The Peak of State Care

For the last one hundred years the primary method of treatment for patients has been plenty of fresh air, good food, and rest. At the turn of the 20th century new methods of treatment were starting to be used. One of the most popular treatments was hydrotherapy. This new
method of treatment would be used until the 1950s. There were several different types of hydrotherapy treatments used at Harrisburg. One method was to wrap a patient from head to toe in wet packs or wet sheets. Patients would lay on a table wrapped tightly in the sheets for long periods of time. The idea behind this treatment was to calm and restrain an anxious or excited patient. Some cases of abuse using this treatment were reported in other Pennsylvania state hospitals, but never at Harrisburg. Other methods of hydrotherapy treatment were rain baths, colonic irrigation, and fully submerged baths in large tubs. Hydrotherapy was likely used to some degree in most of the patient buildings, but the largest hydrotherapy facility was located in the basement of the female Psychopathic Building.
A typical hydrotherapy facility around 1920, this one was at Mayview State Hospital

Life at the hospital during the early twentieth century was a community affair, the hospital had indeed become a small city. Patients worked all over the hospital as part of their occupational therapy. During the warm months they would care for the grounds, mowing grass and tending to flower beds. In the winter months they would shovel snow from the walkways. Patients worked on the farm, which supplied the hospital with all the food it needed, everything from meat, dairy, fruits, and vegetables were produced. The Central Kitchen stored and prepared all the meals for the patients and staff. Broom making and chair caning took place in the basement of the Chapel and a "toy factory" was established in the basement of the Male Chronic Building. Small shops in other buildings around the hospital produced mattresses, pillows, awning, window shades, and "indestructible" blankets. In 1926 a tailor shop was established, it produced suits, pants, and coats. The practice of patients working at the hospital was called occupational therapy, the work was meant to keep an excited mind busy and it was thought to give meaning to patients that would otherwise be sitting idly somewhere in a dayroom. Most of the items that were made at the hospital were used at the hospital and if there were excess items they would be sold at local markets, the money made was put back into the hospital budget. All this helped to make the hospital self-sufficient, and very little in the way of goods needed to be brought into the hospital.

When patients were not working or undergoing treatments they often participated in hospital activities. There were weekly dances in the Sun Parlor, a moving picture show in the Chapel, and a hospital band and orchestra made up of both staff and patients. Each ward had it's own organ or piano. Many patients also had radios or phonographs. There was also a library in the female Convalescent Building that contained 3,600 books by 1928. By 1935 that number had increased to 4,355 and by 1992 the library had accumulated 8,856 books and 31,669 magazines. Male and female patients typically visited the library two times each week, but never at the same time. The library at Harrisburg was the largest in the Pennsylvania state hospital system.

In 1921 the name of the hospital was changed to the Harrisburg State Hospital. Also that year, the Board of Public Charities was abolished and the Department of Public Welfare was created to administer all state hospitals. Soon after Dr. Howard Petry became superintendent in 1934 some new radical patient treatments were introduced. These included several methods of shock treatment as well as a surgical procedure.

Above is the hospital orchestra and below is the band, both photos taken around 1930
These new treatments were considered by many physicians in the United States and Europe to be breakthroughs in the treatment of mental illness. Harrisburg was the first Pennsylvania state hospital to use insulin and electro shock therapy. In June of 1939 the hospital hosted the Pennsylvania Medical Society. Physicians from all over the state visited the hospital and a large display with exhibits and demonstrations was setup in the Chapel. Conditions in the hospital were crowded, but still good. Rather then construct numerous new buildings to fight over crowding, as was done at most other state hospitals, it was decided to transfer patients to other hospitals when ever possible and to increase the use of the parole system.  This decision helped to keep costs down as new buildings would have cost the hospital more money, not only construct, but to take care of in the long run. Only two new patient buildings would be constructed before 1950, and those two buildings were built more to expand the types of treatment and not as a place to simply house an expanding population. Those buildings were the Hospital for the Physically Ill and the Tuberculosis Ward Building, a new power plant was also built in 1938. However by 1946 there were 2,441 patients at the hospital (and 437 on parole) and even with the additions made to the male and female Violent Ward Buildings it seemed inevitable that the hospital was going to need to expand.

During World War II many of the male staff were drafted into the military. This caused a 50% shortage of attendants, at the lowest level of employment there were as few as one nurse to 166 patients. In June of 1945 only 26 of the 92 authorized positions on the male side were filled. The manpower shortage resulted in widespread curtailment of services to both the public and patients. The 1950s were a time of expansion at the hospital. The patient population was far higher than the current buildings could handle. In 1951 the Admissions and Hillcrest Buildings are constructed and in 1957 the Eaton Building was completed. Psychotropic drugs were used for the first time in 1952. Up until 1955 certain administrative responsibilities, such as the selection of the hospital Superintendent and the enactment of rules and regulations governing the hospital were vested in the Board of Trustees of the Harrisburg State Hospital. In 1955 an amendment to the Administrative Code authorized the Department of Public Welfare to assume administrative responsibilities for the Harrisburg State Hospital, relegating its Board of Trustees to specific advisory duties. This act also provided for the appointment of a Commissioner of Mental Health in the Department of Public Welfare who assumed overall responsibility for Pennsylvania's mental health program.

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