Iowa Girl on the Go

Independence State Hospital

When I visited the first of three historic mental health facilities last summer, it was so hot that I could feel the searing heat of the pavement right through my shoes.

That was in Clarinda, a small town in southwest Iowa, the third week of June. Before the month was over I had visited the other two facilities – once known as insane asylums – in Cherokee and Independence.

My interest in these buildings is two-fold: I’m primarily interested in the historic architectural design of the institutions, but I’m also fascinated by the history of how we as a society have treated people who have been diagnosed with mental illness.

I stumbled upon a fascinating website some months ago that describes the architecture and use of the facilities known as Kirkbride buildings. Dr. Thomas Story Kirkbride (born 1809) was superintendent of the Pennsylvania Hospital for the Insane, and he promoted a standardized method of asylum construction and mental health treatment, popularly known as the Kirkbride Plan. Kirkbride believed that asylum buildings and their surroundings were a central component of treatment for the mentally ill.

Kirkbride buildings – most built between 1848 and 1890 – feature a central administration with tiered wards on both sides. Patients were housed in a hierarchical system based on gender and illness. In general, men were on one side, women on the other, with each ward subdivided into areas for “better behaved, rational” patients and “excited” patients. Kirkbride felt this arrangement would make patients more comfortable and their treatment more productive by isolating them from “other patients with illnesses antagonistic to their own” while still allowing for ample fresh air and natural light.

Cherokee State Hospital

The campus concept makes for a truly remarkable atmosphere, even today. Placing patients in a natural environment away from urban centers, surrounded by cultivated parks and farmland was thought to both stimulate and calm the patients. In fact, patients were encouraged to help work the farms and keep up the grounds.

Eventually these state-of-the-art mental healthcare institutions gave way to more modern facilities. Many of the original Kirkbride buildings across the U.S. have been abandoned or demolished. According to the website, just a few of these grand buildings remain in their entirety, and three of them are in the state of Iowa.

As I mentioned, the day I visited the Clarinda State Hospital (above) in June was hot – and it was also deathly quiet. I drove up the long, tree-lined drive (all Iowa facilities under the Kirkbride Plan have these long, beautiful, tree-lined drives) and parked my car near the Clarinda Academy, a residential foster care facility that provides treatment to at-risk youth. The Academy is housed on the grounds of the state hospital, behind the main building. I walked down the road and onto the main campus to get a good look at the historic insane asylum that opened in 1888. The gothic structure is huge – more than 500,000 square feet – with the distinctive center section flanked on both sides by patient wards.

At the time I was there, the facility had not yet been closed by the governor – a controversial move that I won’t explore in any depth here except to say it was hasty and motivated by a line in the state budget rather than by patient needs – but I’m told that some patients had already been moved elsewhere and the staff was reduced. I’m guessing that explains why it was so quiet on a Saturday afternoon, a day I expected to be a popular visitors’ day for families of the remaining patients. I walked the grounds, taking photographs, without seeing a single person. I walked inside, hoping to ask someone for entrance to the museum that is said to exist within the building, but I saw nobody in the common spaces or offices. I took a few pictures of the main interior space – I obviously didn’t continue to the patient wards – and I could hear muffled voices coming from what sounded like a distant meeting. But that was it: no human sightings.

The Kirkbride website says that the building is “well maintained throughout and is in fantastic shape” and it appeared so to me.

Despite protests, the facility was shut down later in the summer; 53 employees were laid off, and the remaining patients (some of the state’s frailest and most complicated psychiatric patients) were transferred to other facilities. At last count, three had died.

The Cherokee State Hospital (above) was built in northwest Iowa, the fourth of the four state asylums, in 1902. According to the Kirkbride website, the original facility had 1,810 windows, 1,030 doors, 550 rooms, 23 dining rooms, and 30,000 square feet of tile. Much of the original building remains; the website notes that changes in the exterior have “diminished the historic character, but it’s still an attractive building.”

I thought it was still grand and impressive, but it has a notable difference from the Clarinda facility: prison-grade fencing. The south wing of the Cherokee Mental Health Institute houses criminally insane and violent patients.

I visited the Cherokee facility on June 26 with a friend. We parked closest to the south wing and walked toward the building. But I only got a few frames snapped on my camera before a large man on a cell phone came toward me and told me that no photos could be taken of the south wing, even after I told him that I was just documenting the architecture for my blog. (He also asked me, in an authoritative voice, if I knew what the building was originally built for. No? Well, he said, it was supposed to be the location for Iowa State University. I didn’t argue with him, but I do have to quibble with that “fact.” I work at Iowa State University, and I happen to know that it was founded in 1858 and opened its doors to students in 1868. The Iowa legislature didn’t even begin talking about the Cherokee facility until 1894. So there you have it, you annoying, officious man.)

Officious Man said we needed to speak to the superintendent about photographing the other parts of the building, which we did, because he happened to be standing on the front steps and we couldn’t avoid him. He was young, and seemed to be a very nice man, but he said we’d need to go inside and ask the person at the front desk. Turns out she was NOT nice and told us in no uncertain terms that we could NOT take pictures anywhere, inside or out, and pretty much kicked us out. I kept thinking she was going to call security. We walked around the grounds anyway (many of the secondary buildings are in a state of glorious disrepair, such as the one below) and took a few more photos of the main structure from a distance – I swear, we were not being disrespectful of any patients or their families or physicians; I would not have photographed anyone, even if I saw anyone, which I did not. I just wanted to document the architecture, for crying out loud.

So when we went to the Independence State Hospital (above) a few days later on June 29, we didn’t ask permission to take pictures of the outside, and we kept a low profile.

But once we documented the exterior of the facility that opened in 1873 as the Iowa Hospital for the Insane, we bravely went inside and asked very nicely if we might be permitted to snap just a couple of photos of the gorgeous hardwood staircase in the main welcoming area. The woman on duty said it would be okay! Here’s what it looks like:

The Independence facility is a beauty, and it is said to look much as it did when it was built. The main building appears to be in excellent shape, and the grounds are lovely and park-like. Hanging in the entryway is a huge, colorful painting of the building:

I should mention that Iowa once had four Kirkbride buildings. The Mount Pleasant State Hospital – opened in 1861 and originally called the Iowa Lunatic Asylum – burned in 1936. It was the first public asylum in the state of Iowa. The state built a more modern structure in its place. The Mount Pleasant mental health institute was shuttered by Iowa Gov. Terry Branstad, along with the one in Clarinda, on June 30. Branstad has been quoted by the media saying that he is open to the possibility of closing one or both of the remaining mental hospitals in Independence and Cherokee.

According to a report issued by the Pew Charitable Trust, Iowa ranks 47^th in its general-fund spending on mental health services.