Allentown State Hospital
The first step for the establishment of a homeopathic state hospital for the insane in the Commonwealth of Pennsylvania was taken by the Germantown Homeopathic Medical Society of Philadelphia, which appointed a committee of twelve of its members, of which Isaac W. Heysinger, M. D., was chairman, for the purpose of introducing and furthering a bill before the State Legislature to provide for the selection of a site and the construction of a state hospital for the care of the insane to be under homeopathic management and control. After several unsuccessful attempts a bill was finally passed by both houses of the Pennsylvania Legislature, June 25-26, 1901, entitled, " An Act to Provide for the Selection of a Site and the Erection of a State Hospital for the Treatment of the Insane Under Homeopathic Management, to be Called the Homeopathic State Hospital for the Insane, and Making an Appropriation Therefor."
Section 1 of the act directed " that the Governor shall appoint three persons, the President protempore of the Senate shall appoint one member of the present Senate, and the Speaker of the House of Representatives shall appoint one member of the present House, who, together with the present President protempore of the Senate, and the present Speaker of the House of Representatives, shall constitute a commission, who shall serve without compensation, to select a site and build a hospital, to be conducted under homeopathic management, for the care and treatment of the msane of the following counties, to wit: Bradford, Bucks, Carbon, Lackawanna, Lehigh, Monroe, Northampton, Pike, Sullivan, Susquehanna, Wayne and Wyoming, and of such other insane patients as are hereinafter specified." Section 2 directed the commissioners to select a tract of land suitable for the purpose of the said hospital, to be located as nearly as possible at the center of population of the district above named. Section 3 directed that the tract of land be good, arable land, with an adequate supply of good water, and large facilities for drainage from the hospital buildings, the cost of the land so selected to be approved in writing by the Governor and the Board of Public Charities before the purchase money be paid. The deed for same to be taken in the name of the commonwealth. Section 4 provided that the plans for the hospital be prepared by the Commissioners and approved by the Board of Public Charities, the buildings to be of the best design for the construction of such institution, and without expensive architectural adornments or unduly large or costly administrative accommodations. Section 5 appropriated the sum of $300,000 or so much thereof as may be necessary, to purchase the land and commence the erection of the buildings. It was provided, however, that no part of the money appropriated should become available until the Governor, Auditor General and State Treasurer should have filed in the office of the Auditor General and State Treasurer a certificate setting forth that there was in the treasury a sufficient sum of money not otherwise appropriated to pay the said appropriation. Section 7 directed the commissioners, upon the completion of the hospital, to surrender their trust to a Board of Trustees, to consist of nine members, to serve without compensation, and be appointed by the Governor, by and with the advice and consent of the Senate. Said trustees to be a body corporate, by the name and style of the Homeopathic State Hospital for the Insane, they to manage and direct the concerns of the institution, and make all necessary by-laws and regulations. Of the trustees first appointed, three to serve for one year, three for two years and three for three years and at the expiration of the respective periods the vacancies to be filled by the Governor. Section 8 directed the Board of Trustees to appoint a competent physician of the homeopathic medical school and practice to be superintendent and have charge, supervision and direction of the hospital, both professional and otherwise. He to nominate for appointment assistants, attendants and other employees as may be considered necessary by the Board of Trustees. Section 11 provided that whenever the hospital should have sufficient accommodations for the proper care of a larger number of insane patients than shall be committed to it from its designated district, the Committee on Lunacy of the State Board of Charities shall have authority to transfer to said hospital patients from any other state hospital for the insane, or to authorize the comm1tment to said hospital of patients from any other part of the state, giving the preference in all cases to those whose family or friends desire them to receive homeopathic treatment. Section 12 provided that the Governor, judges of the several courts of record of the commonwealth, members of the Legislature and members of the Board of Public Charities shall be ex-officio visitors of said hospital.
On July 18, 1901, the bill was approved by Gov. Wm. A. Stone, except as to Section 5, which provided for an appropriation of $300,000 to enable the commissioners to purchase land and commence the erection of buildings, from which the Governor withheld his approval in the sum of $250,000 because of insufficient state revenue. The commission received several propositions from places within the territory of the twelve counties comprising the hospital district. During December, 1902, they visited a number of the sites offered to them in Lehigh, Northampton, Monroe, Bradford and Wayne counties. Three places in Lehigh County were under consideration aid finally the section in Hanover Township, near Allentown, was chosen upon which to locate the new hospital, the tract secured by the state comprising 209 acres. The corner-stone was laid June 27, 1904. The failure of the Legislature to appropriate, and of the Governor to approve what the Legislature did appropriate, the moneys that were necessary to expeditiously proceed with the erection and construction of the buildings caused a great deal of needless delay in the completion of the institution for its estimated capacity of 1000 patients. This delay occasioned considerable public and legislative agitation, so that the organic law of 1901 was amended by the Legislature and approved by the Governor the 10th of May, 1911. The amendment vested the appointment of the entire commission in the Governor and required the approval of the Superintendent of Public Grounds and Buildings to plans and specifications and expenditures incurred by the commission. It also authorized the commission to turn over to a Board of Trustees the buildings when completed. The amended act brought about the removal of the original commission and the appointment of a new one. This, with the appropriation of an ample sum of money, resulted in the completion of the institution during 1912.
The hospital is located on a high tract of land on the north bank of the Lehigh River, between Allentown and Bethlehem, about two miles from the former and three miles from the latter city. The Central Railroad of New Jersey runs immediately adjacent to the farm at the foot of its southern slope. The Allentown and Bethlehem Electric Line passes along the front of the property to the north. The arrangement of the institution consists of an administration department, three buildings; four ward buildings, two chapels, a building containing staff and congregate dining rooms, operating room and auditorium; a building for kitchen, ice and cold storage plant; a laundry building, and a boiler, power and electric light plant. The main water supply is obtained from the Bethlehem City water works, and is brought to the hospital grounds by gravity, from which point it is pumped into two 1,000,000-gallon capacity reservoirs. In addition to this, the institution has an artesian well and a 3600-gallon storage tank for emergency use. The original cost of the land and erection of buildings was: for farm $58,000; buildings, power and electric plant and sewerage system, $1,821,000; reservoir, $29,950; pumping station, $22,320; a total of $1,931,270. The hospital was architecturally patterned after the Kirkbride block plan. The administration, ward and service buildings are all connected by corridors, mainly of two stories, and the internal arrangement consists of dormitories of varying capacity.
Governor John K. Tener in February, 1912, appointed the following Board of Trustees: Harry C. Trexler, president; Edward M. Young, secretary and treasurer; Russell C. Stewart, Archibald Johnston, John J. Tuller, M. D., Wm. A. Seibert, M. D., Leonard Peckitt, F. J. Slough, M. D., and George R. Bedford. Their first act was the appointment of Henry I. Klopp as physician and superintendent, February 17, 1912. He assumed charge March 25, 1912. The first years may well be regarded as epoch-making ones for the hospital. There devolved upon the superintendent all the labor of furnishing and equipping the institution for a capacity of 1000 patients; the developing and perfecting of an organization consistent with the rapid growth in numbers of the patient population, especially so during the first six months of the opening of the hospital; the outlining of methods of treatment and classification of patients; above all, laying the foundation for future development and expansion along modern scientific lines.
The hospital was opened for the reception of patients October 3, 1912. From this date to February 1, 1913, a weekly transfer was received from either Norristown State Hospital or the Danville State Hospital; there were admitted within this time 820 patients; of this number 750 were transfers. By the end of the official hospital year, namely, May 31, 1913, the total admissions numbered 934 For the year ending May 31, 1914, there were admitted 299 patients; the whole number under treatment for the year was 1166. First consideration was given to the treatment of the so-called "recoverable" patients; also to the organization of a training school for nurses, upon a three-years basis, in accordance with the recommendations of the State Board of Registration for Nurses. The value of diversional occupation and recreation as therapeutic agents was recognized; provision was made accordingly by the equipment and organization of workshops and special occupation therapy, and the employment of industrial instructors educated for such work. Many difficulties had to be met, as the internal layout of the hospital was far from ideal to carry out twentieth-century ideas in the classification and treatment of patients, as well as for economy and efficiency in operation, the plans for the building having been made almost a decade prior to the opening of the institution, the most serious drawbacks being inadequate accommodations for the reception and proper classification of newly admitted cases and lack of facilities to carry out hospital treatment, especially the absence of continuous baths and hydro-therapeutic equipment.
The medical work was organized along general hospital lines, each patient receiving a thorough mental and physical examination. Efforts are made to obtain family and personal history in detail. Patients on admission are treated as sick, a preliminary course of rest in bed (of varying duration) being prescribed; mechanical, drug or chemical restraint as well as seclusion is dispensed with; the treatment, in conjunction with rest in bed, consisting of an ample supply of fresh air, nutritious food, hydrotherapy, individual attention and influence, and indicated remedy. With improvement, and as progress permits, modification of rest by gradual exercise, bedside suggestion and re-education are substituted, and finally occupation therapy is employed. Medical staff meetings are held daily for the examination and study of patients and the review of current medical literature, both general and special. The staff has been provided with the most practical diagnostic appliances covering the various specialties, thus being able to make an intelligent diagnosis and treat the individual patient scientifically from a medical as well as a surgical standpoint. The equipment includes pathological, bacteriological chemical and haematological laboratory outfits, an electrical and X-ray apparatus, a dental outfit and a medical library. The trustees appointed a consulting staff, consisting of 26 members of the profession, each prominent in his chosen specialty.
Not being content with the arrangement of the hospital, application was made, through the Board of Trustees, to the first session of the Legislature after the opening of the institution, and a bill was passed covering special appropriations for " new buildings, changes and improvements," amounting to $200,000, which, on account of lack of funds, the Governor found it necessary to veto to the amount of $127,500. The appropriation included a reception building for new admissions, a home for nurses, two buildings for tubercular patients, isolation cottage for contagious diseases, changes in the buildings for hydrotherapy and continuous bath equipment, dairy, barn, piggery, farm building repairs, and coal tramway from railroad to power house.
The superintendent in his first annual report, under date of May 31, 1914, makes the following statement: "What we may accomplish within the coming decade will largely depend upon the General Assembly. If this " state hospital" is to grow in efficiency in the care and treatment of the mentally sick, the commonwealth must provide liberally for it. Within another year we will have reached our full capacity and soon will be overcrowded. To properly care for this growing population the state should appropriate money for buildings for 100 additional beds annually." In order to obtain proper observation, classification and treatment of patients the plans of the reception building for new admissions, which is to form the first unit of a psychopathic division, contain modern facilities for the admission of patients, continuous baths, hydrotherapy and open-air treatment. Among the needs for which requests for special appropriations from the 1915 Legislature will be made are a reception building, to form the second unit for a receiving division so as to properly care for both sexes; a second nurses' home; two buildings to provide for nurses' and attendants' dining rooms, with second-story quarters for employees; a double house for farm employees; industrial building for men patients, and items covering improvements and changes for the more advantageous operation of the mstitution.
The business methods of the hospital were organized along lines of economy and efficiency. The bookkeeping system, storeroom accounts, issuing of supplies, discarding and exchange system, variation of weekly dietaries and per capita cost of same, and daily waste reports, received attention. A saving of thousands of dollars in water and steam was effected by the installation of a central hot-water system through the collection of hot water which had been daily going to waste from the cold storage plant. In addition to this an economy of 1500 tons of coal per annum was brought about by various changes in the steamheating plant. The installation of an aerial tramway from the railroad to the power plant for the delivery of coal supplants the expensive method of delivery by teams.
The hospital receives its maintenance for the care and treatment of patients under the dual system of the " County and State Care Act" Patients are classed either as indigent or private; for the former, the county is required to pay a per capita of $1.75 and the state S2.50 per week; when the financial circumstances of the patient or relatives are such that they can pay a rate of not less than $5 per week, the patient is designated as " private." For the year ending May 31, 1914, the institution maintained itself upon this basis. Schedules are issued quarterly by the institution for the purchase of supplies and provisions, for which bids are received and contracts awarded to the lowest bidder consistent with quality. The medical department was organized by securing the services Dr. Harry F. Hoffman as assistant superintendent, prior to his appointment senior assistant physician at the Norwich State Hospital, Norwich, Conn., and Dr. Walter E. Lang as senior assistant physician, and prior to his acceptance associated with the Easton Sanitarium. The junior assistants, Dr. Charles S. Trites and Dr. Sarah Adleman, received their appointments in December, 1912. In June, 1913, Dr. Charles B. Reitz was appointed to take charge of and develop the laboratory. Dr. Sarah Adleman resigned August 31, 1913, to accept a position in a private institution. Dr. Bernice A. Bartlett was appointed to the position of junior assistant September 10, 1913.
Over the years, the population and physical plant continued to expand, reaching a census high of 2,012 in 1950. The population of 175 (in 2008) represents a trend towards decreasing populations in state hospitals, especially over the past decade. The major decline in the census since the 1950s can be attributed in part to the Mental Health Procedures Act of 1976 which lead to an increase in community mental health services, also the developments in the field of psychopharmacology, and a transfer of funding from the State Hospitals to the community through the Community Hospital Integration Program Project (CHIPPs). Allentown State Hospital received patients primarily from a five-county service area. The counties specifically were Lehigh, Northampton, Carbon, Monroe, and Pike. These counties included the cities of Allentown, Bethlehem, and Easton, as well as a number of smaller municipalities.
Another unique aspect of the hospital was the development of a psychiatric treatment program for psychiatrically impaired children. This program, under the direction of Dr. Klopp, was opened in 1930 and functioned as the only program of its type in the state until the 1960s when Eastern State School and Hospital was opened. The Mental Health Institute for Children, as it was called, maintained a population of 140 children from across the state during the years when it was the only statewide facility for children. With the development of alternate programs in the community and construction of a State Hospital dedicated to children and adolescents, the need for the facility became less crucial and the unit was closed in June of 1992.
The Hospital maintains a close working relationship with the county mental health programs resulting in a free flow of information which assists in enhancing the treatment of patients, both in the Hospital and in the Community. This was due, in large part, to the CHIPPs program which not only discharged 130 patients from the hospital to more appropriate community settings, but transferred monies from the hospital budget to the county for developing long lasting infrastructures. CHIPPs would not have worked unless there were close and cooperative interactions between the hospital and the counties.
During the past decade, the hospital has undergone several significant changes in treating patients. The practice of seclusion, restraint and prn medications was replaced by the philosophy of "The more you do with the patients, the less you have to do to them". In 1992 a Psychiatric Emergency Response Team (PERT) was formed and trained to handle individuals in crisis by talking to them and putting them in restraint/seclusion only as a last resort. Following Deputy Secretary of Mental Health, Charlie Curie's decree to reduce these two means of controlling patients, Allentown State Hospital saw seclusion and restraint as treatment failures rather than as treatment options. Two hours of program off the unit every weekday was instituted as a unique Centralized Program in September of 1998. In November of that year, seclusion was used for the last time at Allentown State Hospital - the first in the nation to go "seclusion free". The use of restraints was cut dramatically as well. Recreational activities were increased four fold on the weekends, although participation in them is voluntary.
In October of 2009 several news agencies announced the possible closure of Allentown State Hospital. The PA Department of Public Welfare announced in January of 2010 that it would completely close the hospital by the end of 2010. Patients would be either transferred to Wernersville State Hospital or to community care facilities. Many protests to the closing have been made by employees and the community, but as of March 2010 the hospital is still on track to be closed by the end of the year.
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