Guiding Principles Safe Environments Best Practices of Clinical Care and Treatment Professional Competency and the Highest Ethical Standards Promotion of Patient Rights and Responsibilities Johns Hopkins, the wealthy Baltimore merchant and investor after whom both the university and the hospital are named, had been involved for two decades in the oversight of the Maryland Hospital for the Insane as a member of its Board of Visitors and as part of his many philanthropic activities. The building and grounds became the property of the City of Baltimore in May, 1798, when Captain Yellott consummated the purchase. employee cottages (in the employee ], Dipsomania [Alcoholism - 48 of the hospital's 138 admissions that year. Mackenzie and Smythe to construct a major addition to the hospital, in the form of an 'east wing' (see below). This may have been a function of the fact that by 1834 the hospital buildings were in such a state of disrepair (see below) that the hospital was no longer able to accommodate the number of patients for which it had been designed. By the 1920s it had been converted into a medical facility and later an insane asylum and a retirement home. Room produced thousands of items such as dresses, petticoats, night gowns, socks and stockings, aprons, chemises and other undergarments, sheets, napkins, table cloths, blankets, shirts, curtains and even shrouds. [Roh, George H. 'The Relation of Pelvic Disease and Psychical Disturbances in Women. The Commission inspected public and private institutions for the insane and advised their boards of managers. Reportedly, his original intent had been to build his hospital on his 330 acre country estate, Clifton, north of the 19th-century Baltimore City limits. Furthermore, many individuals, including Ms. Dix, had emphasized for a number of years that efforts to treat psychiatric patients in accordance with the principles of Moral Management (see below) were generally not practicable in the middle of a crowded, noisy, urban area. The "Old Main" was the original building at the Spring Grove site of the Maryland Hospital for the Insane. In 1794, Spring Grove's predecessor facility, the Retreat, seems to have been the very first freestanding health facility in Baltimore. (It is not clear if this figure represented the continuous use of physical restraints in 2% of the patient population at any given time, or if it meant that 2% of the population had been restrained at some point.) It is impossible to provide for this class of insane in State Hospital without associating them with the white patients. In 1911, the hospital treated 597 patients (though not all at one time). Furthermore, the terms of the sale allowed Johns Hopkins to withhold $25,000 of the payment until such time as the General Assembly of Maryland passed a resolution that would afford him immunity from any unfriendly extensions of Baltimore City streets through the property. Pennhurst State School and Hospital, Spring City Pennhurst State School was in operation for around fifty years during the first half of the 20 th century. To prevent mistreatment of the mentally ill in Maryland, the Legislature created a body known as the Lunacy Commission in 1886 to inspect 'all public and private places where the insane [were] kept' (Acts of 1886). The primary modality used to treat mental illness at the time was called 'Moral Management.' In 2013, a consultant for the state health department documented serious assaults on hospital staff members at the Spring Grove Hospital Center in Catonsville, and two patients were killed by . For example, a report made to the House of Delegates by 'The Committee on the Part of the House of Delegates Appointed to Visit and Inspect the Maryland Hospital' (1834) indicates that the west wing of the building was in such bad repair that it was not being used. The agreement allowed Dr. Mackenzie, the younger, to maintain control of the daily operations of the hospital and to be in receipt of any profits until his lease expired in 1834. The facility was often referred to in documents from this period as 'The Maryland Hospital for the Insane, at Spring Grove,' 'The Spring Grove Asylum,' or, just as it is today, simply 'Spring Grove. There were also separate carpentry, paint, blacksmith and upholstery shops for men. As noted above, contemporary reports indicate that when the State resumed full operating control of the hospital in 1834 it found that the building that housed it had been permitted to fall into serious disrepair. It seems clear that it must have always been Captain Yellott's intent to convince the State and local governments to aid him in his efforts to build a larger hospital to replace his Retreat. The The hot water was used to heat air that was contained in heat exchangers that were located in the basement, and then a series of air shafts were used to allow the heated air to rise to the upper floors through gravity-fed convection. The founding of Crownsville State Hospital and the Eastern Shore State Hospital in the early part of the 20th century -- together with major expansions of the bed capacities at Spring Grove and Springfield State Hospitals at around the same time stemmed from what may have been the first major mental health patient advocacy movement in Maryland since the days of Dorothea Dix in the mid-nineteenth century. The research included investigations into the efficacy of shock therapy and pre-frontal lobotomy. It was noted, for example, that the Hospital and it's farm used approximately 13,000 gallons of water a day in 1877 -- more, it was pointed out, than was supplied by the city of Lowell, On October 27, 1852 the commission purchased 136 acres of land, near the town of Catonsville, Maryland (five miles southwest of Baltimore City). firehouse; and several other Furthermore, neighbors downstream complained of the smell and the fact that the stream was now heavily contaminated with raw sewage. However, several years later a decision was made to construct the MPRC Building on a hill at the northern end of the campus -- its current location. It is not clear if the above picture of the hospital, as shown on a map of Baltimore in 1801, is the same building that housed Captain Yellott's Retreat (c. 1794) or if it is the c.1798 structure that followed the founding of the hospital in 1797. Although certainly not suggested in the 1857 report, an alternative explanation for the much higher 'cure rate' for the private patients could have been , of course, that they may very well have received better care and treatment than the public patients -- and, just like today, the private patients were probably more likely to have had housing available to them in the community. Other than Market St. (Broadway), none of these streets existed when the hospital was built. In addition, several buildings that were built at the site a matter of only several years after the Main Building opened are still extant. The property purchased from Captain Yellott in 1798 included a tract of six and three-quarters acres of land at the crown of what was then called Loudenschlager's Hill. A temporary solution that was employed at first involved the digging of large cesspools ('earth closets') near to the hospital building. As noted above, the release of the property to Mr. Hopkins was subject to the completion of the new facility at the Spring Grove site and the removal of the patients. Its wooden floor joists, some of which dated back to 1853, reportedly were rotten and at risk of collapsing; and it's heating, plumbing and electrical systems were dangerously outdated. For example, it However, several annual reports from the end of the 19th-century For example, by one report the hospital maintained horses and carriages so that patients could go out for rides and other activities. )The term 'idiocy,' not unlike terms such as moron, imbecile and lunatic, did not have the pejorative meaning in 1844 that it does today. Dorothea Dix, the outspoken advocate and crusader for the mentally ill, pointed to the inadequacy of the bed capacity of the Maryland Hospital for the Insane in her 1852 impassioned address before the Maryland General Assembly. Known collectively as the Commissioners for Erecting a Hospital for the Insane, the group was n headed by Dr. Richard Sprigg-Steuart. . (Note: The old 'Joppa' or 'Philadelphia Road' in this part of the City was abandoned in the 1840s. The story may say more about contemporary perceptions of Mr. Hopkins than it does about an actual event. It held 362 patients by 1880, and 461 by 1893. In addition to the Main Building at Spring Grove, Mr. Neilson designed a number of notable buildings in Maryland and in neighboring states. (Note: Dr. John Mackenzie continued to serve as one of the hospital's treating physicians after 1834, and so, presumably, he did not stop admitting his private patients to the facility. created the Board of Mental Hygiene, which became directly responsible for the state mental hospital system. With the approval of local trustees of the poor, county levy courts were authorized in 1817 to commit persons referred to as 'lunatic paupers' to the hospital, upon agreement by the county to provide an annual payment to the hospital (Acts of 1817).While no direct evidence exists today that slaves were ever used to staff the hospital, it should be noted that, during this period, similar institutions did use slave labor for certain tasks. The Main Building had a There is some evidence that the original (1798) building may have been oriented towards Market St. (Broadway), but it was situated on open land, far back from road -- and the closest street was the Old Road to Philadelphia, to its north. The property was sold to Johns Hopkins, after whom the hospital and university have been named, and proceeds of the sale were then applied to the construction costs of the new hospital at Spring Grove. However, it was roughly where McElderry Street is located today, were it to extend through the Hopkins Hospital campus.) Complicating the situation was the fact that the same stream was used to empty and carry off wastes from the hospital's sewers and since as much as three-quarters of the fresh water was being diverted into the hospital's plumbing system, the remaining volume of water in the stream was insufficient to efficiently carry-off the waste water that was being piped into it. The rate at which the patients were transferred from the old site to the new one is not know for certain. Founded in 1797, Spring Grove State Hospital, now known as Spring Grove Hospital Center, is the second oldest continuously operating state psychiatric hospital in the country. However, Spring Grove RN's who do not wish to apply for this this national certification can participate in the Spring Grove Hospital Center Psychiatric Nursing Certification program. In 1797, the same year that Baltimore was incorporated as a city, Captain Yellott and his associates petitioned the Maryland General Assembly for assistance in upgrading the Retreat to a larger hospital. Today, the Dayhoff Building, the White Building, and portions of the Stone Cottages are located on land that was part of the 1909 'Sunnyside' farm acquisition and not, as might be imagined, part of the hospital's original parcel of land, acquired in 1853. The north wing was called the "Male Department," and the south wing was called the "Female Department." J. Crawford Neilson is perhaps best known as the architect of the South Carolina State capitol building. (The term 'retreat' had been used in England and America to describe what today might be called sanitariums or infirmaries.) According to the terms of the new lease, the 'Centre Building' was to serve exclusively as a 'lunatic asylum.' The report indicates that the use of the building had been offered at no cost to the 'Inebriate Asylum' by the State. Later it became a whites-only facility. This evidently inflated estimate may have been made in the face of the fact that in 1856 consideration was being given to the possibility of selling the property -- and the Board of Visitors may have been attempting to make it appear that the site was more valuable than it actually was. ), It is perhaps interesting to note that the current 'Spring Grove Hospital' may technically be the third hospital located at the Catonsville site. The sum of five-hundred dollars was appropriated by the Baltimore City Council in 1809 for repairs of the original building, and, in 1811, an allocation of $18,000 was granted by the Maryland General Assembly -- specifically for the purpose of the ongoing expansion. Visit Spring Grove Cemetery daily from 8 a.m. to 6 p.m. (extended summer hours can be viewed on the website); admission and parking are free and pets are prohibited. Male patients were primarily occupied with farm and workshop chores, while female patients were employed with housekeeping, laundry, sewing, and kitchen tasks such as vegetable preparation. https://health.maryland.gov/springgrove/Pages/home.aspx, Johns Hopkins Bloomberg School of Public Health, "James E. Steuart Papers, 1785-1955, MS 758 - Maryland Historical Society", "Baltimore County takes next step to purchase Spring Grove land", "Baltimore County makes move to purchase Spring Grove land for regional park | Maryland News Feed", "Hogan administration proposes selling Spring Grove Hospital campus in Catonsville to UMBC for $1", "Hospital sale to UMBC for $1 is approved", "Bd. Besides these, there are a large number in the almshouses of the State whose condition demands early attention. However, as seen in the hospital's annual reports, a wide variety of other articles were also produced. This facility dates all the way back to 1911, when it opened as the Hospital for the Negro Insane of Maryland. In the early 1890s, the Hospital's medical superintendent, Dr. George Roh, published data that he believed pointed to afavorable effect of total hysterectomies on the psychiatric conditions of a series of female patients at Spring Grove. Smyth and Mackenzie), As with any setting that provides for the care of vulnerable individuals, the possibility of exploitation and abuse was always present at Spring Grove. Furthermore, records from the period indicate that many, if not most, patients were routinely locked in their bedrooms at night while the nurses and everyone else, other than the men and women who served night as watchmen, slept.). The presence of an abundance of mosquito-breeding wetlands in the environs and a generally warm climate led to a number of Yellow Fever Epidemics at the turn of the nineteenth century - and the decision to construct a public hospital was clearly partially related to this circumstance. Following the departure of the Sisters of Charity, the Hospital engaged a matron and a number of nurses to replace them. The Main Building stood on the lot across the street from the current Spring Grove Administration Building, and extended north to beyond where the Jamison Building stands today. The reader will agree that the formula, which follows, reads more like the directions for an exotic cocktail than it does an oral hygiene product: Another medicine listed in the 1899 formulary was referred to as a 'Gastro Intestinal Tonic.' ], Erotomania [Masturbation was thought to be the cause of mental illness in about 8% of the admissions], Cloves, macerated into a coarse powder --30parts, Cinnamon, macerated into a coarse powder --30 parts. The old heating system that had included 13 separate hot air furnaces and five coal stoves, was replaced in or around 1864 with a single hot water heating system -- an improvement which was cited as resulting in significant improvement in both comfort and safety. Various improvements were made to the Maryland Hospital during the 1850s and 1860s. I worked three twelves normally but would pick up overtime and picked up a night shift. A series of wings that were arranged in echelons emanated from the center building. However, this also proved to be unsatisfactory because odors from the cesspools easily found their way into the interior of the building, and, understandably, the patients and attendants complained. the western most section of the hospital's west wing, was demolished and rebuilt. Although the property was sold to Johns Hopkins in 1870, and although Mr. Hopkins agreed to pay for the property before he was actually able to take possession of it so that the proceeds could be used to finish the new facilities at Spring Grove, the new hospital building was several years away from completion -- and so an agreement was reached at the time of the sale for the State to lease the property back from Mr. Annual Report of the Board of Managers, 1877. structured activities. Spring Grove Hospital Center in Baltimore, MD is not nationally ranked in any specialty. Main Building (1853) had been built in accordance with the previous era's 'Kirkbride' plan of institutional design -- a plan that led to the construction of hospitals that consisted essentially of a single, imposing, often immense, even monolithic building. The Dairy House survived on the campus of Spring Grove until the early 1990s when it burned to the ground in a fire that may have been set by an arsonist. The Center is also the host site of the Maryland Psychiatric Research Center, a world-renowned research institution that focuses on identifying the causes and cure for schizophrenia. Although leased to Drs Mackenzie and Smythe, who controlled the day-to-day operations of the hospital, both the City of Baltimore and the State of Maryland maintained at least titular oversight powers during this period -- and both entities continued to provide some of the hospital's funding. In July 1925, the remaining Veteran's Bureau patients were moved to a new federal hospital (now known as the In the 1870s, the Hospital experimented with the use of colored lights and walls to treat or aid in the management of certain psychiatric conditions. response to wartime politics, the group of men who had originally been appointed to oversee the project (some of whom were reportedly Confederate sympathizers) was replaced in 1862 (Acts of 1862). Originally, the hospital used the Sunnyside property as its main farmland.However, the demands of the growing hospital were such that within the next ten years it began to further expand its farmland by purchasing much larger tracks of land south of Wilkens Avenue, where the University of Maryland Baltimore County is located today. The farm, which was purchased for $12,226, was known as 'Sunnyside.' Colin Mackenzie and James Smythe, persuaded the Baltimore City Council to lease the hospital to them for a period of 15-years. Psychiatric hospitals do still exist, but long-term health care for mentally ill patients is very limited. Rehabilitation Services Social Work Volunteer Services Main Number (Operator/Page) 410.402.6000 Toll Free Number (Operator) 866.734.3337 Chief Executive Office: 410.402.7455 Fax: 410.402.7094 Admissions Office ( 24-hour): 410.402.7398 Hospital Police: 410.402.7937 Medical Student Office: 410.402.7455 Fax: 410.402.7094 Questions, Ideas or Concerns? As recently as the late1950s, Spring Grove had as many as 3,400patients at any given time, and the 'construction boom' at Spring Grove continued into the 1960s.The With the active encouragement of Dr. Sprigg-Steuart and Ms. Dix, an additional $10,000 was appropriated by the General Assembly in 1852 to begin construction of the new hospital building. The doctor also gave the patient 35 grains of mercury and applied 12 ounces of mercurial ointment. Other sources suggest that the new building may not have been completed until two years later, in 1800. floor plans of the building, c.1853, indicate that indoor plumbing and 'water closets' (flushing toilets) were part of the original design. (Note: The name 'Spring Grove' does not seem to appear on maps from the period.) For more information about Springfield Hospital Center's History, see It has also been noted that Mr. Pratt donated, in addition to his time, several gifts to the Maryland Hospital over the years. For example, records indicate that during the yellow fever epidemic of 1819, 145 yellow fever 'victims' were admitted to the City Hospital of Baltimore (the then contemporary name for Spring Grove), 85 of whom died. By 1815 the hospital was sometimes referred to as 'The Hospital in the Vicinity of Baltimore' -- the use of the phrase 'in the vicinity' possibly referenced the fact that part or all of the hospital's property may have extended beyond the 1815 Baltimore city limits. According to a 'History of Baltimore, Maryland', published in 1898, the 1794 Retreat was considered to have been 'the first hospital established in Baltimore.' Vision Spring Grove Hospital will be recognized as a national leader for excellence in psychiatric care, research and education. A second physician was hired shortly thereafter. [1], Main Image Gallery: Spring Grove State Hospital, Spring Grove Hospital Center Alumni Museum, https://asylumprojects.org/index.php?title=Spring_Grove_State_Hospital&oldid=39468. The Hillcrest Building (1921), the Grove's treatment providers began to regularly use psychoanalytic techniques to treat certain patients. As noted above, politics came to the fore again when the original commissioners were reappointed (Acts of 1868). Eastern State Hospital of Virginia, no psychiatric hospital is older than Spring Grove. Unfortunately, the fate of the building used by the Retreat between 1794 and 1798 is not known. And there is again a psychiatric illness research facility in the same building where the LSD experiments once occurred. The Hospital opened a school for Practical Nursing on October 4, 1929. In any event, the Hospital's Annual Report, dated January 1870, indicates that the debt hadn't been paid -- and seems to suggest that there was no expectation that it would be. Rehabilitation Building (a portion of which is also known as the 'Rush Building,' and now the headquarters of the Alcohol and Drug During the Depression, Spring Grove began joint research programs with Johns Hopkins Hospital, the Phipps Clinic, and the University of Maryland Hospital. However, these accounts seem to be specious. The Athletic Field, formally known as the It is also reasonable to assume that the Retreat building remained in use by the hospital after 1798, at least temporarily, until the new building could be built and fully readied later in 1798 (see below). It may originally have been referred to as the 'Maryland State Lunatic Asylum [at] Spring Grove.' Jamison Building in 1981. Colin Mackenzie and James Smythe, persuaded the Baltimore City Council to lease the hospital to them for a period of 15-years. For example, the Hospital had installed gas lighting fixtures by 1858. 3,120 were here. Under the provisions of the State Government Reorganization Act of 1922, Spring Grove was placed administratively within the Maryland Department of Welfare and under that department's Board of Welfare (Acts of 1922, art. Dr. James Smythe died in 1819, and Dr. Colin Mackenzie in 1827. However, the State of Maryland did continue to exert some control over the hospital -- for example by making certain appointments to its board of directors. Smith Building (also known as the 'Medical/Surgical Building') was constructed in 1975, and the Spring Grove hospital workers, including dietary and maintenance staff, gathered outside the central kitchen to rally for COVID-19 response pay extra salary given to Maryland's front-line. At least one of the early Spring Grove structures, the of Public Works OK's Controversial $1 Lease for State Psychiatric Hospital Grounds", http://www.leaguelineup.com/welcome.asp?url=shep, "Spring Grove State Hospital" by David S. Helsel, M.D. unless the organs involved were found to have been diseased. Between 1798 and 1807, according to at least one source, Captain Yellott and his associates may have continued to manage the hospital, under an agreement with the City of Baltimore. (It is not known if the patient survived.) The 1836 report does indicate that the facility was clean, and that the patients were generally well cared for. In 1813 admission to the City Hospital could be ordered or authorized by the chancellor of an entity known as the 'Chancery Court.' African-American patients were identified in the records by the notation 'col' or 'colored.' This volume will reveal through a broad array of poignant historic images the extensive, complex, and fascinating history of Maryland's oldest hospital. Springfield was built according to what was called the 'cottage' plan, a scheme that called for a series of relatively small, often modest, patient 'cottages' that, while separate from each other, were frequently interconnected by covered walkways or porticos. In 1939, the Board of Mental Hygiene assumed the physician appointment authority formerly held by the hospital's Board of Managers (Acts of 1939). A number of documents that date from the period between the end of the Civil War and 1872 refer to it simply as 'The Spring Grove Asylum.' Additional information about Maryland's history (including additional information about Maryland's public mental health system) is available through their web site: For example, the board appointed all employees, from servants to physicians. The various buildings in the Other farm animals included calves, young pigs, hogs, bulls, horses and mules. In 1901 there were 7,404 separate ), Between 1909 and 1922, under the superintendence of Dr. Percy Wade, the hospital's land holdings were systematically expanded to 506 acres. Over the years, the hospital's land holdings were expanded considerably, so that, eventually, its grounds covered an area that today is roughly bordered by the present Monument St. to the north; Broadway (formerly Market St.) to the west; Jefferson St. to the south; and Wolfe St. to the east. 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