons around Pennsylvania. Farview’s population increased steadily in these early years and soon outgrew its two wards. The hospital’s 43 acre farm also grew as patients and staff members worked to clear Farview’s wooded hills and produce enough food for everyone. By 1920 the farm operated on 307 acres and included many lush orchards and vineyards.

Farview, like many other mental institutions at the time, developed an extensive industrial therapy program. Patients labored in the hospital farm, laundry, and power house in order to employ their time productively and to help encourage a feeling of self-worth. The Committee on Lunacy believed that industrial therapy improved patients’ quality of life and introduced the practice at many state facilities: “the main object of employment or other pursuits is not so much to impart useful knowledge but to stimulate the sluggish circulation of mind and body, to break up the monotony of hospital life and prevent the rapid degeneration of physical and mental facilities.”[6]

Over time, Farview and other state mental institutions came to rely on industrial therapy, also known as “industrial peonage” as a method of offsetting facility costs and as a way to help patients prepare for life after they were released from Farview. After only a few years, Farview had enough dairy cows that it was able to cancel its contracts with local milk suppliers. A staff member remarked in 1920 that the farm “does far more for our patients than to produce potatoes, tomatoes, and other vegetables for their daily sustenance…in clearing the land and removing the rocks and stones, the patient in led to think about what is to become of them. As he helps solve these problems his mind of necessity must become stronger and more normal.”[7]

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Examples of materials made by Farview patients. Circa 1942. Image credit: PA State Archives RG23.992 Farview State Hospital.

Farview also created an occupational therapy program that trained patients in several industrial arts such as carpentry, cooking, knitting, and the construction of supplies like soap and bricks. These programs continued to expand as Farview’s population increased; by 1920 the institution’s brick plant was producing over one million bricks annually and were used in the construction of other mental institutions in Allentown and Norristown. In 1961 it was reported that sixty percent of Farview patients were involved in industrial or occupational therapy programs.

Life at Farview, however, was not all about work. The institution encouraged patients to participate in sports, art, and a variety of other activities. Patients wrote and published the hospital’s monthly newspaper, the Farview Echo. Farview’s 1915 Annual Report announced the organization of a brass band made up of fifteen “especially musically inclined” patients and guards.[8] Performances were given around the community and over the telephone as far away as Philadelphia. “We encourage the playing of musical instruments of all kinds, among our patients, and as soon as one shows the least aptitude in this direction he is given special attention.”[9] Dr. Fitzsimmons and his colleagues believed that these kinds of activities were good for the patients, and helped maintain good relationships between patients, staff, and residents living nearby.

Farview also hosted a popular softball league that played every other day in the summer months, often against teams from around Wayne County. In 1954 one doctor noted that “games with visiting teams reveal the good being done by the sports program at Farview. Players and spectators look forward to the games with visitors as well as they do to the interward games.”[10] Even with Farview’s secluded location, recreational activities allowed patients to participate in the larger community beyond the hospital’s grounds.

Being isolated in the Moosic Mountains did not cut Farview off from the world. Global events also had significant impacts on the lives of many patients and staff. Many doctors and guards were drafted and served in the armed forces during World War I, creating a staff shortage that was complicated by Dr. Fitzsimmons’ death in 1917. As Farview struggled to care for the increasing number of patients, the hospital was suddenly struck by the Spanish flu epidemic that killed millions around the world. Despite a strict hospital quarantine, over 75% of patients contracted influenza in October 1918. Many cases were fatal. 52 of Farview’s 476 patients and one doctor died in a single month and were buried in the hospital cemetery. At the height of the emergency, State Police officers served as guards, attendants, and nurses until conditions returned to normal.

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Guards and attendants at Farview. Circa 1915. Image credit: PA State Archives RG23.992 Farview State Hospital.

Despite occasional setbacks, the population grew at Farview and facilities had to be expanded to accommodate hundreds of new patients and staff. By 1962, fourteen more ward buildings had been constructed to house a population that peaked at 1410 men. Tuberculosis and geriatric wards were built for patient care, as well as facilities to provide psychiatric, psychological, medical, and social services to patients. A new recreational building and minimum security building were also built to allow some patients to walk around the hospital grounds and participate in activities with “complete freedom.”[11]  The 1960s also saw the beginning of an annual Open House program where Farview was open for public visits and hospital tours. Occupational and industrial therapy programs also grew so that Farview became an “almost self-contained community, with its own facilities for the manufacture of clothing, repair of shoes, and farms to grow much of the food consumed by patients.”[12]

Changing perceptions about civil rights and mental health in the United States also had lasting effects on life at Farview. Beginning in the 1960s, reports and investigations brought public and government attention to patient mistreatment and other abuses in many mental institutions including Farview State Hospital. As a result, many of Farview’s policies and procedures were reformed to make sure its patients were treated with compassion and care.

In 1971, the Supreme Court ruled in favor of several Farview patients that had been held for additional treatment at the hospital without their consent after their criminal sentences ended. Under this practice, patients could be held indefinitely against their will, in some cases even without their family’s knowledge. Once this practice was declared unconstitutional, over 700 Farview patients were released.

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Farview’s kitchen was operated by hospital patients. Circa 1915. Image credit: PA State Archives RG23.992 Farview State Hospital.

After investigations in the 1960s revealed that industrial and occupational therapy programs in Pennsylvania hospitals were routinely taking advantage of patient labor for profit, many state institutions reduced or ended the practice. A 1974 law made involuntary labor illegal in mental health facilities, and guaranteed patients the right to receive payment for any voluntary work they performed. After 60 years of raising crops and livestock, the farming operation at Farview was ended in 1975.

Several other scandals at Farview revealed patient abuse and other serious issues that continued to erode public confidence in Pennsylvania’s mental institutions. In 1973 former patient William Wright made headlines when he kidnapped and murdered two boys from Scranton. Wright had been held at Farview for years for murder and other crimes, but was allowed to live unsupervised in Scranton on a work-release program after officials mistakenly believed he was no longer dangerous. This decision was widely condemned by critics in a sensational trial that concluded with two consecutive life-sentences for Wright.

Three years later, The Philadelphia Inquirer published a series of articles exposing systematic patient abuse at Farview. Interviews with former patients reported crimes such as fatal beatings at the hands of guards and indiscriminate use of psychoactive drugs to keep patients sedated and under control. Journalists Acel Moore and Wendell Rawls wrote that “those who have been patients at Farview and who have been lucky enough to get out describe it as a living hell on earth.” [13]

The articles, known as “The Farview Findings” won a Pulitzer Prize and led to a series of criminal investigations of the hospital. “Farview was overcrowded and inappropriately staffed,” Public Welfare Secretary Helen O’Bannon said after visiting the institution in 1979, and “regulations protecting patient rights…were non-existent or inadequate at best.”[14] Governor Milton Shapp proposed closing Farview and sending patients to other facilities around Pennsylvania. Other mental health officials agreed, reporting that Farview “is no longer safe for either hospital staff or patients, and meaningful evaluations and treatments cannot occur.”[15]

Instead of closing Farview, the Governor and Public Welfare officials decided to introduce a series of reforms in Pennsylvania mental institutions to improve the treatment and quality of life for patients. “We all recognize that much more can and should be done,” Governor Dick Thornburgh announced in 1980, “to provide a humane and secure facility for those persons who pose a threat to themselves and society.” [16]

Changing public views on civil rights of the mentally ill and highly publicized investigations of mental institutions spurred a change in how Farview operated. Legislation passed in the 1970s and 1980s protected patient rights and mandated new treatment methods that reduced the time patients spent at Farview before they were released. The smaller population also lowered the strain on staff who had struggled in the past to maintain overcrowded wards. Increased scrutiny and accountability likewise made, as one staff member wrote, “the goal of adequate treatment for the mentally ill offender…no longer a remote dream.”[17] Reforms at Farview, motivated by new definitions of patient rights and protective legislation, helped the hospital get much closer to its mission of humanely treating the criminally insane.

Farview, like many other mental institutions, saw its patient population continue to decline towards the end of the 20th century. New trends in mental health encouraged families and local communities to care for the mentally ill at home instead of sending them away to isolated hospitals like Farview. In 1987, the bed capacity had shrunk to 225 (less than a fifth of its capacity 25 years earlier).

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Farvew (northwest corner of Pennsylvania) was the state’s only institution for the criminally insane.  Image credit: PA State Archives RG23.992 Farview State Hospital.

Modern ideas about mental health care eventually led to the closure of Farview State Hospital. The Pennsylvania Department of Public Welfare closed Farview Hospital and transferred its buildings to the Department of Corrections control in 1995. DPW closed or divested control of many state hospitals in the 1990s and relied more on outpatient and residential programs to care for Pennsylvania’s mentally ill citizens. Farview was renamed the SCI-Waymart Forensic Treatment Center and operates as a correctional facility today. However, Farview’s legacy still remains: SCI-Waymart still occupies several original Farview buildings, where staff provide psychiatric treatment and care for mentally disabled inmates.

Farview State Hospital was more than just a place for the treatment of mental illness during its 84 years. It was a home for thousands of Pennsylvanians and an important part of the local community. The institution and its residents were also at the center of transforming ideas about mental health care and institutionalization in Pennsylvania and the United States. Looking back, the hospital lives up to its founders’ belief that  “the occupation of the insane involves trouble, constant, persistent effort and ingenuity; yet the benefit is so great, the good effect so certain, that neither time, trouble nor reasonable expense should be spared.” [18]

This is a draft of an article that I’m currently working on for a Pennsylvania history journal. Any comments or ideas about how to improve it are very welcome! Last year I helped transfer some historical Farview State Hospital records to the PA State Archives and was lucky enough to get to tour the old Farview facility (currently operating as a state prison). This draft is based off of what I learned from these records as I processed them into the State Archives’ collections. Since I wrote this draft, I have found many more sources and am planning some major changes and expansions. Please don’t cite any material in this post without my permission.

[1] Dr. John Shovlin to Grace Steley, June 26 1961, Box 2, Folder 6, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[2]  Report of the State Hospital for the Criminal Insane, 1921, pg. 27 Box 1, Folder 7, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[3] 12th Annual Report of the Committee on Lunacy, 1894, pg. 27 Box 1, Records of the Department of Public Welfare: Committee on Lunacy, 1883-1921, The Pennsylvania State Archives.

[4] Ibid.

[5] Ibid.

[6] Eighth Report of the Committee on Lunacy. Harrisburg: Commonwealth of Pennsylvania, 1890, pg. 16.

[7] Links to the Past: The Farview State Hospital Agricultural Complex, 2002, pg. 9 Records of the Department of Public Welfare: Office of Communication 1921-2002, The Pennsylvania State Archives.

[8] Annual Report of the State Hospital for the Criminal Insane, 1915, pg. 17 Box 1, Folder 6, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[9] Ibid.

[10] Biennial Report of the Farview State Hospital, 1954, pg. 118-19 Box 1, Folder 8, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[11] Dr. John Shovlin to Grace Steley, June 26 1961, Box 2, Folder 6, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[12] 75th Commemoration Booklet, 1987, Box 2, Folder 12, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[13] Moore, Acel, and Wendell L. Rawls Jr. “Unnatural Causes of Death at a Psychiatric Hospital.” In The Pulitzer Prize Archives, edited by Heinz-Deitrich Fischer, 208-22. New York: K.G. Saur, 1898.

[14] Helen O’Bannon to Dick Thornburgh, June 13 1979, Box 44, Folder 8, Dick Thornburgh Papers 1979-1987, The Pennsylvania State Archives.

[15] Scott Nelson to Dick Thornburgh, February 20 1980, Box 44, Folder 8, Dick Thornburgh Papers 1979-1987, The Pennsylvania State Archives.

[16] Farview Press Announcement, December 16 1980, Box 44, Folder 8, Dick Thornburgh Papers 1979-1987, The Pennsylvania State Archives.

[17] 75th Commemoration Booklet, 1987, Box 2, Folder 12, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.

[18] Eighth Report of the Committee on Lunacy. Harrisburg: Commonwealth of Pennsylvania, 1890, pg. 15.

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Author: Tyler Stump

Historian and archivist who likes writings about history kinds of things.

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