Castle Hill State Hospital is a closed asylum in central Massachusetts. Influenced by a traditional New England town common, Castle Hill opened in 1896 and remained in use until 2003. It was the Commonwealth’s first facility built specifically for long-term, high-need chronic patients.
The actual name of the location has been modified to protect the location as much as possible from vandalism.
Castle Hill Insane Asylum was authorized by Chapter 425 of the Acts of 1892 as a 1,000-bed hospital for the “care of chronic and incurable cases of the insane.” 1 4 The Legislature appropriated $25,000 towards the purchase of 426-acres atop Castle Hill and $500,000 towards the construction of buildings.
William Pitt Wentworth of Boston was selected as the architect chosen to design the facility in the unique cottage plan that would allow for the complete classification of patients, the Commonwealth’s first. 1 4 5 Wentworth, a native of Vermont who studied architecture in New York City, had moved to Boston in 1870. 5 A noted progressive architect of hospitals, Castle Hill was one of his last major works before his death in 1896.
Prior hospital iterations mostly followed the Kirkbride Plan, a system of mental asylum design advocated by Thomas Story Kirkbride, which involved designing buildings where exposure to natural light and fresh air was imperative. 2 Most buildings under Kirkbride were built with a bat wing” floor plan, with wings that sprawled outward from the center. But Castle Hill, designed around a quadrangle, was reminiscent of a typical New England town common. 1 5 The Administration Building and wards for quiet patients were at the front, with wards for the untidy, excited, and epileptic patients around the perimeter. The infirmary and industrial buildings were located at the corners. The chapel, powerhouse, carpenter’s shop, and laundry, kitchen, and dining facilities were placed in the center.
The completed plan will show twenty-seven buildings facing along the sides and ends of a rectangle. The situation is upon a summit of a hill, about 250 feet elevation above the sea, the top of the hill is graded on a slope towards the west. The prospect from all the buildings is beautiful and extensive, and the location of the asylum was often sought in years past for the beauty of its view. The woodland north of the institution borders on the river and offers an excellent opportunity for a magnicent park. It is already covered with desirable well-grown trees, and is diversied by picturesque rocky hills, pleasant vales and many natural advantages.
-Superintendent Edward French, MD 5
By May 1, 1896, twelve buildings that could accommodate 600 patients were completed. 1 4 The first 60 men and 60 women were admitted from Taunton later that month and by the close of September, Castle Hill’s population had risen to 563 patients.
Six additional buildings, including wards for the untidy, excited, and epileptic patients (E, F, and L Wards) were finished in early 1897, boosting the patient capacity to 1,100. 1 4 By the end of 1897, Castle Hill had 961 patients, most who had been transferred from other institutions and were “old, sick, feeble, filthy in their habits.”
A farmhouse (Building 31) to accommodate a farmer and 15 to 20 patients and an industrial building for clothes making, ironwork, mattress fabrication, and upholstery was added in 1898. 1 4 A male ward was also converted into a female ward as female patients were in the majority.
An additional $80,000 had been appropriated for a second ward for excited female patients (R Ward) in 1902, as well as $2,000 towards the purchase of an additional 40 acres for the construction of additional buildings for 600 patients. 1 4 A nurses residence (Building 24) for 75 nurses, a male attendants’ home (Building 23), a hospital for tubercular patients (Building 53), a ward for 100 excited male patients (Ward S, Building 20), and a new powerhouse were added in the year.
Several wood-framed cottages were built in 1906, two of which were for tubercular patients (Buildings 21 and 22), and three for employees (Buildings 25, 26 and 27). 1 A superintendent’s house (Building 46) was added in 1907. By the close of the year, there were 1,500 patients at Castle Hill.
A two-year training school for nurses was established in 1902 and expanded into a three-year program in 1914. 1 A laboratory was added in 1920.
Reflecting changes in the treatment of the mentally ill, Chapter 504 of the Acts of 1909 renamed the hospital to Castle Hill State Asylum. 1 4 More importantly, Chapter 442 of the Acts of 1914 renamed it again as Castle Hill State Hospital, which also allowed the institution to care for patients with all types of mental illness.
Castle Hill’s first social worker was hired in 1914, followed by the onboarding of the first occupational therapist in 1921. 1 A physiotherapy department was added in 1928 and by 1930, the hospital boasted a pathological laboratory, a hydriatric department for tonic treatment, and sedative hydrotherapy equipment.
But by the dawn of World War II, Castle Hill was overcrowded and had on average, 1,700 to 1,900 patients in a facility designed for 1,568 persons. 1 Because of the need for men during the war, staffing fell by 50%; to fill the employment gap, higher-functioning patients performed laundry, housekeeping, food service, groundskeeping, farming, and other duties as assigned. The training school for nurses was discontinued in 1943.
By 1945, Castle Hill was in poor physical condition. 1 A state report noted that a new acute treatment facility, wards for violent patients, an administration building, a warehouse, a shop, and a canning plant were all needed.
The dawn of the 1950s saw the treatments at Castle Hill shifting once again. Electroshock and insulin shock therapies were introduced to Ward B-1, and the first unlocked wards were put in place in 1949. 1 New psychotropic drugs began to replace hydrotherapy, seclusion, and sedatives in the 1950s.
Deinstitutionalization, the process of replacing long-term psychiatric hospitals with community mental health services, began in the 1960s. The movement towards deinstitutionalization was born out of a socio-political movement for community-based services and open hospitals and the advent of psychotropic drugs and financial rationales. 3
Castle Hill’s resident population was gradually reduced by releasing stabilized patients, shortening inpatient stays and reducing admission and readmission rates. Programs were implemented to mitigate the reinforcement of dependency, hopelessness, and other maladaptive behaviors. Additionally, under the leadership of Dr. Harold Lee, Castle Hill gained a national reputation for its innovative “step” rehabilitation program, which entailed increasingly independent living situations on campus and intensive vocational work training. 5
Castle Hill State Hospital was added to the National Register of Historic Places in 1994.
By 2001, Castle Hill had just 150 inpatients, with 29 out of the 54 buildings in use. 6 With an annual maintenance budget of $900,255, many of the buildings were in fair to poor condition. Just a few years prior, the hospital received $500,000 from the legislature to repair leaky roofs and broken windows, although it didn’t prevent some of the in-use buildings from being condemned.
Facing mounting maintenance costs and a vastly underutilized campus, the Commonwealth announced in 2002 its intent to close Castle Hill State Hospital. 5 The last of the patients were transferred out into other facilities in April 2003.
Prior to the closure of Castle Hill, the local community learned of plans to turn over the property to the pension system. 8 The pension managers would have considered the site for large-scale housing of at least 400 housing units in an effort to maximize revenues. 7 8 The town, however, wanted no more than 300 housing units. In a compromise in May 2004, the Commonwealth slashed the proposed housing units from 400 too 300 in exchange for adding assisted-living facilities for the elderly.
The Town of Medfield established the State Hospital Advisory Committee (SHAC) to investigate acquiring Castle Hill State Hospital in 2013, which cumulated in the town voting in April 2014 to purchase the former institution from the Commonwealth for $3.1 million. 5 It became the official owner of record in December 2014 after the last of ten installment payments were made.
SHAC conducted surveys and concluded upon the following broad reuse principles for Castle Hill: 5
- The creation of mixed-use housing for senior citizens and single-family residents, and those with income restrictions;
- The renovation of the Chapel into a performing art center;
- The inclusion of retail and restaurants;
- The preservation of the surrounding farm fields for use as open space with passive recreation options and trails.
The town then decided to mothball all of the Castle Hill structures to minimize the risk of vandalism and to prevent the intrusion of water into the buildings, and to remove most of the wood porches to prevent further deterioration and avoid the appearance of blight. 5
The Castle Hill State Hospital Master Plan was released in 2018, calling for the preservation and rehabilitation of as many historic buildings as financially possible, the retention of the historic architectural character, and the historic landscape. 5 It called for the creation of senior citizen housing, new commercial and shared workspaces for businesses, a cafe and a restaurant with a focus on local foods with farm-to-table offerings, a cultural center at Lee Chapel, trails for walking, hiking, and horseback riding, and community gardens. Overall, half of the land would be preserved for open space and agriculture.
Administration Building (Building 52)
The Administration Building was designed by William Wentworth in the Queen Anne style in 1896. 1
Lee Hall/Chapel (Building 54)
The chapel was designed by William Wentworth in the Queen Anne style in 1897 to allow patients to pray and attend mass. 1 A morgue was later outfitted in the basement. The chapel was later reused as a gymnasium.
Male Employees’ Home (Building 23)
The Male Employees’ Home was designed in the Classical and Craftsman styles and constructed in 1904. 1
Men & Female Dining Hall/Kitchen (Building 57)
A central kitchen flanked by identical male and female dining halls were designed by William Wentworth in the Queen Anne style in 1897. 1
Men’s Infirmary/Ward C-3 (Building 7)
The Men’s Infirmary/Ward C-3, designed by William Wentworth in the Queen Anne style, was constructed in 1896. 1
Men’s Quiet Ward/Ward B-3 (Building 3)
The Men’s Quiet Ward/Ward B-3 for passive male patients, designed by William Wentworth in the Queen Anne style, was constructed in 1896. 1
Ward R (Building 19)
Ward R, designed by Park & Kendall, was constructed in 1904. 1 It served as an overflow ward for excited female patients.
Ward S (Building 20)
Ward S, designed by Shepley, Rutan & Coolidge in the Beaux-Arts style, was constructed in 1906. 1 A two-story passageway and porch were added to the rear circa 1930. The building was later used as a training facility for the Department of Corrections.
Women’s Convulsive Ward/Ward L-1 (Building 17)
The Women’s Convulsive Ward/Ward L-1 for epileptic female patients, designed by William Wentworth in the Queen Anne style, was constructed in 1897. 1
[su_spoiler title=”Sources” icon=”caret”]
- Jenkins, Candace. National Park Service, United States Department of the Interior. Medfield Insane Asylum. Sept. 1993.
- United States, Congress, National Park Service, and Kate Ohno. “Connecticut General Hospital for the Insane.” Connecticut General Hospital for the Insane, 1983.
- The Rockland Campus Plan. New York State Office of Mental Health, 1989.
- Jenkins, Candace. Massachusetts Historical Commission, Commonwealth of Massachusetts. Medfield State Hospital. Aug. 1984.
- Medfield State Hospital Strategic Reuse Master Plan. Town of Medfield, MA, 2018.
- Casey, Janet. “Future of hospital raises concerns.” Boston Globe, 1 Jul. 2001, p. W12.
- Kocian, Lisa. “State’s new plan cuts units.” Boston Globe, 9 May 2004, p. W3.
- Kocian, Lisa. “Town seeks consensus on hospital.” Boston Globe, 6 Apr. 2003, p. W4.