Farview State Hospital operated as Pennsylvania’s only institution for the “criminal insane” and was open from 1912 to 1995. Throughout most of its existence, the hospital was plagued by low budgets, terrible treatment of residents, and numerous scandals. This essay examines the hospital’s long history, focusing on the unintended “second lives” of decisions made in the formative years of the institution. Understanding the origins of these trends and their relationship with transformations in attitudes towards mental health and disability, criminal justice, and institutionalization in Pennsylvania helps us understand why Farview was created as it was, and why it operated the way it did.
This is an expansion of an earlier draft essay on Farview I’m hoping to get published in the future, if you have any questions or comments on how I can improve anything here, please let me know.
“Desolation”
Unhappy he! Who from the first of joys,
Society, cut off, is left alone—
Amid this world of death. Day after day,
Sad on the jutting eminence he sits,
And views the main that ever toils below,
Still fondly forming in the farthest verge,
Where the round ether mixes with the wave.
Ships, dim-discovered, dropping from the clouds;
At evening, to the setting he turns
A mournful eye, and down his dying heart
Sinks helpless.-Anonymous Farview Inmate, c. 1954
Introduction
In 1901 the Pennsylvania General Assembly established a commission to review and inspect the state’s mental institutions. Made up of several prominent state senators and representatives including future Governor William Sproul, the commission spent the next year traveling to institutions around Pennsylvania and as far away as Wisconsin. When the commission reported in 1903, members discussed topics such as fire safety for patients, debated whether county or state-run institutions were more effective, and suggested that “light physical employment” be allowed for all able-bodied patients.[1] In most respects, they concluded, Pennsylvania’s mental institutions were doing an adequate job providing housing and care for the state’s insane population.
At the same time, however, the commissioners noted that the Commonwealth was delinquent in one important regard- the treatment of the criminally insane. “Upon no sound principle of equity or fair treatment, can the association of convicts and criminal insane be tolerated.”[2] Mental hospitals were no place for violent criminals, and the commissioners feared that convicts sentenced to serve time in mental institutions would encourage immoral behavior or even physically harm other patients. “The lunatic is entitled even more so than the sane person,” their report read, “to protection from the brutal instincts of the criminal classes.”[3] Likewise, prisons were inappropriate for inmates with mental illnesses. Prison guards and staff were not equipped to manage these inmates at all, let alone offer any sort of treatment for their condition. The only reasonable solution, the commission proposed, was the establishment of a new hospital, one built especially for the care and treatment of the criminal insane. Their report concluded with a warning that this new hospital should be built quickly: “the pleas of humanity cannot be disregarded, and your Commission urges with all earnestness with which it is capable, some immediate action to relieve the…condition of the existing hospitals.”[4] The commission’s appeals were well received by the General Assembly, and funds were appropriated to build Pennsylvania’s first hospital for men considered criminally insane.
Just a few years later local dignitaries and welfare officials gathered atop a tall plateau in Farview, Wayne County to lay the cornerstone of the State Hospital for the Criminal Insane. Dr. Charles Wagner, superintendent of the neighboring Binghamton State Hospital for the Insane, reflected the optimism felt by audience in his address. “The state therefore owes it to itself, as well as to the patient, to provide such care for its insane as will give the best chance of recovery to the unfortunate sufferer. Nor is the task as hopeless as is commonly believed, for, with proper treatment, undertaken early in the course of the disease, a large percentage of the insane may be cured of their infirmity.”[5] This modern institution specially dedicated to criminally insane patients, he continued, would “banish the idea of prison bars” and serve as a “friendly shelter” for all its patients.[6]
Later known as Farview State Hospital, Pennsylvania’s first and only state mental institution dedicated to the criminally insane opened in 1909 and quickly grew to become an important part of the state’s welfare system. Pennsylvania’s definition of criminally insane was broad: inmates with mental illnesses, violent patients from mental hospitals, individuals found innocent in court by reason of insanity, and other court-ordered offenders. All were sent to Farview. By the 1960s, the hospital was supporting well over a thousand patients and several hundred doctors, guards, and attendants. In 1966 Farview’s superintendent told a crowd of visitors that “we, as members of the state hospital system, are moving forward positively, ambitiously, consciously, and steadily.”[7]
Beneath the optimism of Farview’s reports, however, lay a complicated web of political, economic, and medical issues that impacted the lives of inmates, staff, and government officials in a myriad of ways. Tragically, Farview failed to live up to Dr. Wagner’s high standards and made living conditions for patients unbearable and even dangerous in many cases. For decades, newspaper investigations and interviews with patients identified patterns of systemic neglect and abuse of patients. One former patient described life at Farview as “a hospital of horrors.”[8] A judge called Farview a road of no return; a grand jury determined that “excessive brutality” and “beatings and assaults were a way of life” at Farview.[9] A journalist wrote in 1976 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.”[10] Internal and public investigations routinely concluded that Farview had failed its mission and patients miserably and called for the immediate closure of the institution. By the time Farview State Hospital was closed and reconfigured into a state prison in 1995, it scarcely resembled the state-of-the-art institution its founders had envisioned.
Farview State Hospital endured political battles, scandals, and economic hardships for 84 years. Though some inmates did benefit from their time spent institutionalized, many suffered from neglect, miserable living conditions, and cruel treatment at hands of staff and government administrators. During this time, the hospital was influenced by changing views regarding proper care for people with mental illnesses, and became the cause of major changes in the treatment and care of those considered criminally insane on the state and national level. Far from being an isolated hospital tucked away in northeastern Pennsylvania, Farview was at the center of many important moments in the history of mental health and criminal justice in the 20th century.
Historians of criminology and mental health policy in the United States typically examine institutions like Farview State Hospital from two differing viewpoints The rise of asylums and other segregative institutions is either seen as a benevolent and humanitarian effort on the part of reformers that made mistakes but were nonetheless well intended, or as an inherently flawed and harmful move that was doomed to dehumanize and further harm people with mental illnesses and intellectual disabilities.[11] Both schools of thought have their merits but neither is entirely appropriate to understand Farview.
Because of its dual role as a mental and correctional institution, Farview was witness to conflicting desires to treat people with mental illnesses humanely and to protect the public from dangerous criminals. Among Pennsylvania institutions, Farview is unique in many respects that deserve close investigation. First among these are the roots and far-reaching impacts of problems and controversies that plagued the hospital. An analysis of Farview’s long history and new documents at the Pennsylvania State Archives reveal that many of its failures originated from decisions and policies made in its formative years. This study seeks to identify the origins of Farview’s operations and inmate conditions and place them in the larger transformations around mental health and intellectual disability, criminal justice, and institutionalization in the United States during the 19th and 20th centuries.
Farview’s history and its major faults were not fated to happen by accident. They were the result of specific policy choices and economic decisions on the part of the state government, and officials within various government agencies and at Farview itself. Though decisions may have been well intentioned, they made it next to impossible to provide effective rehabilitation or allow severe problems for inmates to be successfully reformed.
Farview’s story is especially relevant as mental health programs in prisons are called into question and efforts to reopen mental asylums are growing. We need to understand under what circumstances mental hospitals were created, and how this impacted the lives of patients in them. Conditions in mental institutions are not unpredictable and the origins of institutions dramatically shape their histories and impacts patients and their communities.
19th Century Attempts to Create a Hospital for the Criminal Insane
The establishment of Farview State Hospital in the early 20th century was the result of centuries of reform in mental health care and criminal justice in Pennsylvania. State leaders created a series of progressive reforms and attempted to improve patient conditions and make treatment more efficient, all while keeping costs low for the government. Though changes did fix certain problems for people with mental illnesses and criminal convictions, reformers and critics always felt there was room for improvement. Reformers first worked to remove all people with mental disabilities and illnesses from prisons and poor houses in the 18th and early 19th centuries. When new mental institutions became inadequate in the late 19th century, reforms shifted to move certain classes of patients, such as the criminally insane, into their own specialized institutions.
In the early years of the Pennsylvania Colony, little thought was given to people considered insane. Even less consideration was given to the insane who had been convicted of crimes; they deserved their punishments because of their own sins or personal failings. The criminal insane in Pennsylvania, like the other colonies, could expect to be punished harshly, ignored, and sent away to rot in a penitentiary or work house.[12]
Pennsylvania’s first official attempt to recognize mental illness and the need for specialized treatment was in 1755 when the Pennsylvania Hospital was founded in Philadelphia. As the first public hospital in the United States, it began the process of separating people with mental illnesses from criminal populations and providing opportunities for treatment. However, in many respects the Pennsylvania Hospital only offered a physical separation of people with mental illnesses from those with criminal convictions. Conditions were dirty, undignified, and generally poor. Patients regularly found themselves restrained in shackles and the objects of amusement from thrill-seeking visitors.
As the state’s first mental hospital, the Pennsylvania Hospital began the practice of institutionalizing mental patients in Pennsylvania that would ultimately lead to Farview’s construction. However, the facility was small and could only accommodate a small number of patients. Most individuals deemed criminally insane or too violent remained in prison.
Patients displaying violent or criminal tendencies were considered threats to public safety and usually charged with breaches of the peace or petty misdemeanors in order to place them in jails and poorhouses. The accommodations for the criminal insane in the Philadelphia poorhouse at the turn of the 19th century was typical of the era: “a single room, in which the furious and violent are confined,- male and female in the same apartment, separated only by the length and restraint of their chains…destitute of all comforts, and with everything around calculated to aggravate their madness, is degrading and deplorable in the extreme.”[13]
Observing the deplorable conditions people with mental illnesses in Pennsylvania faced, calls for a government-funded hospital dedicated to mental illness in Pennsylvania first came in 1838. Prominent Quaker Thomas Cope and Joseph Konigmacher, a Lancaster County state senator petitioned the General Assembly to purchase land and authorize the construction of a “State Asylum for the Relief of the Insane Poor of the State of Pennsylvania.” Reasoning that there were at least 2,000 insane citizens in Pennsylvania who were currently suffering in prisons and poorhouses, the petition urged lawmakers to consider the crushing weight of poverty and insanity upon these men and women. “To have the mind diseased, distracted and tormented; and to endure, beyond all this neglect, abuse and cruelty, without the power of resistance…presents a picture of human woe, which few can contemplate without a tear of pity.”[14] The petition also criticized the practice of keeping the insane locked up with paupers and criminals. Testimonies from county jailers reported that sane inmates cruelly provoked or abused their insane neighbors, “and thus aggravate the violence of their disease.”[15]
Despite the objections to current conditions the petition raised, Governor David Porter and the General Assembly quickly rejected the proposal due to lack of government funds. Porter conceded that “the solemn sanctions of official duty, social obligation, and Christian Philanthropy” made it clear that Pennsylvania must properly care for its citizens who were insane. But an “exhausted treasury” meant that for the present time the government would have to wait until more resources would allow the state “to accomplish the laudable undertaking, which is now unavoidably postponed.” Economic concerns, not the “desire to alleviate the suffering of the insane” were the main factors in when and how a mental institution would be built in Pennsylvania.[16] Cope and Konigmacher petitioned the government again in 1840 and managed to convince the legislature to appropriate limited funds for an asylum, but the project was abandoned when those resources quickly ran out. Without further pressure from the public, Pennsylvania was content to keep current conditions in place and rely on county prisons and poorhouses to hold people with mental disabilities.
Several years later in 1845, the General Assembly was again confronted with the deplorable conditions people considered insane lived in, and with mounting public pressure the funds to build an institution were finally secured. Dorthea Dix, known at the time for her work building a mental asylum in Massachusetts, came to Pennsylvania to expose the living conditions of the insane to the public. She planned to use public indignation as leverage to shame legislators into finally constructing an institution dedicated to the insane.
Like she had in Massachusetts, Dix traveled throughout Pennsylvania, visiting people with mental illnesses wherever they were kept and recording their living conditions at the hands of neglectful jailers and “those who bid cheapest” for their labor in farms and factories. She found living conditions and treatment equally deplorable across the state. “The revolting exposure of men; the infinitely more revolting and shocking exposure of women; with combination of miseries and horrors that will not bear recital.”[17] Dix observed men and women weighed down with iron chains, trapped in foul cells without clothes or furniture. Those who were lucky were not abused by other prisoners, guards, or curious visitors.
Dix’s findings were published in Pennsylvania newspapers and shared widely by galvanized reformers. In 1845 she organized her investigation into a formal memorial and presented it to the General Assembly. Fierce public pressure and the detailed investigation of Pennsylvania’s insane proved to be more persuasive than the petition written by Cope and Konigmacher the decade before. Spurred to action, the General Assembly passed legislation creating the Pennsylvania State Lunatic Hospital. $50,000 was appropriated for land purchases and construction. Maintenance and future hospital operations were to be funded privately by trustees.[18] This first government-run mental institution was built in Harrisburg and admitted its first patients in 1851.
As Pennsylvania began to operate state-run mental institutions, the American Psychiatric Association (APA) was founded in Philadelphia. This organization, made up of leading mental health practitioners, promoted treatment methods and other strategies that would shape how these new institutions were run. The group was instrumental in changing the way that the medical profession viewed mental illness, and these views in turn were adopted by government leaders and the public. Insanity was not a moral issue to the APA but a “disorder of the brain, to which everyone is liable.” It argued that people with mental illnesses were “better and more successfully treated in a well-organized institution,” and should never be “kept in almshouses nor in penal institutions.”[19] These ideas about insanity and its proper treatment in segregated institutions quickly gained traction and would have a profound impact on how Pennsylvanian mental institutions were created and operated.
The restraint and treatment of people deemed criminally insane was among the first topics the APA discussed at their inaugural 1844 meeting. Rather than remain locked away in cells all day, the APA encouraged institutions to adopt what became known as “industrial therapy” programs for patients. The practice was introduced by Philadelphia psychiatrist and architect of the State Lunatic Hospital, Thomas Kirkbride. Like Dix, he had seen men and women with mental illnesses shackled and confined to jail cells and believed that labor and physical activity could aid in their rehabilitation. “Labor, judiciously used, is one of our best remedies: it…promotes a good appetite and a comfortable digestion, and gives sound and refreshing sleep to many who would, without it, pass wakeful nights.”[20]
Hospital administrators in Pennsylvania quickly realized that industrial therapy was more than just a treatment method- it was an unlimited source of labor and resource for state-run institutions. Patient labor, also called industrial peonage, could offset the building and operating costs of mental institutions. Having a large and affordable workforce available made it possible for the state to build more institutions and locate them in isolated areas far away from other sources of labor. Patients built and maintained buildings, labored on farms, made bricks and other materials for sale, mined coal, cleaned buildings, and worked in laundry facilities. Their labor made Pennsylvania’s mental hospitals economically self-sufficient and reduced state appropriations needed for maintenance.
In 1869, the General Assembly established the Board of Public Charities (BOPC) in order to provide a degree of oversight for Pennsylvania’s growing welfare system. Its five commissioners were given authority to inspect all charitable, reformatory, and correctional institutions and were responsible for requesting appropriations from the General Assembly on behalf of each institution. After its initial inspections, the BOPC recommended moving all persons considered criminally insane from penitentiaries to state hospitals. In 1874, it began to plan for the construction of secure hospital wings (known as forensic mental units in the 20th century) in each hospital where court-committed patients would be housed and treated.
Fearing that criminally insane convicts would blur the distinction “between virtue and vice” and increase the “moral odium” associated with insanity in their institutions, board members from Danville and Dixmont State Hospitals lobbied the legislature to prevent any patients classified as criminally insane from entering their hospitals.[21] Many medical practitioners and hospital administrators still did not believe that convicts deemed insane needed any special provisions. In 1873 prominent Baltimore alienist Dr. E. Lloyd Howard argued that “confinement in a penitentiary is not a more severe punishment, in reality, than in the cells of a mad house.”[22] Others agreed, writing that they preferred sending insane criminals to prisons because the discipline and severity of prison life was more beneficial than any treatment patients received in asylums.[23]
Rather than keep patients considered criminally insane in special wings of their own institutions, Pennsylvania’s hospital administrators believed that the best solution was for the state to establish a new institution dedicated to the criminally insane. In 1875, a delegation headed by Kirkbride and John Curwen (Superintendent of the State Lunatic Hospital) proposed that the General Assembly establish a “Central Hospital for the Insane.” Located somewhere between Altoona and Tyrone, this hospital would treat “dangerous insane persons,” insane people convicted of crimes or acquitted on grounds of insanity, and convicts who went insane while they were in prison.[24]
Medical literature of the late 19th century stressed the impact that “born criminals” and the “criminal race” were making on rising crime rates. Hospital administrators, mental health experts, and other reformers believed that the only solution was segregation and long-term confinement of these “biological criminals.” Influenced by the growing eugenic strains in medical thought, they believed the criminal insane needed “flexible indeterminate sentences, the length of which would be decided by administrators and medical experts” at a dedicated institution.[25] This would keep dangerous insane criminals off the street and prevent them from passing their mental traits on to their children. Henry Boies, a pioneer eugenicist and member of the BOPC argued that “if criminality is a defect of character, or a disease to be remedied or cured, common sense rejects the fixing of a positive time in which the cure shall be effected.”[26] If the criminal insane were hopelessly sick, they needed to be permanently removed from prisons and mental institutions with curable patients. A hospital exclusively for the criminal insane, Boies and his colleagues believed, would do just that.
That same year, a commission made up of Kirkbride, Curwen, and others reported to the General Assembly that “in Pennsylvania a very large proportion of the class that has been styled the criminal insane are confined either in prisons, jails or almshouses, none of which are provided with the means for the proper care and treatment of this afflicted portion of our people.” The commission called for a new hospital specially built to take in “dangerous insane persons.”[27] Removing the criminal and violent insane from hospitals and prisons would make their treatment, as well as the treatment of non-violent insane persons, more effective. The proposal was well received by the legislature, but with no means of funding this hospital no action was taken.
The BOPC and various hospital administrators continued to lobby the legislature for a hospital for the criminally insane the rest of the 19th century. Despite the efforts of vocal reformers like Dorthea Dix, public pressure, and appeals from hospital administrators, most of Pennsylvania’s residents deemed criminally insane were still living in prisons and poor houses by the century’s end. Dependent on the support of the General Assembly, supporters of a hospital for the criminal insane would need to find a different strategy to achieve their goal.
The Establishment of Farview State Hospital
At the turn of the century, the BOPC was still lobbying for a hospital for the criminal insane. In the previous decade, specialized institutions for the chronic insane (Wernersville State Hospital, 1891) and intellectually disabled children (Polk Center, 1897) were opened to accommodate classes of patients with specialized conditions that other hospitals could not treat. Importantly, these new institutions were intended to be economically self-sufficient. The act creating Wernersville State Hospital specified that “as soon as temporary quarters can be provided,” the hospital commissioners would “transfer twenty able-bodied, harmless, chronic insane from each of the State hospitals for labor upon the grounds and buildings.” Patients would save tax dollars by constructing roads and buildings, laboring on farms, and performing any other tasks needed to get the hospital operating cost-effectively. This plan, the legislation read “recognizes and enforces the industrial theory of the asylum plan care.”[28] Uncompensated patient labor, originally intended as a method of treatment, was now being used expressly to expand the state hospital system and keep maintenance costs low.
Unpaid patient labor had been used for decades by hospital administrators to run their hospitals efficiently. When state officials adopted the practice and wrote it into legislation, it became a tool to build new hospitals as well.
The BOPC and other reformers lobbied the General Assembly again in 1901 to build a hospital for the criminal insane, and a commission of elected officials was created to investigate the matter. After two years of investigation, the commission did support a new hospital. The commission, however, was also careful to make sure legislators understood the role industrial peonage would play in this new institution. “The occupation of some sort, steady, and, if possible, outdoor, should be provided for such inmates as are physically and mentally able to do the same.” Their report also added that inmates should not be regarded as “money-making machine[s],” and that the “question of cost or compensation should never enter into this phase of his existence.” The commissioners believed paying inmates for their labor would be degrading and would reduce them to the “mere level of agents to make money.” This practice of uncompensated industrial therapy was justified because “a number of our State and several county institutions are [currently] acting upon this well-established theory.”[29]
A separate 1905 government commission headed up by Speaker of the Pennsylvania House Henry F. Walton (and future president of Farview’s Board of Trustees) reported that the conditions in the state’s hospitals, prisons, and almshouses were totally inadequate and inefficient. Most problems stemmed from “the ancient construction of many of the buildings and their overcrowded condition.”[30] A hospital for the criminal insane would alleviate the overcrowding in all of these institutions. With Walton’s backing, legislation creating a hospital for the criminal insane was quickly drafted and submitted to the General Assembly. On May 11, 1905, an act was signed establishing the State Hospital for the Criminal Insane and appointing a new commission to select a suitable parcel of land and oversee building construction.[31]
Support from prominent elected officials, pressure from the BOPC and hospital administrators, and most importantly a state-approved method of keeping maintenance costs down finally convinced the General Assembly to create a hospital for the criminal insane. The establishment of what would be named Farview State Hospital was the result of a specific combination of economic, political, and administrative factors. And just a few years after the hospital’s construction, it became clear that it could not survive without each of these pieces staying precisely in place.
Site Selection of Farview
Once the General Assembly appropriated funds for the new hospital its selection committee didn’t waste any time finding a suitable home for Pennsylvanians deemed criminally insane. The committee published advertisements in Philadelphia, Pittsburgh, and Harrisburg papers and shortly received fifteen proposals for sites all over the state.
Most offers were rejected because the plot of land was too small and the price too high. However one proposal did catch the committee’s attention: a parcel in Wayne County owned by the Delaware and Hudson Canal Company (D&H). The area had been the location of a gravity railroad and picnic spot in years past and was currently vacant. More importantly to the committee members, the land also contained thousands of tons of coal “sufficient to last the institution for many years.”[32] The D&H had recently closed this stretch of railroad and was no longer interested in owning the property. They offered 180 acres of land to the committee for a generous sum of five dollars.
After the D&H made their offer, the members of the selection committee visited the site, high stop a plateau in the Moosic Mountains. Liking what they saw, they excitedly reported to Governor Samuel Pennypacker it was a fitting location for a hospital. “Ponce DeLeon should not have searched for the fountain of youth in Florida,” one member wrote, “for if it is anywhere…surely it is here, softly murmuring over these moss-covered rocks.”[33]
The Farview plateau was beautiful, “truly a sight to charm the eye and make the blood run quicker,” but most notably it offered many economic advantages.[34] Much of the land had already been cleared for the old railroad and picnic grounds and there were roads and a large reservoir in good condition. Nearby railroads could easily be extended to new hospital buildings. The location was also good for farming and coal mining- two operations the committee knew could be done efficiently with industrial peonage.
Its location was also near a “rapidly developing section of the Commonwealth.”[35] Coal mining and manufacturing in were booming in Wayne County and in the early 20th century showed no signs of slowing up. Rapid development would also bring access to the few goods and services that couldn’t be supplied by the hospital itself.
Farview also appealed to the committee because of its rural remoteness in northeast Pennsylvania. Isolating people deemed criminally insane was therapeutic, protected them from public scrutiny, and relieved communities from the burden of their care. Keeping with the older traditions of Pennsylvania prisons and poorhouses, they were to be kept out of sight and out of mind of society and the government in Harrisburg. In their report to Pennypacker, the committee cited the writings of William Spratling, an authority on asylum construction, to support the Farview location. Spratling, the superintendent of a New York asylum, discouraged letting any outsiders have access to the asylum or letting any patients have access to the world outside. Isolation protected patients and prevented the “evil influence that contaminate densely populated districts to come easily into colony life.”[36] Seclusion was the key, he wrote, “for we cannot place a money value on the good to society…and to a growing posterity of the effective removal from society of a people of this class.”[37]
After some negotiating with the D&H to increase their offer to 625 acres for the original five dollar sum, the selection commission officially made Farview the site of the new hospital for the criminal insane. Just as the General Assembly had been guided by financial self-interest, the selection commission picked an economically viable location that would meet approval with legislators.
Farview’s Construction and Early Years
Hospital construction was overseen by Dr. Thomas Fitzsimmons, a Wayne County physician who specialized in treating “nervous diseases.” Fitzsimmons had been involved in efforts to build a hospital for the criminal insane for many years and had personally lobbied key legislators in 1901 and 1905 to support hospital appropriations.[38] Fitzsimmons designed Farview’s hospital buildings to function as a prison without walls. Wards, dayrooms, and other buildings were grouped together with connecting brick passageways that created two large enclosed exercise courts. This allowed inmates to have access to building interiors and outdoor space while simultaneously restricting their access to areas outside the building complex.[39]
After ground was broken in 1908, most of the first buildings were built by local contractors.[40] Fitzsimmons waited to transfer patients to Farview until secure housing had been built. In December 1912, the first patients, now inmates, arrived and were immediately put to work building the rest of the institution. In 1917, Farview’s Board of Trustees reported that inmate labor constructed a piggery at a low cost of $3,500. The same job, they estimated, would have cost $15,000 if paid contractors had done the work.[41] A brick-making plant, hospital, and barns were also built using inmate labor. As Farview’s inmate population grew in the 1910s and 1920s, the trustees specifically asked the architects to include inmate-made bricks and labor into specifications for new ward buildings.
As soon as Farview’s doors were opened, hospitals and prisons across Pennsylvania clamored to relocate their violent patients and inmates with mental illnesses. After the first two ward buildings were completed in 1912, the BOPC quickly filled Farview to capacity with transfers from other institutions. The BOPC and court system had complete freedom to admit any persons to Farview, “giving preference in all cases to those having known criminal tendencies.”[42] In theory this would have meant that the only persons transferred to Farview were those that were classified as criminally insane. But in reality, patients were sent to Farview for any reason imaginable, creating an unexpected challenge for Farview staff.
By 1915, 277 patients were packed into Farview’s wards and temporary buildings, but 145 of them were not classified as “criminally insane.” Some came from the overcrowded Blockley Almshouse in Philadelphia, others from Retreat State Hospital where a nurse’s strike had crippled admission rates.[43] To relieve overcrowding at their own institutions, any patients might be transferred if there was room at Farview.
State hospitals across Pennsylvania had been waiting for decades for an institution like Farview to take away violent patients they didn’t have space or resources to treat. Administrators and bureaucratic officials decided who was transferred, and staff at Farview had little control over who showed up at their door. At a 1914 state-wide meeting of hospital superintendents Henry Walton complained that “we know very little about very many of the criminal patients sent to Farview.” Superintendent Fitzsimmons reported that “we know nothing about him more than he is insane.” Inmates arrived with little to no documentation from the courts or previous hospitals, and often times with no diagnosis or doctor’s notes. Six months after one inmate arrived in 1914, a new guard happened to recognize him as the patient who stabbed him while they were both at a different hospital the year before. “Here was an instance,” Fitzsimmons protested, “in which an inmate of our Institution had made a deadly assault upon another man and we know nothing about it. We immediately got all this information together and it put a new phase on our inmate’s relations with us.”[44]
Medical staff at Farview routinely identified inmates who did not display criminal or violent tendencies. It was difficult to discharge these inmates, and even harder to prevent more like them from arriving in the first place. BOPC inspections of Farview in the 1910s often mentioned inmates with “no evidence of insanity” that had still not been discharged or paroled.[45]
Children were sent to Farview too. In 1921 a 17-year-old was found to have been living at the hospital for the past three years. “Could be sent to Huntingdon Reformatory,” an inspection note read, “this is not a proper place for him.”[46]
The ambiguity in the laws and policies regarding who should be admitted to Farview rapidly crowded its ward buildings and overwhelmed staff that was expected to provide effective treatment for all.[47] There was little encouragement from the public or officials in Harrisburg to reform admission or discharge policies. Keeping people deemed criminally insane and any other “troublesome” inmates locked away at Farview was helping relieve problems in other institutions and in the court system. It was more convenient to keep inmates at Farview for as long as possible. Farview held court-committed inmates well after their sentences had expired and tried to employ any individuals who were discharged so they wouldn’t leave the institution. Fitzsimmons said that hospital was “in the habit of employing all our paroled patients,” and had found that “they make excellent and efficient employees.”[48] As early as 1920, over fifty percent of inmates were living at Farview even though their prison terms had expired.[49]
On top of overcrowding, Farview never received the resources it needed to house or treat inmates properly. Temporary sewage facilities and housing arrangements were inadequate and dangerous for staff and inmates alike. A BOPC official described the hospital and workshop buildings as a “fire-trap” in 1916, noting that radiators were uncovered, there were no fire extinguishers, and there were flammable materials stored near bread ovens. The fire hydrant outside had a working hose, but it was too short to reach into the building. Most reports mentioned staff shortages and unanswered requests for additional physicians, nurses, and guards. “The present conditions are unsatisfactory” one 1920 inspection bluntly stated, “and prevent the patients from receiving proper care and treatment.”[50] Despite knowledge of Farview’s problems among BOPC officials, they would endure for decades.
One area where Farview excelled from the start was its industrial and occupational therapy programs. Along with construction work, inmates labored on a variety of other tasks, all of them unpaid. When Farview opened there were 52 acres of farmable land on the grounds. By 1920, the farm had swelled to 307 acres. Farview’s administrators were pleased with the progress and planned for inmates to clear hundreds more. “If we can accomplish ninety-five percent of this work with our inmate labor we believe it will not only be a great benefit to our patients, but also help reduce our cost of maintenance.”[51]
Farview’s textile mill and brick-making plant were also expanded as new inmates arrived and were put to work. In just three years, the brick plant was able to produce one million bricks annually with just two paid employees. Inmates made hundreds of thousands of bricks that were used in construction at the State Institution for Feeble-Minded and Epileptics for Eastern Pennsylvania (Pennhurst Center) and Homeopathic State Hospital for the Insane (Allentown State Hospital).[52] Hospital administrators and the BOPC agreed that labor from all Pennsylvania mental institutions should be pooled and collectively make all institutions more economically viable and less of a burden on government funds. “Why should we not manufacture much that we consume and interchange our surplus outlet with other…institutions” Henry Walton asked, “this would all trend in the direction of making our charitable institutions less burdensome to the State.”[53] Patient labor seemed to be more about keeping maintenance costs low than providing effective therapy for Farview inmates.
Industrial peonage, ambiguous admission and discharge standards, staff shortages, and little meaningful oversight from Harrisburg became the real foundation that Farview State Hospital was built on. These practices were present in the debates surrounding the hospital’s establishment and written into the law itself. The first years of Farview’s construction and operation entrenched each practice so much that they would become impossible to remove. Even by 1920, Farview was failing in its mission to provide effective “treatment and care for the criminally insane.”[54] Conditions would not improve over time.
Status Quo: Farview, 1920-1960
Farview’s inmate population steadily rose each decade. As inmate numbers increased inspections by government officials, newspaper reports, and judicial inquiries all exposed the systemic failures and dangerous living conditions at Farview. Farview’s struggles were no secret in Harrisburg or to the general public. Yet no major changes were made to address Farview’s shortcomings between 1920 and the 1960s.
The Department of Welfare, successor agency to the BOPC, conducted major evaluations of Pennsylvania’s mental institutions roughly each decade. In each of these Farview was cited as one of the most neglected and problematic hospitals in the state. Despite recurring themes of overcrowding, staff shortages, and poor patient treatment, investigators maintained that conditions at Farview were adequate and did not recommend major institutional changes.
The first major Department of Welfare investigation at Farview occurred in 1935. The hospital had recently finished building a new administration building and several new inmate wards and the report found that building hazards were much improved from fifteen years earlier. Farview’s inmate labor programs received a positive rating, noting that inmates were harvesting over 50% of all food consumed at the hospital, keeping the cost per inmate down to 87.5 cents a day.[55]
However, inspectors did note several serious issues that “created an extremely dangerous situation were [sic] the possibilities of riot [are] ever present.”[56] Overcrowding was still endemic at Farview, and there were not enough staff to treat so many inmates. Farview only had three physicians to treat hundreds (the inspector recommended having at least five), and there were no special therapists of any type to treat inmates with particular disorders. Nurses and guards, also in short supply, were not trained to treat criminally insane inmates either.[57] The most pressing issue in the report was Farview’s admission and classification system. Incoming inmates were rarely, if ever, examined or diagnosed when they arrived and were all given a general classification and sent off to live in one of Farview’s large ward units. Lack of a more detailed classification system and the use of large general wards meant that Farview’s staff hardly knew their any of the inmates or their mental status. Despite the risks present at Farview in 1935, the report concluded: “the Inspector has no criticisms of any type concerning the appearance and operation of this institution.”[58]
Neglect, fiscal conservatism, and shifts in government priorities caused by the Great Depression and World War II caused Pennsylvania’s state hospitals to become even more crowded and understaffed.[59] A 1944 inspection reported that Farview was no exception, with a population of 1,059 crammed into an institution that was rated to hold 853 inmates at the absolute most.[60] The situation was so extreme that the investigating committee urged Governor Edward Martin to build new ward buildings to hold 1,500 beds or to consider the development of a second hospital for the criminally insane built somewhere in central Pennsylvania.[61] Both of these proposals came with hefty price tags. The governor was not pleased. He believed that Farview and other mental institutions existed to keep dangerous criminals with mental illnesses away from the general population and were not in the business of supporting expensive treatments and therapy. Especially during wartime, Farview was not expected to create additional financial burdens on the state and the Governor only granted Farview a small appropriation to improve its infrastructure.
In the post-war era, public and government views of mental institutions began to shift in Pennsylvania. Several well-publicized accounts of conditions in American mental hospitals, including Philadelphia State Hospital at Byberry, revived conversations about treatment of people with mental illnesses and the role that institutions should play in their lives.[62] In Pennsylvania, progressive Governor George Leader was elected in 1954 and introduced sweeping reforms in government social services, including mental health. But before Leader or his crusading Secretary of Welfare Harry Shapiro could investigate Farview or initiate any improvements, the hospital became embroiled in a scandalous court case that exposed widespread corruption, violence, and neglect on all levels.
Farview was still bound by ambiguous laws in the 1950s that complicated discharge policies. Inmates, whether they were admitted by the judicial system or transferred from other institutions, were incarcerated at Farview “until further order of the court.”[63] Farview’s administration was required to certify that patients were no longer insane and petition the courts for the release of any patient, a time-consuming and expensive process.[64] It would have been difficult for any hospital to discharge inmates with this system. It was practically impossible at Farview given its staff shortages and history of holding inmates indefinitely.
In 1954, Farview inmate Louis “The Laughing Eel” Ross brought a lawsuit against Farview alleging that he was not insane and was being held against his will decades after his original sentence expired. Ross, a Pittsburgh jewel thief, had been arrested for robbery and imprisoned in 1921 for a sentence of six to ten years. In 1923 he was transferred to Farview and remained there until 1954. Testimony from Farview staff revealed that Ross had not exhibited any signs of insanity since at least 1943, yet no physicians had ever examined him or recommended his release while he was institutionalized. In desperation, Ross escaped and found an attorney to take Farview on in the courts.[65]
Farview only had two physicians who could give psychiatric examinations to the hospital’s 1,250 inmates. Ross’ case was similar to hundreds of other patients who were never examined, even on their arrival to Farview. They were all given a general psychiatric classification and any records on their mental state were created from observations as they went about their daily routine. Further testimony revealed there were at least 100 other sane inmates incarcerated at Farview, and many more that had been held long involuntarily after their criminal sentences expired. Farview’s staff believed that once an inmate was considered to be criminally insane “they would be taking a chance in permitting him to return to society for fear that he would remit to his old conditions.”[66] Calling admission to Farview a “Road of No Return,” the court condemned the hospital’s discharge policy and ordered Ross’ release. Farview’s policy, the court continued “would mean that no person incarcerated for an infraction of the law, or because of some mental illness, would ever have the hope of returning to society because of the fear that they would revert to a life of crime or revert to prior mental delusions.”[67]
Ross’ battle for freedom and victory in the court was widely publicized in Pennsylvania and the rest of the United States. Officials in the Department of Welfare scrambled to closely investigate Farview and additional allegations of inmate abuse and corruption. Correspondence received from Ross’ lawyer claimed that “the worst kind of brutality is practiced on the inmates” including regular beatings, murder, graft, and “almost every form of vice has been practiced with the knowledge of some of the authorities or at least they have winked at this kind of conduct.”[68]
Secretary Shapiro sent his Commissioner of Mental Health to personally review the allegations at Farview. The Commissioner’s report made it clear that all the allegations were true. Farview was controlled by a corrupt Board of Trustees that sold hospital jobs to political allies and Wayne County residents willing to pay them a cut of their salary. Board meetings were little more than “bargaining market[s] for patronage” and there was hardly any discussion of inmate living conditions or treatment. Any staff who failed to make “the usual voluntary contribution from his pay check” was summarily fired, while compliant employees were given immunity from any crimes they committed against inmates. “In all investigations of abuse the guards and even the patients cover up for each other so that evidence is practically impossible to obtain.” After guards beat a patient to death in 1953, the Board’s influence led to the case being declared an accident and no prosecutions were made.[69] It was common practice for guards to take patients to closets or store rooms and beat them to the point of unconsciousness or hospitalization. The Commissioner recommended that the Department of Welfare eliminate “irresponsible” members of Farview’s board and conduct a “complete reconsideration” of the program at Farview.[70]
The Ross case contributed to growing concern among the public and government officials that Pennsylvania’s mental institutions were due for serious reforms, especially Farview. Listening to vocal interest groups like the Pennsylvania Citizens Association and Pennsylvania Association for Retarded Children (ARC), Governor Leader asked the American Psychiatric Association to survey all state hospitals and report on patient living and treatment conditions. Their evaluation of Farview was not much different than the investigations of the 1930s or 1940s. Farview was singled out by the APA’s as the most overcrowded (62.5%) and most understaffed institution in the state. Farview’s six physicians were far below the APA’s minimum recommendation of seventeen, and its nurse/inmate ratio of 1:450 was also far below minimum standards. The report also mentioned the low per capita patient spending at Farview, which “probably represents inadequate treatment, plus the possibility of inadequate housing and food.”[71] The APA’s recommendations, which matched the Department of Welfare’s own internal investigations, urged more spending on qualified staff, housing and treatment buildings, and inmate examinations. With support from the Governor and vocal citizen groups, it was the right time to improve Farview’s living conditions and treatment programs. If Farview and Department of Welfare officials failed to respond to “the wave of interest and demand,” the report warned “there may result a downward sweep of the pendulum and loss of opportunity not to be realized again for a generation.”[72] This prediction turned out to be truer than the APA could have known.
The 1960s: Farview’s Peak
Reforms came to other Pennsylvania mental institutions in the 1950s, but not to Farview. Elected officials were uncomfortable extending reforms to people convicted of crimes and felt they deserved their punishment.[73] Just two years after the APA’s investigations, Secretary Shapiro received news that inmates were still being abused and neglected. That year, six guards attacked an inmate, kicking his teeth out and destroying one of his eyes. The inmate was forced to sleep on cement floors and repeatedly confined in restraints for days at a time. When family members complained to Farview’s head guard they were ignored. The same informant also stated that physicians neglected to visit entire wards for months at a time and that staff were not maintaining any records on nursing or doctor’s visits to inmates. [74] Corruption and impossible discharge standards still plagued Farview’s administration, and Harrisburg was not willing to spend the money to change anything.
As public concern died down and Governor Leader left office in 1959, conditions at Farview continued as they had in previous decades. The hospital was unable to recruit staff that could diagnose and treat inmates properly, which hospital administrators blamed on low pay, and “the distasteful nature of the institution and its unfavorable location.”[75] Farview’s perch high atop its Wayne County plateau, though appealing during the site selection process in 1905, had become a liability and deterred qualified professionals. In 1957 the hospital ended its practice of providing staff with housing on grounds, making it even more difficult to recruit. “Were it not for my residence here,” one departing psychiatrist wrote after the policy change, “I serious [sic] doubt whether my wife and children could live in the professional and social isolation represented by the communities of Northeast Pennsylvania.”[76] Other potential hires were discouraged by Farview’s “reputation for harsh and punitive treatment of patients” and its inmates, “regarded by many as hopelessly maimed in the psychiatric sense, thought to deserve nothing better than custodial care.”[77] Farview’s staff was not interested in improving treatment and didn’t have the resources to hire anyone who did.
Part of keeping the status quo at Farview meant avoiding future scandals like the Ross case. To accomplish this, Farview’s staff used ineffective treatment procedures and harsh discharge policies to keep inmates at Farview and out of the public eye. Industrial peonage likewise kept Farview’s maintenance expenses low and under the General Assembly’s radar.
Many inmates were routinely administered powerful sedatives and psychotropic medications like Thorazine and Sparine. Drugs were intended to control manifestations of mental illness and were “regarded as a form of treatment only in the sense that by enabling patients to feel better, to sleep, eat, work, read and relax more easily, they promote the chances for spontaneous recoveries.”[78] Industrial and occupational therapy, Farview’s unpaid labor programs, continued to enroll a majority of inmates in farming, printing, woodworking, and textile production. The only treatment many inmates received was known as “milieu therapy.” Merely experiencing the bars, guards, and routine at Farview was thought to provide a feeling of security that “relieves the immediacy of patients’ problems and makes them better able to cope with fears and anxieties.”[79] In 1960, Farview administrators estimated that at least forty percent of Farview inmates would benefit from some type of formal psychotherapy. However, reluctance of staff to administer psychiatric treatment “of any type” and a lack of staff time and resources resulted in less than two percent of inmates actually receiving any formal treatment.[80]
Death was the most common form of discharge from Farview. The byzantine judicial process remained unchanged from the previous decade and inmates continued to stay at Farview long after their sentences expired.[81] Farview’s standards for release “slide all over the place.”[82] Superintendent John Shovlin stated in an interview that “much of the final decision is feeling, knowing a person, reviewing his conduct and progress while at Farview.”[83] Given Farview’s staff shortages and poor record of diagnosing and treating inmates, it was no surprise that discharges were still difficult to obtain.
Strict discharge policies kept the criminal insane locked up at Farview away from negative publicity. The hospital also maintained a public relations operation to demonstrate that it was a safe place for inmates and for the public at large. Farview had a brass band that performed around the region and hosted a popular softball league that played every other day in the summer months, often against other Wayne County teams. In 1954 one doctor boasted 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.”[84]
Farview also began opening up its doors to the public on annual Open House days. Hundreds of visitors toured spotless wards each year and could speak with model (and sedated) inmates and physicians. “The public is becoming…confused about the trends in the Mental Health Movement,” Shovlin wrote in a 1966 visitor address, “the truth is that we, as institutions, have not matured to ripeness for decay…We are still busy growing.”[85] Shovlin viewed public programs as chances to demonstrate Farview’s “usefulness” and educate the public about the need to keep the criminally insane isolated from the rest of society. These carefully controlled interactions between the public and inmates were intended to reduce the chances for public outrage over misconduct and corruption at the institution.[86]
Legislative Changes and Scandals at Farview in the 1970s
By 1970 conditions at Farview had remained largely the same for decades. Admission and discharge policies, overcrowding, poor treatment and living conditions, staff shortages, and inmate work programs were virtually unchanged despite reform efforts and several damning investigations. Despite Farview’s reputation for harsh inmate treatment, its public image was unchanged. Over the next decade, however, legal and financial changes made at the state and federal levels would force Farview to change some of these practices. At the same time public scandals would shake Farview to its foundations and come close to shutting the institution down for good.
Drawing inspiration from a growing civil rights movement in state prisons, Farview inmates wrote letters and solicited help from prisoners’ rights and advocacy projects. In 1969 advocates filed a lawsuit against the Commonwealth of Pennsylvania alleging that holding Farview inmates involuntarily past their sentences was a violation of their Fourteenth Amendment rights. The Pennsylvania Mental Health Act of 1966 still allowed Farview staff to hold inmates indefinitely, even though most inmates were not receiving effective treatment or psychological evaluations. The lawsuit, Dixon v. Attorney General, also revealed that minority groups were overrepresented in Farview’s population, and that most inmates were uneducated, working-class men.[87]
Publicly, the Department of Welfare protested the efforts to release Farview inmates and argued that if released they would pose a danger to society. In private however, department officials supported the effort to release inmates and encouraged using legal tactics to change their strict discharge policies. In the past, staff feared that they would be held responsible for any crimes discharged inmates committed. If the court system ordered the release of inmates, then the hospital and its staff would avoid blame.
As earlier judicial and internal investigations had observed, the Dixon verdict cited the “inadequacy of funds” and lack of qualified staff at Farview. Ruling in 1971 that “confinement in a maximum security institution is adverse to rehabilitation; and that, at worst, a comparatively small proportion of criminally insane persons should be committed to maximum security institutions such as Farview,” the court found that involuntary confinement could only occur if there was a clear risk of danger to the inmate or society.[88] Within months of the verdict hundreds of inmates were released from Farview and thousands more in institutions in Pennsylvania and the United States.
Legal action also ended Farview’s industrial peonage system. Several lawsuits brought to federal court in the late 1960s and early 1970s challenged the legality of unpaid labor in mental institutions, arguing that it was a violation of the Fair Labor Standards Act and the Thirteenth Amendment. Even though Farview and other hospitals had always maintained that its labor programs were therapeutic first and economic second, the court ruled that mental patients had a right to be paid at least the federal minimum wage. “So long as the institution derives any consequential economic benefit,” the ruling stated, “the economic reality test would indicate an employment relationship rather than mere therapeutic exercise.”[89] Shortly after the ruling, Pennsylvania passed the “Institutional Peonage Abolition Act,” which mandated the therapeutic needs of patients could not be subordinated to the labor needs of an institution.[90]
Farview was unable to prove the therapeutic benefits of its industrial therapy and many work programs were quickly ended.[91] The hospital farm ceased operation in 1975. Farview had always depended on its large and inexpensive labor force; its founders saw it as an unlimited economic resource and elected officials had supported Farview’s creation specifically because inmate labor would not create a large financial burden on the state. Between 1970 and 1977, new maintenance expenses raised the cost per Farview inmate from $7,470 to $64,591.[92]The end of unpaid inmate labor and easier release requirements meant that the hospital would need to rely on other financial resources, mainly state funds and insurance programs such as Medicare and Medicaid to stay in operation.[93]
Legal challenges and new legislation did more to change Farview’s operations than any of the reforms or investigations in the previous 40 years had. But even with a smaller population and an end to unpaid labor programs, life for remaining inmates remained virtually the same. Brutality at the hands of guards, indiscriminate use of powerful psychotropic drugs, neglect, and lack of effective treatment were still part of the daily routine.
In 1976 Farview made headlines yet again when the Philadelphia Inquirer revealed violence and inhumane conditions still existed at the institution. Reporters Acel Moore and Wendell Rawls Jr. picked up the story after the mother of an inmate wrote them. Her son had died, allegedly of a heart attack, and she suspected there was more to the story. Moore and Rawls investigated dozens of Farview inmates who had died or were recently released under the Dixon ruling. Their report, The Farview Findings, exhibited a pattern of forced sedation and brutal neglect, especially to black and lower-class men. Murdered inmates, sexual crimes, extortion, and gambling on forced inmate fights were described in detail in article after article that summer. The mother who initiated the Inquirer’s investigation learned her son was one of dozens of inmates beaten to death by Farview guards.
“If the guards thought you were too big or belligerent, or if they wanted to render you helpless so they could do something to you,” one former inmate recalled, “they might ask the doctor to prescribe Sparine or Thorazine as a tranquilizer that would make you a zombie.”[94] Farview’s medical staff also admitted “the guards still run this place. They do what they want regardless of policy…the professional staff might as well be standing on its head.” Lawsuits and new legislation couldn’t change everything at Farview. “If it is possible for Farview to get worse in the past two years, it has.” When a guard was questioned about the effectiveness of therapy programs he laughed. “Therapy at Farview. That’s a joke. There is no therapy. There are fewer reports of beatings because there are fewer patients. Things are pretty much the same as they have been for years.”[95]
The Farview Findings reported that “none of this is a secret” to the administration or officials in Harrisburg. The truth, “in ample detail” was filed away in the Department of Public Welfare (DPW) and other government offices. “Nobody ever said that what they were doing to patients here in the past was wrong,” newly appointed superintendent Robert Hammel offered in Farview’s defense, “there were never any complaints from the public about the way the criminally insane were treated here. The view was that the public wanted these people locked up and heavily controlled.”[96]
The public was shocked by The Farview Findings and prisoners’ rights activists organized to close the hospital. Governor Milton Shapp organized a task force to investigate the allegations and decide whether the institution should remain open. Its findings repeated many of the criticisms published in the press. Farview’s isolation made it difficult for inmates to have regular contact with their families or to access the courts. Its location also still made retention of professional staff impossible and contributed to a harmful “racial imbalance” of guards and inmates. At the top of the list, unsurprisingly, was the “inordinately excessive” cost of treatment. Farview was too “economically inefficient” to continue operation.[97] Ultimately, the task force and DPW decided that Farview should be closed and replaced by new forensic mental health facilities near Philadelphia and Pittsburgh.
But Farview did not close in the 1970s, or in the 1980s either. Opposition to closure at the local level and from interest groups that benefited economically from the hospital’s existence lobbied hard to keep the hospital running. Criminologist Joseph Jacoby has argued that Farview’s “latent economic functions” as an employer and source of business in rural Wayne County superseded its primary function to house and properly treat inmates with mental illnesses, and thus kept the institution even through it was not benefitting its inmates.[98]
After the task force’s report was released, waves of opposition from Wayne County residents flooded Harrisburg. The state employees’ union mobilized and wrote a petition with 40,000 signatures to keep Farview open and its jobs secure.[99] The task force’s proposal to build new forensic mental health units for Farview inmates in Norristown and Warrendale was also met with protest from local business leaders and residents who felt that large populations of criminal insane would drive away business and make employee recruitment impossible.[100]
At the same time, Farview did its best to convince the public and state officials that it was truly reforming and should remain open. A grand jury investigation of the abuses alleged in the Farview Findings, hampered by poor funding and a “stone wall of silence” from Farview employees, resulted in only one conviction for assault and 34 acquittals and dismissals.[101] Blame was shifted onto individual ex-guards and away from the institution itself. Hospital administrators were replaced and Farview resumed its Open House public relations campaign. To address residents’ concerns about lost jobs, Shapp visited Farview. After meeting with sedated inmates who called it a “real swell environment,” he rejected his task force’s recommendations and declared that Farview would stay open.[102] New reforms, Shapp felt, would ensure that inmate abuse at Farview would not continue.
The community around Farview, seen as economically promising in the early 1900s, was now so reliant on the institution that its residents could not let it close for any reason. Another unforeseen consequence of the economic factors guiding Farview’s establishment, its fate was now dictated by economic self-interest instead of the needs of Farview’s inmates. Closing Farview would require legislation and large appropriations from the General Assembly. Without the support of local elected officials, one state senator told Farview’s Board, “the reality of that taking place is next to nothing…it will never happen.”[103]
Shift From Welfare to Corrections Spending: Farview from 1980 to Closure
As government officials introduced new reforms and increased annual appropriations, public outrage and calls for Farview’s closure died down. Newly elected Governor Dick Thornburgh announced that “my administration has taken a number of steps to ensure that the disturbing kinds of abuses of the past…would not occur again.”[104] Blame for Farview’s problems was shifted to previous administrations and ex-staff and the administration moved on.
Looking forward, Governor Thornburgh pursued criminal justice-oriented strategies to address issues of proper and economical treatment of Pennsylvania’s criminal insane. Since Farview could no longer easily hold inmates involuntarily, people deemed criminally insane could either be moved to community-based living arrangements (as many deinstitutionalized patients were in the 1960 and 1970s) or confined in the state prison system for the duration of their sentences. Thornburgh’s administration chose the prisons. To Thornburgh and many other elected officials, deinstitutionalization was intended to benefit innocent and nonviolent people with mental illnesses. Criminals with mental illnesses were deemed too dangerous to society to be released.
Pennsylvania prison system underwent massive expansion in the 1970s as part of the growing war on crime in the United States. A dedicated crime warrior, Thornburgh supported new legislation to increase prison funding and expand their capacity. Deinstitutionalization and public concern about crime gave Pennsylvania an opportunity to shift resources away from emptying mental institutions and into prisons instead.[105] Farview also received millions of dollars from the Bureau of Corrections for renovations, new staff, and expanded forensic treatment programs.
Increased corrections-earmarked funding and the lasting impact of the Dixon lawsuit and other legislation were the catalyst for real change at Farview in the 1980s. With the inmate population now under 250, overcrowding and the issues it caused were finally alleviated at Farview. More staff also meant that inmates were able to receive routine psychological evaluations and treatment intended to improve their condition. In 1982 the average length of stay at Farview was reduced to six months.[106] 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.”[107]
Continuing public support for “public safety” spending and change in government priorities away from welfare meant that access to rehabilitation and treatment was more available in the prison system than welfare institutions.[108] In 1989 vacant Farview buildings were reopened to house inmates under the jurisdiction of the Department of Corrections. This new prison, the State Correctional Institution at Waymart, existed side-by-side with Farview for six years until the entire facility was transferred to Corrections control in 1995. Farview State Hospital, survivor of decades of scandals, government investigations, and reform attempts had met its anticlimactic end.
SCI Waymart still operates today as a minimum security prison with a forensic treatment center for male inmates with mental illnesses. The prison still maintains the state’s institutional presence and economic role in the area, housing well over 1,000 inmates and providing hundreds of jobs for the region. In a sense, Farview was never closed; it was simply recycled into a state prison.
Conclusion
Farview was conceived after decades of calls to reform Pennsylvania’s welfare system and improve the treatment and care of Pennsylvanians with mental illnesses. The actual establishment of the hospital, however, was the result of economic self-interest and a desire to isolate those considered criminally insane. Farview was explicitly built and operated in such a way that it would not create substantial costs for the state and would keep a low public profile.
Hundreds of acres of free land with rich natural resources in an “up and coming” part of Pennsylvania seemed like the perfect place for Farview. An unlimited supply of inmate labor, ambiguous mental health laws, and lack of serious oversight meant that Farview could operate without inmates’ interests in mind. What Farview didn’t anticipate was the end of these advantages. In the end, it was Farview’s inmates that suffered for their institutions flaws. Isolated from their families, the court system, and government officials inmates were subject to abuse, brutality, neglect, and a host of other appalling conditions. For many inmates simply surviving Farview was a challenge, let alone receiving treatment or rehabilitating.
Generations of welfare officials, journalists, advocates, and Farview administrators tried to improve conditions at the hospital and were all unsuccessful. Ironically, the same issues that hindered the creation of a hospital for the criminal insane in the 19th century were the same reasons that Farview seemed unable to reform or close in the 20th. Farview’s faults were built into its very foundation and set into stone after its first few years of operation. Protected by the economic interests of region and elected officials uninterested in increasing spending on the criminal insane, inmates and advocates were practically powerless to reform the hospital. Major lawsuits and ensuing legislation were the reason that inmates couldn’t be institutionalized involuntarily or forced to work without compensation. State-wide shifts from welfare to correctional spending gave Farview the funds it needed to hire enough staff and provide effective inmate treatment and was the ultimate reason the institution closed.
The causes surrounding Farview’s establishment are essential to understanding how it operated and impacted the lives of its inmates. Reformers and advocates for change in our mental health and correctional systems would do well to inspect the ground where they propose institutional changes today, before they start to build.
Endnotes:
[1] “Report of the Commission Appointed by Concurrent Resolution of the Senate and House of Representatives, Approved July 11, 1901, to Inquire Into the Condition of the Insane Within Hospitals of the State of Pennsylvania” in Journal of the Senate of the Commonwealth of Pennsylvania. (Harrisburg: William Stanley Ray, 1903), 367.
[2] Ibid, 373.
[3] Ibid, 373.
[4] Ibid.
[5] “Address at the Laying of the Cornerstone,” July 24 1909, Box 1, Folder 9, Records of the Department of Public Welfare: Farview State Hospital 1906-1985, The Pennsylvania State Archives.
[6] Ibid.
[7] “1966 Open House Booklet,” 1966, folder 11, box 2, Patient Records and Related Material, RG 23.992: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[8] Bill Thomas and S.L. Stebel, The Shoe Leather Treatment: The Inspiring Story of Bill Thomas’s Triumphant None Year Fight for Survival in a State Hospital for the Criminally Insane as Told to S.L. Stebel (Los Angeles: J.P. Tarcher, Inc., 1980), 246
[9] [9]“Address to the Court by the Investigating Grand Jury,” 1977, Records Relating to the Sub-Committee on Crime and Corrections and the Judiciary Committee of the House of Representatives, MG 407.9: Joseph Rhodes Jr. Papers, Pennsylvania State Archives, Harrisburg.
[10] Acel Moore and Wendell L. Rawls Jr., The Pulitzer Prize Archives, ed. Heinz-Deitrich Fischer (New York: K.G. Saur, 1989), 208-22.
[11] For an informative historiography on mental health policy in the 20th century see Andrew Scull. The Milbank Quarterly 70, no. 3 (1992): 557-79.
[12] “In an early day in Maryland, Connecticut, Rhode Island and New York, little thought was given to the manifest inhumanity of attempting to care for the insane and still less to care for insane criminals in connection with the jail, house of correction of penitentiary; in fact many people believed that insane criminals were justly punished by imprisonment or even by hanging for crimes committed when manifestly insane.” Henry M. Hurd, The Institutional Care of the Insane in the United States and Canada. Vol. I. (Baltimore: The Johns Hopkins Press, 1916), 348.
[13] Philadelphia Citizens Committee on an Asylum for the Insane Poor of Pennsylvania, A Second Appeal to the People of Pennsylvania on the Subject of an Asylum for the Insane Poor of the Commonwealth (Philadelphia: Brown, Bicking, & Guilbert, 1840), 11.
[14] Journal of the Forty-Ninth House of Representatives of the Commonwealth of Pennsylvania Vol. II (Harrisburg: Boas & Coplan, 1839), 824.
[15] Ibid. 829.
[16] Philadelphia Citizens Committee, 3-4.
[17] Dorthea Dix, Memorial Soliciting a State Hospital for the Insane Submitted to the Legislature of Pennsylvania, February 3 1845 (Philadelphia: Isaac Ashmead, 1845), 3.
[18] This practice was common among private asylums and poorhouses in the 17th and 18th centuries. Ernest Morrison, The City on the Hill: A History of the Harrisburg State Hospital (Self-published, 1992) , 43.
[19] American Psychiatric Association, quoted in Ernest Morrison, The Physician, the Philanthropist, and the Politician: A History of Public Mental Health Care in Pennsylvania (Harrisburg: Pennsylvania Historical and Museum Commission, 2001), 15-16.
[20] Thomas Kirkbride, On the Construction, Organization, and General Arrangements of Hospitals for the Insane (Philadelphia, 1854), 270.
[21] Morrison, The Physician, the Philanthropist, and the Politician: A History of Public Mental Health Care in Pennsylvania, 35.
[22] The Transactions of the American Medical Association, Vol. XXV (Philadelphia: Collins, 1874), 348.
[23] Hurd, 348.
[24] “Fifteenth Annual Report of the Board of Commissioners of the Board of Public Charities,” 1885, Carton 1, Annual Reports of the Board of Public Charities and Committee on Lunacy, RG 23.243: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[25] Philip Jenkins, “Eugenics, Crime and Ideology: The Case of Progressive Pennsylvania.” Pennsylvania History: A Journal of Mid-Atlantic Studies 51, no. 1 (1984): 71.
[26] Henry M. Boies, The Science of Penology: The Defense of Society Against Crime (New York: The Knickerbocker Press, 1901), 141.
[27] Miscellaneous Documents Read in the Legislature of the Commonwealth of Pennsylvania During the Session Which Commenced at Harrisburg, January 5, 1875 (Harrisburg: B.R. Meyers, 1875), 529.
[28] Official Documents Comprising the Department and Other Reports, Made to the Governor, Senate and House of Representatives of Pennsylvania Vol. IX (Harrisburg: Clarence Busch, 1894), 53.
[29] “Report of the Commission Appointed by Concurrent Resolution of the Senate and House of Representatives, Approved July 11, 1901, to Inquire Into the Condition of the Insane Within Hospitals of the State of Pennsylvania,” 369.
[30] Report of Investigations and General Findings and Recommendations of the Legislative Commission to Investigate Various Charitable Institutions (Harrisburg: Harrisburg Publishing Co, 1907), 3.
[31] “Laws of Pennsylvania No. 247. An Act to Provide for the Selection of a Site and the Erection of a State Hospital for the Treatment and Care of the Criminal Insane, and Making an Appropriation Therfor,” Laws of the General Assembly of the Commonwealth of Pennsylvania Passed at the Session of 1905 (Harrisburg: William Stanley Ray, 1905), 400.
[32] “The Commission for the Selection of a Site and the Erection of a State Hospital for the Treatment and Care of the Criminal Insane,” 1906, folder 8, box 28, Executive Correspondence, MG 171.4: Samuel W. Pennypacker Papers, Pennsylvania State Archives, Harrisburg.
[33] “Farview on the Moosic Mountains,” 1905, folder 4, box 28, Executive Correspondence, MG 171.4: Samuel W. Pennypacker Papers, Pennsylvania State Archives, Harrisburg.
[34] Ibid.
[35] “Board of Trustees to Governor Pennypacker,” 1906, folder 4, box 28, Executive Correspondence, MG 171.4: Samuel W. Pennypacker Papers, Pennsylvania State Archives, Harrisburg.
[36] “Farview on the Moosic Mountains,” Pennsylvania State Archives.
[37] William P. Spratling, Transactions of the National Association for the Study of Epilepsy and the Care and Treatment of Epileptics, ed. William Letchworth (Buffalo: C.E. Brinkworth, 1901), 29.
[38] “Biennial Report of the State Hospital for the Criminal Insane,” 1920, folder 7, box 1, Patient Records and Related Material, RG 23.992: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[39] Louis Berger Group, The Farview State Hospital Agricultural Complex: An Institutional Farm in Twentieth-Century Pennsylvania. (United States: U.S. Department of Justice, 2003), 14.
[40] “Construction Minute Book,” 1919, box 3, Patient Records and Related Material, RG 23.992: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[41] “Memorandum Book of the Committee on Lunacy,” 1910-1921, Committee on Lunacy, RG 23.347: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[42] “Biennial Report of the State Hospital for the Criminal Insane,” 1920, Pennsylvania State Archives.
[43] “Biennial Report of the State Hospital for the Criminal Insane,” 1920, Pennsylvania State Archives.
[44] “Semi-Annual Meeting at Danville Proceedings,” 1914, Proceedings and Programs of the Semi-Annual Meetings of the Association of Trustees and Medical Superintendents of the State and Incorporated Hospitals, RG 23.247: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[45] “Memorandum Book of the Committee on Lunacy,” 1910-1921, Committee on Lunacy, RG 23.347: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[46] Ibid.
[47] Pennsylvania’s mental institutions were governed by over 50 different acts or parts of acts that frequently addressed issues other than mental illness until the Mental Health Act of 1951 was passed. Joint State Government Commission, Commonwealth of Pennsylvania, Report on the Mental Health System and Laws of Pennsylvania (Harrisburg: 1987), 17.
[48] “Semi-Annual Meeting at Harrisburg Proceedings,” 1914, Proceedings and Programs of the Semi-Annual Meetings of the Association of Trustees and Medical Superintendents of the State and Incorporated Hospitals, RG 23.247: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[49] “Memorandum Book of the Committee on Lunacy,” Pennsylvania State Archives.
[50] Ibid.
[51] “Biennial Report of the State Hospital for the Criminal Insane,” 1920, Pennsylvania State Archives.
[52] Ibid.
[53] “Semi-Annual Meeting at Farview Proceedings,” 1914, Proceedings and Programs of the Semi-Annual Meetings of the Association of Trustees and Medical Superintendents of the State and Incorporated Hospitals, RG 23.247: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[54] “Laws of Pennsylvania No. 247,” 400.
[55] “Inspection of Mental Hospitals,” 1935, RG 23.966: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[56] Ibid.
[57] Ibid.
[58] Ibid.
[59] For a useful discussion of PA’s mental hospitals during this period, see Anne Parsons, “The Last Hurrah of Mental Institutionalism,” in “Re-Institutionalizing America: The Politics of Mental Health and Incarceration, 1945-1985” (dissertation, University of Illinois at Chicago, 2013.
[60] Report of the Committee Appointed by Honorable Edward Martin to Make a Complete Study of the Mental Hospitals of the Commonwealth of Pennsylvania (Harrisburg: Pennsylvania Department of Welfare, 1944), 29.
[61] Ibid., 8.
[62] Stephen Taylor, Acts of Conscience: World War II, Mental Institutions, and Religious Objectors (Syracuse: Syracuse University Press, 2009); Albert Maisel, “Bedlam 1946: Most U.S. Mental Hospitals are a Shame and a Disgrace,” Life, May 6, 1946.
[63] “Commissioner of Mental Health to Harry Shapiro,” 1957, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg
[64] One attorney reported to Secretary Shapiro: “boy and a lot of judges take advantage of their power to impose the indefinite sentence. They love it” “Alexander Negley to Harry Shapiro,” 1957, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[65] Administrative reports from Farview routinely mention escape attempts, some organized by as many as 15 inmates at a time.
[66] The Pittsburgh Legal Journal, Volume 102 (Pittsburgh: Pittsburgh Legal Journal, 1954), 488.
[67] Ibid., 488.
[68] “Louis Little to Harry Shapiro,” 1954, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[69] “Hilding Bengs to Harry Shapiro,” 1955, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg
[70] Ibid.
[71] “A Mental Health Program for Pennsylvania by the American Psychiatric Association with the Pennsylvania Mental Health Survey Committee,” 1956, Chief Clerk’s Files, RG 10.88: Records of the Office of the Governor, Pennsylvania State Archives, Harrisburg.
[72] Ibid.
[73] Parsons, 163.
[74] “R. Matthews to Harry Shapiro,” 1958, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[75] R.M.H. and B.B.W. “Hospitalization of Mentally Ill Criminals in Pennsylvania and New Jersey.” University of Pennsylvania Law Review 110, no. 1 (1961): 83.
[76] “Letter to Harry Shapiro,” 1957, Administrative Files of the Secretary of Welfare, RG 23.349: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[77]B.J. Willis, Clinical Director of Farview State Hospital, quoted in R.M.H., 83.
[78] Ibid., 85.
[79] Outside of Farview medical professionals doubted the effectiveness of milieu therapy. One critic wrote that “a consideration which casts doubt upon the permanency of this kind of treatment is the fact that the ‘cured’ patient, regardless of his life while hospitalized, must return to his community to face problems and tensions similar to those which may have contributed to his original illness.” R.M.H., 86.
[80]B.J. Willis, quoted in Ibid., 84.
[81] In 1960, the average length of time inmates spent at Farview was fifteen times longer than neighboring New Jersey’s hospital for the criminal in Trenton. R.M.H., 92.
[82]B.J. Willis, quoted in Ibid., 91.
[83] Ibid.
[84] Ibid.
[85] “1966 Open House Booklet,” Pennsylvania State Archives.
[86] After the 1968 Open House, Shovlin reported that “Remarks by the visitors were generally complementary. We feel that this annual event has done much to improve this hospital’s image and public relations over the years.” “Farview State Hospital Board of Trustees Minutes,” 1968, Minutes of the Board of Trustees for State Institutions, RG 23.3: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[87] Terrence P. Thornberry and Joseph E. Jacoby, The Criminally Insane: A Community Follow-up of Mentally Ill Offenders (Chicago: University of Chicago Press, 1979), 57.
[88] Dixon v. Attorney General of Pennsylvania, 325 F. Supp., 966 (M.D. Pa. 1971).
[89] Souder v. Brennan, 367 F. Supp., 808 (1973).
[90] Institutional Peonage Abolition Act 1974 Riebman, Murray, Lamb, Coppersmith, Frame, Hobbs, Bell, Ross, Scales and O’Pake, Pennsylvania Senate Bill No. 731, 1973.
[91] In 1970 a U.S. Senate Investigation reported that: “the Pennsylvania State hospital farm program is a big operation with vested interests and its patient laborers are not limited to…duffers ‘gravitating’ to the business end of shovels and pitchforks…it has since become self-evident that maintaining a labor force of 3,000 patients, able and compliant enough to work and needed to keep the operation and the fiscal delusion alive, represented a cost of some kind, and no amount of rationalizing the work as therapy could convert the extravagances of exploiting patient labor to a profit. Furthermore, as this drudgery is not therapeutic… the working patient’s dreary career may well be at the expense of his life’s potential outside the hospital.” U.S. Congress, Senate, Committee on the Judiciary, Constitutional Rights of the Mentally Ill: Hearings Before the Subcommittee on Constitutional Rights of the Committee on the Judiciary, 91st Cong., 1st and 2nd sess., 1970, 197.
[92] Joseph E. Jacoby. “Endurance of Failing Correctional Institutions: A Worst Case Study.” Prison Journal 82, no. 2 (2002): 184.
[93] Andrew Scull, Deacarceration: Community Treatment and the Deviant: A Radical View (New Brunswick: Rutgers University Press, 1984).
[94] Acel Moore and Wendell Rawls Jr. “Pattern of therapy: Sedation and brutal neglect,” Philadelphia Inquirer June 28, 1976.
[95] Acel Moore and Wendell Rawls Jr. “The view from inside- ‘guards still run this place,’” Philadelphia Inquirer June 28, 1976.
[96] Moore and Rawls, “The view from inside.”
[97] Governor’s Task Force on Maximum Security Psychiatric Care, A Plan for Forensic Mental Health Services in Pennsylvania, Harrisburg, 1977, 13.
[99] Acel Moore and Wendell Rawls Jr. “Gov. Shapp to seek $50 million to replace Farview,’” Philadelphia Inquirer July 9, 1976.
[100] “Joseph Gilbert to Joseph Rhodes,” 1978, Records Relating to the Sub-Committee on Crime and Corrections and the Judiciary Committee of the House of Representatives, MG 407.9: Joseph Rhodes Jr. Papers, Pennsylvania State Archives, Harrisburg.
[101]“Address to the Court by the Investigating Grand Jury,” 1977, Records Relating to the Sub-Committee on Crime and Corrections and the Judiciary Committee of the House of Representatives, MG 407.9: Joseph Rhodes Jr. Papers, Pennsylvania State Archives, Harrisburg.
[102] James Robins, “Shapp: Farview State Hospital Stays Open,” Washington Observer-Reporter (Washington, PA), December 21, 1977.
[103] “Farview State Hospital Board of Trustees Minutes,” 1980, Unprocessed Collection, Pennsylvania State Archives, Harrisburg.
[104] “Farview Press Release,” 1980, Carton 227, Dick Thornburgh Papers 1979-1987, The Pennsylvania State Archives, Harrisburg.
[105] In 1981 Retreat State Hospital was transferred to the Bureau of Corrections and turned into a new state prison.
[106] “Farview State Hospital Board of Trustees Minutes,” 1982, Unprocessed Collection, Pennsylvania State Archives, Harrisburg.
[107] “75th Commemoration Booklet,” 1987, folder 12, box 2, Patient Records and Related Material, RG 23.992: Records of the Department of Human Services, Pennsylvania State Archives, Harrisburg.
[108] Parsons, 197.
Another Century 
I am amazed after reading the history of Farview State Hospital for the criminally insane of how little I knew about what was going on there. I was a young girl of 19 just graduated from a scranton business college and had a job in theaccounting office. My immediate boss was Charles Conmy. We were 6 employes. As I recall, there were several prisoners roaming around freely……they were called trustees. One of them used to wash and polish our car for a fee that I was told was posted to the patients account. Another painted a portrait of my deceased brother and that fee was posted to his account. Another older patient, Tom Poff, had alot of freedom and enjoyed sitting by my desk for long period of time…….I recently found a photo of Tom and I outside the building I worked in——he always seemed harmless and quiet. The guards seemed to be locals and I knew some of them, They obviously chatted wiith prisoneers and one of the prisoners sent a letter to me at my home address. It seems that he was in a ward that could look into our office and it had to be a guard from Carbondale who supplied the info. At that I become alarmed and decided to leave my job there. I left my family home in Carbondale and went to Dallas, Tx to train as a stewardess for American Airlines and was assigned to Newark , LaGuardia and Kennedy Airports. I met my husband in NY city and married after 3 yrs. of flying. My Carbondale family thought I was risking my life flying and never considered the dangers of working at Farview State Hospital.
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